Someone tell me about cervical-spine fusion surgery.

[Cuban_Liberal]

If I'm a little cranky tonight, it's because we just found out that Paddy has a badly-herniated disc between C-7 and T-1, and that's causing an 8th cervical nerve entrapment. He's in a fair amount of pain, which is quite an admission for him (he has a high threshold of pain). I'm not crazy about the idea of him having surgery, because that's irreversible, but I want him to do whatever's best for him.

Any input?

[supernova]

1. I have Harrington Rods

for scoliosis. My entire back is rock rigid. But it's not painful.

I can't imagine that fusing the vertibrae would be terribly difficult. And he'll have lots more movement that I do.

edit: back pain of any sort is almost unbearble.

[Cuban_Liberal]

3. Thanks!

His doctor said his movement would be compromised somewhat, but that his pain would be gone within a matter of days after surgery.

[Sanity Claws]

2. It's not fun.

You're right to get as much information as possible and have the surgery done only as a last resort.
I know someone who had a fusion, I think it was C-5 and C-6. Somehow a fusion places pressure on the other vertebrae and she ended up with a second fusion.
I think I remember hearing about an advancement (was it artificial disks?) that would make that kind of fusion obsolete. In the back of my mind, I think I heard it from a man in his early 20's who is a candidate for the new procedure. They thought he would be ideal because of his age.
How old is Paddy?

[Cuban_Liberal]

5. He's 21.

That's something we need to ask the doctor about. It seems preferable, in theory, to fusing two bones together.

[nothingshocksmeanymore]

7. They aren't even approved for the low back yet which is far less

dangerous than the neck.

Fusion is only about a 60/40 chance for improvement. Certain things can IMPROVE the odds such as:
Having a board certified neurosurgeon
having a doc who does ONLY necks

[Sanity Claws]

9. Yes, not approved yet

You seem to know more about the advancement I was referring to. Since the guy is only 21, it might be worth it for him to wait. Do you know what the new thing is called? Is it artificial disks?

[nothingshocksmeanymore]

11. Yes it's an artificial disc but I don't think it would work in the neck

The reson it would work in the back is the discs get bigger the further down the spine you go. In the neck, they take a plug of bone from a donor site such as the hip and put it between the vertebra so that the nerves can pass through without the vertebra collapsing on them which is what causes the pain.

[Cuban_Liberal]

13. Yeah.

We saw the pics from his MRI today, and the C-7 is compressing the foramen where the nerve root is. The doctor said it would essentially be like replacing a broken brick with and unbroken one, and returning the foramen opening to its normal size.

[nothingshocksmeanymore]

15. So you are sure the culprit is c7? not another level?

Has he tried doing physical therapy yet?

[Cuban_Liberal]

16. Yes, to both.

The disc between C-7 and T-1 is badly herniated on the left side, and he has major brachial bundle pain from shoulder to elbow.

[nothingshocksmeanymore]

18. OK if T1 is involved then ONLY get the surgery done by a thoracic or

neurosurgeon. They are trained for the worst spinal levels.

[Cuban_Liberal]

20. Okee dokee.

Thanks!

:hi:

[nothingshocksmeanymore]

22. Best wishes to both of you

oh..and Irish whiskey is a great painkiller and muscle relaxer

[Cuban_Liberal]

24. I've dosed him already.

Gave him two fingers of Jamesons with his hydrocodone, and he seems quite pain-free.

;)

[nothingshocksmeanymore]

19. OK if T1 is involved then ONLY get the surgery done by a thoracic or

neurosurgeon. They are trained for the worst spinal levels.

[Cuban_Liberal]

10. I've been talking to `him about a 2nd opinion.

I'd like a 2nd opinion from a neurosurgeon at St. Louis U. Hospital, or Indiana U. Hospitals, e.g. . I also agree about getting a doctor who only does necks/spines.

[nothingshocksmeanymore]

14. I think there are better orthopedic hospitals in your area than those

I will ask my orthos where they would go in your area.
The other thing is if his pain is c8 then ANY of the discs ABOVE that level can be causing his pain. Make sure he has had an EMG.

Where is the most pain? His neck or his arm?

The reason the area there is so tricky is because it is SO close to the thoracic spine and the LAST thing you want is any compromise to spinal cord at THAT level since the t spine is where most paralysis results from.

[Cuban_Liberal]

17. St. Louis U. is one of the best in the nation.

J.A.M.A. rated it one of the 'Ten Best Hopsitals in the US'. Yes, we're sure his pain is from a C-8 nerve-root compession; his MRI was from C-1 to T-4, and that is the only abnormality noted, other than some moderate arthritic changes (no surprise, since he has a form of degenerative arthritis).

[GingerSnaps]

4. Tell Paddy to ask the Doctor

To try injections of (Novocaine?) before surgery. My Back was injured when I was a teenager and the pain was unbearable. My Orthopedic Surgeon injected something that numbed my back up for 6 months and I don't remember what it was and I keep thinking that it was some type of Novocaine derivative. I went through physical therapy along with the injections and I was able to build my back muscles up and I have slipped disks. :hug:

[Cuban_Liberal]

6. Thanks!

The more info we can get, the better decision we can make.

[nothingshocksmeanymore]

8. They use botox injections for pain control now and some people

have good results.

[GingerSnaps]

26. Are you serious?

I guess you can kill two birds with one stone. Get your wrinkles removed while you get your back fixed.

"Doctor, after you fix my back can you please save a little bit of that botox for my face" :D

[nothingshocksmeanymore]

30. Well it works on the same theory

It tightens the tissue around the spine and gives support to the muscles but I think it also kills or dulls sensory nerves which relay pain.

[GingerSnaps]

32. That makes sense

A couple of days ago I found an article on the Internet about two women that are in the same hospital from a botox injection. I believe both ladies were friends that went to a botox party and they ended up in intensive care from the salmonella in the injection. :scared:

[GingerSnaps]

29. Surgery should be your last option

Get several opinions before you make a decision and always call the State board and find out about the Doctor. Most of the time they don't file complaints on Doctors but real bad ones have complaints down.

Always check your Doctor out because you can't check them out after they make a mistake. Good luck to you and Paddy! :hug:

[supernova]

12. Here's a Googly search

for spine fusion surgery

http://www.google.com/search?q=spine+fusion+surgery&sourceid=firefox&start=0&start=0&ie=utf-8&oe=utf-8

[Cuban_Liberal]

21. Thanks!

:hi:

[Corgigal]

23. Please look into this first

My husband was struck by a car and has some spinal cord damage and pain. Everyone and their brother wanted to cut on him. We never allowed it however he did decided to try this device out. It was experimental at the time but it's not anymore. It gave him a quality of life that I doubt any surgery could fix. It's rare when a patient has only ONE back surgery. Once you go down that path you will go again in a few years.

Anyway, read up on this. Ask around to see if this is something that they can do for him. It's amazing.

http://my.webmd.com/content/article/71/81231.htm

[Cuban_Liberal]

27. Thanks!

:)

[LauraT28]

25. several famliy members have had that surgery done with sucess

However the recouperation time varies. If he's 21, He could be doing very well in a few months. I believe the operation has a very good chance of ridding him of his pain...There are some new procedures in the wings but they are still some years away. He should get this now and maybe in the future they will have an even better procedure that he could get when he's older...

[Cuban_Liberal]

28. Thanks!

His surgeon says that after a few days of post-op pain (to be expected) he should experience total relief from the constant pain he has now, which is moderately-severe.

[lumberingbear]

31. DON'T MIX BOOZE AND PAIN PILLS!!!

1.) Neurosurgeon only
2.) Get second opinion

I am dealing with a lumbar-sacral problem. Need a new disc also. Pain doc gave me a epidural with an anti-inflammatory steroid that stopped the pain in 8 days. Now after 6 weeks it is coming back. Of course my problem is not as serious as Paddy's because of it's location. I feel for him. Pain is bad. If I got up and walked, I would be ready to hurl and faint after a few steps. I was on Vicodan, Ultracet and Flexeril and still couldn't get rid of pain.

Take good care of him Cuban_Liberal and give Paddy my best!!!