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Spinal Cord Disorders Message Board

Spinal Cord Disorders Board Index

Yeah, I would find it hard to accept surgery without any noticeable neurological symptoms as well. As a matter of fact I *do* have symptoms including muscle twitching, tingling and slightly "heavy" legs which can be early symptoms of myelopathy which is functional disturbance of the spinal cord. Possibly caused in my case from the slight compression of my spinal cord by bone spurs. Even then, for me and most of the surgeons I spoke to, there isn't necessarily a clear improvement to be gained from surgery. A couple weren't convinced that the symptoms were due to the compression, for instance. I get checkups every 6 months and I'll have a new MRI at my next one to make sure nothing is progressing. I don't know if that is the right decision or not, but so far at 10 months things are going pretty well with my exercises and such.

I would consider going outside the practice where you got the original opinion just to get a completely unbiased view. If it were me, I'd also make sure you get an accurate picture of the risks. ACDF is a pretty commonly performed procedure and is generally safe given someone is poking around in your spine a couple of milimeters from the cord. Complications do happen though. Generally, there is a 3% risk of infection, 29% risk of temporary swallowing difficulty, 25% risk of adjacent segments requiring surgery within 8 years, a roughly 5% chance of non-fusion which may require more surgery, and rarely serious complications such as paralysis. Even in complication free surgeries, there is normally some pain from the surgery itself and possibly some nerve pain also due to moving things around to get access for the surgery. This is generally temporary, but many folks feel some amount of relief of their previous symptoms which helps balance this whereas it is quite likely you will feel worse after the surgery for a while because you are having no symptoms now. Also recovery can be long and hard, taking up to a year or more to be fully healed/fused. I'm definitely not trying to talk you out of the surgery, I just want to make sure you get good information on the risks involved.

If you do decide on surgery, the next most important decision is the surgeon. There are studies that indicate outcomes vary quite a bit based on the experience and skill of the surgeon. As an example, the surgeon I would have do surgery on me should I ever feel that necessary (heaven forbid), has done more than 3500 surgeries not including his residency, about 95% ACDF. He has tracked his own success and complication rate over the years and is much better than the average in terms of fewer preventable complications like infection, and has a lower non-union and re-surgery rate than average as well. The point is to make sure you have the best you can get, and that you feel totally comfortable in the person's skill, follow-up plan etc. Ask lots of questions too: will you need to wear a collar, if so what type? How long do they expect recovery to take and how long will they give you off work? When will the Dr see you after surgery? if the Drs/support staff aren't forthcoming that tells you something.

Hopefully the above helps you think through your decision... Good luck!

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