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Hi I am new on this site. I'm a dentist and facing 3 level cervical fusion. My question is will be able to work again as a dentist. I've been searching for a dentist that has similar problem but can't find one. Please help
Remar has offered excellent advice.
I was once a large animal veterinarian and worked with cervical disease for many years.
In the early 1990s, I was referred to surgery by my PCP who was 'uncomfortable' with the level of my need for opioid analgesia -- at the time I was using 8 Percocet / day, and in moderate to severe pain.
I was told by two different surgeons that I required a three-level fusion and I had a 75% chance of improvement through ACDF, or anterior cervical discectomy and fusion. (What of that other 25%?)
It was the third consult who told me the truth about what I could expect.
If he fused C4-C7, that the C7-T1 disc would blow within 24 months, requiring fusion at that level. With those 5 vertebra fused, I'd lose over 80% of my head ROM. I'd lose my ability to drive -- my job depended on my getting to out of the way places.
He concluded that if he were me, he'd try to control pain with medication for as long as possible -- maybe until I was 60 or more.
Today, I am over 60. I have never consented to surgery, but I never dealt with herniation or situations that required spinal decompression -- both reasons to have consider ACDF surgery.
I do live with severe spinal stenosis in both the cervical and lumbar spine. I can no longer practice veterinary medicine -- my life has changed.
I hope that you are aware that ACDF procedures involve verterbral stabilization that will severely limit your head's ROM -- essential to your practice.
If severe cord compression is not an issue in your case, I suggest that you consult with an interventional pain specialist, probably interventional anesthesiologist or DABPM.
Often, a large portion of the severe pain of advanced cervical disc disease comes from facet joint arthritis, seen on film as hypertrophy, or as low-intensity resonance within the facets on MRI. Unfortunately, orthopedic radiology reports often ignore the facet joints, as if these two important parts of the "tri-joint" supporting each vertebral level do not exist.
Facet osteoarthritis is treatable with a medial branch neurotomy procedure, greatly reducing pain with a minimally invasive outpatient procedure.
I've lived on chronic opioid therapy for over 30 years. I realize that with today's bias against opioid therapy, I am viewed as a freak of nature. One pharmacologist I know jokingly remarked "and you're still alive -- isn't that amazing."
I encourage you to explore every option before consenting to surgery, unless you are facing a medical emergency that threatens the patency of your CNS.
My current orthopedic surgeon puts it like this: "Surgery, however, is a last resort to be chosen only if conservative measures fail to provide sufficient relief."
I was once a large animal veterinarian and worked with cervical disease for many years.
In the early 1990s, I was referred to surgery by my PCP who was 'uncomfortable' with the level of my need for opioid analgesia -- at the time I was using 8 Percocet / day, and in moderate to severe pain.
I was told by two different surgeons that I required a three-level fusion and I had a 75% chance of improvement through ACDF, or anterior cervical discectomy and fusion. (What of that other 25%?)
It was the third consult who told me the truth about what I could expect.
If he fused C4-C7, that the C7-T1 disc would blow within 24 months, requiring fusion at that level. With those 5 vertebra fused, I'd lose over 80% of my head ROM. I'd lose my ability to drive -- my job depended on my getting to out of the way places.
He concluded that if he were me, he'd try to control pain with medication for as long as possible -- maybe until I was 60 or more.
Today, I am over 60. I have never consented to surgery, but I never dealt with herniation or situations that required spinal decompression -- both reasons to have consider ACDF surgery.
I do live with severe spinal stenosis in both the cervical and lumbar spine. I can no longer practice veterinary medicine -- my life has changed.
I hope that you are aware that ACDF procedures involve verterbral stabilization that will severely limit your head's ROM -- essential to your practice.
If severe cord compression is not an issue in your case, I suggest that you consult with an interventional pain specialist, probably interventional anesthesiologist or DABPM.
Often, a large portion of the severe pain of advanced cervical disc disease comes from facet joint arthritis, seen on film as hypertrophy, or as low-intensity resonance within the facets on MRI. Unfortunately, orthopedic radiology reports often ignore the facet joints, as if these two important parts of the "tri-joint" supporting each vertebral level do not exist.
Facet osteoarthritis is treatable with a medial branch neurotomy procedure, greatly reducing pain with a minimally invasive outpatient procedure.
I've lived on chronic opioid therapy for over 30 years. I realize that with today's bias against opioid therapy, I am viewed as a freak of nature. One pharmacologist I know jokingly remarked "and you're still alive -- isn't that amazing."
I encourage you to explore every option before consenting to surgery, unless you are facing a medical emergency that threatens the patency of your CNS.
My current orthopedic surgeon puts it like this: "Surgery, however, is a last resort to be chosen only if conservative measures fail to provide sufficient relief."
You're very welcome.
It would be a good idea to sit down with your surgeon to go over all possibilities. I mentioned in my above post that you will indeed need time to heal. Ask your Dr how long he thinks it might be.
Make sure you take things easy after your surgery. Follow your Drs orders and don't over do things too fast.
I understand why this would be causing you so much stress and depression. You have faith though so put all of this in to God's hands.
It would be a good idea to sit down with your surgeon to go over all possibilities. I mentioned in my above post that you will indeed need time to heal. Ask your Dr how long he thinks it might be.
Make sure you take things easy after your surgery. Follow your Drs orders and don't over do things too fast.
I understand why this would be causing you so much stress and depression. You have faith though so put all of this in to God's hands.
Thank you for your input ,as this situation is causing me
stress and depression. This is the only job that I know and the thought that I can't do it anymore is devastating.
God is good and he will give comfort to all our pain and sufferings.
stress and depression. This is the only job that I know and the thought that I can't do it anymore is devastating.
God is good and he will give comfort to all our pain and sufferings.
Hi, and welcome to Medhelp. I know you'll find the people here to be very caring and knowledgeable.
It all depends on how your surgery goes. Of course you will need time to heal and your Dr may recommend physical therapy until he feels you're strong enough to return to work.
I'm not a dentist but I do know that a dentist stands on their feet all day with a lot of twisting and bending. When you do return to work it might be a good idea to where a back brace for awhile. This is something you and your Dr can discuss.
We're always here to listen and help anyway we can.
It all depends on how your surgery goes. Of course you will need time to heal and your Dr may recommend physical therapy until he feels you're strong enough to return to work.
I'm not a dentist but I do know that a dentist stands on their feet all day with a lot of twisting and bending. When you do return to work it might be a good idea to where a back brace for awhile. This is something you and your Dr can discuss.
We're always here to listen and help anyway we can.
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