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Alternative pain treatments and lifestyle changes after anterior cervic...
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Alternative pain treatments and lifestyle changes after anterior cervical fusion

I'm 40 years old and had anterior cervical fusion surgery 2 1/2 years ago. I had ruptured disk C4-5. I was told at the time that the disks above and below the fusion were not in good shape and to be careful. I don't work, I do light strength training 2 days a week and cardio recumbant bike 5 days a week. I continue to suffer debilitating muscle spasms in the neck, trapezius, and mid-back. Is it safe or beneficial to be treated by a chiropractor for the pain? I've also been diagnosed as having myofacial pain and fibromyalgia. I went through all of the trigger point injections and physical therapy a year before I was finally diagnosed with a ruptured disk and subsequently had the surgery. Those treatments helped for a short time but I still had nerve impingement from the disk. Now that the disk is fixed, should I go back for the myofacial treatments again, or should I stick with chiropractic and see if I get any relief. I get very nervous hearing my neck cracking.
Thank you.
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Dear Susan:

I have had osteopathic spinal manipulation training, and I believe that after disc herniation you should not have high velocity neck manipulation.  I would not have the chiropractor crack your neck with high velocity treatments.  Actually, I have seen several patients who ruptured their cervical discs after treatment.  I feel that after surgery, PT and vigorous rehab combined with lifestyle changes and compulsive proper positioning of sitting etc. are the best methods to recover from surgery.  The recumb bike is fine.  Try and stay away from heavy weight training and mud wrestling (only kidding).  Part of the pain tolerance is a mind exercise and since your in constant pain, you will need to develop this aspect of rehab.  Talk to your neurologist about rehab and especially the rehab team.

Sincerely,

CCF Neuro MD
40 Comments
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NO, please don't do any chiropratic manipulation!  I also
had anterior cervical disk C5-6, and have more herniations and
spurring on 4-5, 6-7, 7-8-some impinging on spinal cord.
when they say be careful, be careful.  My Dr says no driving
in winter in particular and walking dangerous too. I walk in the
park, but eventually legs will be affected.  Please be careful
and don't trust any chiropractors..one wanted to put me on table
and drop my head and hit my neck with a hammer.  I ran out of there!
not kidding
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Thank you Dr. CCF and Jo-ann for your replies. I have gone to two treatments and have been seriously concerned by the way I've felt afterward. I don't plan on going back after hearing from you. Thank You!
Susan
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You are welcome.

CCF Neuro MD
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Can I please have the pros and cons of anterior cervical fusion.  Can I also have information from other patients who  
have had this surgery. Thank You.
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Sandi, I can't really tell you pros and cons for your situation but I can tell you mine. Before the surgery, I had terrible arm and shoulder involvement besides the upper back and neck spasms. After the surgery the arm and shoulder stuff was gone, the only thing is, I also had carpal tunnel release during the same surgery. I don't know which one really helped my arm, but I still have deep painful muscle spasms in the same places as I had before the surgery. What I've learned is, you don't have surgery to relieve pain because it usually won't. My doc even told me that before the surgery. If I could go back and do it again, I'd just have had the carpal tunnel release and left my disc in my neck. He took out the disc, replaced it with a donor bone, and held it there with a plate and four screws. The discs above and below the fusion were bad and have much more stress now. As far as the surgery itself, it was pure hell and it took over a year to even recover what I can do now, which aint much. I'd hang on to all the body parts you were born with for as long as you can. Good Luck and God bless. Susan
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thanks for your comments.

CCF Neuro MD
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I am scheduled for surgery on Nov. 4 for severe cervical stenosis.  My spinal column at C-4,5 & 6 is almost completely squeezed shut.  I had pain down my left arm in July before the MRI showed the compression but since then I have no pain or problems Now I wondered why I needed the surgery until I saw the MRI myself. I accept that I need surgery but I'm concerned about the recovery and after effects. I will have a bone graft from my hip and I'm told the pain will be more in my hip, with a 12 week recovery.  Any comments will be appreciated.
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Good luck Elaine. I had a fusion at C4-5 and 5-6 on Oct. 1st. CAT scan showed more problems than a previous MRI. My pain began oveer 10 years ago with a worsening the past 2. I had been to several chiropractors, massage therapy, neurologist, orthopedic surgeon, pain clinic for epidurals, many drugs, and finally a neuro who ordered the CAT scan (after I had been told the MRI was more accurate). The disks I had removed were calcified. My neuro only uses donor bone. He feels there is not enough proof that your own bone has a better success rate. Not enough to warrant putting the patient through basically 2 surgerys. I have talked to many patients with similar surgery and all agreed that the hip pain from bone removal is by far more painful than the neck surgery. I also had posterior spurring on these two disks and the one above and below. After nerve and muscle testing, it was determined that although 4 looked bad, my symptoms were stemming from the two worse ones. I have a real fear that I will be repeating this process in the coming years, on the other two areas. My pain on the right side on my head, neck, and shoulder, which was my major complaint, is gone. Thank the Lord. However, by some twist of fate, I am experiencing similar pain on my left side (head behind the ear, neck and shoulder). I go back to the Dr. on the 15th to have an  x-ray and see how I am healing. I hope everything goes well with your surgery. So far, I feel I made the right decision but only time will tell.
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Hi Sandi-I had anterior cervical fusion at three level last Jan. 5. I had disc herniation at three levels-c4-5, 5-6 and6-7. I had the bone taken from my right hip as I had surgery to rebuild my left hip 2 years ago due to a birth defect. The hip will be sore for awhile for sure but it is tolerable. I had trouble with my throat feeling like it was closing up especially right after the surgery but that subsided eventually. I was in a full neck brace for 6 months while the bone fused since I didn't have any plates. Fusion without a plate is always better if poss. I am still in alot of pain and still have numbness in both arms and hands,neck pain and occipital headaches. This type of surgery should always be used as a last resort. It is not a pleasant experience and the results are not always what you would expect. I have had numerous operations and this one was the most difficult by far. I had an excellant doctor,well respected in his field but the success rate for this type of surgery is not as high as other surgeries. The nervous system is a very touchy area to work on. I am currently being treated by a pain management clinic trying to get some relief. My life has changed drastically. If you have this operation-do everything that the doctors tell you to do and not to do!!! I over did it when I started to feel better and I think that is part of my problem now.Your situation may not be as drastic as mine because I did have 3 levels done at once which is a lot. I wish you the best and hope you are feeling better soon    Debbie
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thanks for your comments.

CCF Neuro MD
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My doc says I need Anterior Cervical Disuectomey and Fusion.  Was explained that bone from hip would be used and something like shock absorbers with rods running along my neck to support my neck. C5-6, C6-7, Cy-T1. Says "no big deal" he's "done 70 of them this year".  What are alternatives people have done with success?  Seems to me that if this stuff squeezing my sping got there, its because something in my body's not working right, or I'm not getting right food for me or something...Like if it got there, there MUST be a way to get it to be taken from the body too.  I'm 56 and after reading the posts on this surgery I'm inclined to say FORGET this.  I think my doc says it's "no big deal" because he doesn't have to have the pain thats left.  I will not be in pain the rest of my life.  There must be something...Help me find it.

Jack
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Dear Jack:

I would get a second opinion from another neurosurgeon.  I would also get an opinion from a neurologist and maybe even a rehab specialist.  I have seen too many screws pull out of the stabilization devices to go and have surgery on only one opinion.

Sincerely,

CCF Neuro MD
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I have had a fusion of discs C4-7, I still have a lot of pain in my neck, mostly on the left. C3-4 was bulging prior to the surgery and I am worried that the strain of the plate in my neck is only going to cause further damage to the discs above and below. What kind of physical restrictions can I expect for the future? I am only 34 yrs and have been involved in only physical related work for over 12 years, none of which I can return to because of my neck. Any messages or advice as to my future?
Please e-mail me at ***@**** I need as much advice as I can get. Thank you
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Dear Marty:

You will have to ask your rehab specialist and neurologist.  It is impossible to give you a prognosis without knowing the surgery, surgeon, neurological exam, neuroimaging studies.

Sorry,

CCF Neuro MD
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Can you tell me are there any good results from a diskectomy with fusion & fixation? My husband is due to have surgery on Monday. We are scared and the Dr. has been wonderful with all of questions however after reading all of this info. we feel as though no one has had good results. He is a 31 one year old male that was rear-ended in July 99. C4-6 are ruptured with a compromise to the spinal cord. The Dr feels that at this point with no help from traction and meds that our final choice is surgery. Surgery meaning a fusion with a plate. He is a very active man with a very demanding job who feels better after a week or so of rest but not perfect. Any words of wisdom or positive results for this? Do we locate a rehab Dr. now? or after recovering time?
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Dear Vicki:

Yes there are good results.  The people who have good results do not go on a forum asking about what to do for their pain.  Yes, I would go talk to your neurosurgeon and ask who she/he recommend.  Then talk to their patients about how good they are.  I would also get a second opinion before surgery.

Sincerely,

CCF Neuro MD
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I am scheduled for cervical fusion of disc C5-6 in March.  I have not been in extreme pain lately;however, the discomfor is always there and I have limited my activities to make sure I do not aggravate it.  Last Spring I had numbness in my left arm and hand and constant pain througout my upper back.  After having epidural steroid injections in July, I felt great for approximately 4 months then slowly the pain started coming back.
My question is "Should I go ahead and get the surgery?'"  After reading the above letters it seem that I should expect a long road to recovery.  I feel that I am still young (31) and I hate having to live my life with such restrictions; however, the thought that I could be worse off scares me.
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Dear Jennifer:

I cannot answer that question for you.  Obviously, you have seen several neurosurgeons and neurologists and have come to the conclusion that surgery is the only and last option for you.  Since it is the only and last option, then you either go ahead with surgery or decide that what you are experiencing is okay and postpone surgery.  Unfortunately, we do not know what will happen in the future and so our decisions are based on things we have no control over.

CCF Neuro MD
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I have a congenital fusion of the C2-3.  I was in a car wreck and was hit from behind.  My left side of my head hit the windshield.  I have MRI results that state "Eccentric protuberant disc material on the lft at C3-4 which warrants further evaluation.  Some mass effect up on the thecal sac is suggested but axial images at this level are non diagnostic.  A later MRI states that "These images do demonstrate some excentric protuberant disc material in the central and left paracentral region at the C3-4 level.  THese images fail to demonstrate any central spinal stenosis or significant left neural foraminal impingement.   My only diagnosis for my pain which is from head to toe....is fibromyalgia and TMJ.   I can not understand these MRI results and have not had them explained to me.  Do you think I should seek out other doctors?  I greatly appreciate any input.
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Dear Cheri:

Essentially what the reports say is that there is some disc material that has bulged out of alignment.  However, there is no compromise of the nerves that run behind the vertebra.  In addition, where the nerves exit the spinal column their pathway is not compromised.  This would suggest that the MRI findings are not significant enough to cause severe pain.  However, you may still have pain, but the MRI just can't give the structural reason.

Sorry,I'm sure this doesn't help you much.

Sincerely,

CCF Neuro MD
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I had anterior fusion with plating,(C5/C6) in 1998. I went through 6 months of physical therapy. I still suffer from neck pain and rotation restrictions. Can anyone help me
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I hope you get alot of responses to your posting.

CCF Neuro MD
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Hello...
I am a 52 year old male who had cervical fusion on April 21, 1999.  I am currently off-work awaiting a second MRI.  I have been told that a person having a cervical fusion, remains at a high risk for reinjury. Also that post fusion future disc herniation above and below the fused levels tends to occur.  In my case, the fusion was at the 6th and 7th vertabra levels.  I am employed at a maximum security forensics hospital, where physical restraint and management of violent patients is an inherrent part of my job functions.  I am considering application for retraining
in a less physically stressing Civil Service job classification.
I am asking if what I have been told about reinjury and/or herniations is correct.
Thank You
Richard Conley
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Dear Mr. Conley:

Alot depends on how extensive the surgery.  Most of the time, the reoccurrance of spinal problems are related to the etiology of the initial problem.  If you have a degeneration of the spinal column, then your risk is higher for more problems.  But if you etiology is something like a trauma then the risk goes down.  Most of the time we say in medicine, if there is a problem in an area and surgery is required, then the patient is at more risk for further problems.  You will have to make a career change based on your wants, needs and medical risks.  Ask your neurosurgeon and rehab team also.

CCF Neuro MD
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I am 43 yrs. old and had 3 discs removed, C4, C5, C6 and had 2 fusions, upper & lower, and a titanium plate w/screws installed, also, the surgery was performed through the front of the neck. Surgery was on July 20, '99. There wasn't an accident or anything, it just happened. After 8 months I am still in pain, especially the back of the neck, theres a protusion where the neckbone is. I should mention there were bone spurs removed and the surgeon told me my spine was like a washboard. Anyway, I saw my neuro surgeon and complained about the "egg" ON THE BACK OF MY NECK. It hadn't changed in size since the swelling of neck and shoulders has subsided, and it hurt!!!! I had a bone scan and went to the orthosurgeon, he took xrays of my neck, w/me looking up & down. He noticed a "movement" where the bottom fusion was, the bone scan confirmed this but he wants to see the films and ordered a cat scan. In the meantime, I am back in a neck brace, he stopped all therapy & excersis. I was told to rest for 6 wks because there's a small chance that the bones will still mend, if not, I'm facing another surgery, through the back this time. I am pretty scared right now, I do not want to become one of those horror stories. I would greatly appreciate your opinion or experience with something similar.
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Dear Carol D:

Sorry to hear about the complications of your neck surgery.  Since, I am not priviledged to see you scan, it is difficult to tell you what has happened.  There are failures to this type of surgery where the screws come loose, the bone does not mend properly, or the apparatus is not placed correctly.  Anyone of those things could have happened.  The surgery you went through is very difficult and complicated.  Although, since july, things should have healed and mostly mended by now.  I hope that they find the problem and it is able to be corrected.  

Sincerely,

CCF Neuro MD
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To all those who are thinking about cervical fusion surgery, I can only tell you to do as much research and asking questions as you can, an when you are done, ask more questions about alternatives.  I had a triple Anterior Cervical Corpectomy in Sept 98, C-4 thru C-7, no plating.  I came out of anethesia in the operating room screaming, because my right arm, from my hand to my neck felt like it was on fire.  It couldn't stand to be touched.  They did an amergency MRI to determine if there was blood pooling around the nerve root, due to extensive surgery, (5 hrs worth), but the MRI showed just a massive amount of swelling around the root.  The surgeon told me in recovery, when I asked what the hell happened?, he said that is not normal, but about every 50 operations I do like that, this happens, but it should go away in about 6 weeks.   It has been 19 months since surgery, and things have gone from bad to worse.  The hyper-sensitivity has been reduced down to just my little finger, ring finger, the outer part of my hand and part of my wrist.  Numbness still remains in those areas as well. I can't stand cold water on that hand, and cant stand for the bed sheet to touch it either.  For the first three months after surgery, I couldnt raise my arm to wash my hair or to even hold a coffee cup.  There has always been a weekness in that arm and hand since surgery.  About six months ago, I started having sharp burning pain in my right elbow whenever I gripped anything or tried to lift a bag of groceries.  Also when gripping anything, my right fingers start cramping.  Then I noticed my right hand would start shaking uncontrollably when trying to raise a glass or cup to my face to drink, or to try doing any small fine work.  My left hand and arm remain fine, just like my right one before surgery.  I reported this to workmans comp.  They sent me to another neurosurgeon for a second opinion.  He had me have another MRI done, as well as another EMG, for comparison studies.  The MRI showed the fusion looked ok, other than one of them being tilted.  But the EMG showed I had nerve damage to the right arm/hand, caused by the 8th nerve root.  This neurosurgeon said the only way he could see that being damaged during surgery, was the way they positioned my head for the surgery to make the incision.  He said this had happened to a few of his patients as well.  He prescribed Neurontin for me, saying there was only about a 35% chance it would help, and that he wanted to try things like injections an physical therepy an some more medications before talking about more surgery.  That was four months ago and so far workmans comp has refused any further treatment for me.  I think everyone should make up their own minds as to whether they are willing to accept the possibility of things going wrong with cervical surgery.  I can remember very well, my surgeon telling me he could get rid of 95% of my neck pain with this operation.  Well he missed it by a pretty fair margin, and for the last 19 months I have had to live with not only still neck pain, but the added problems of my  right hand an arm.  four the last four months I thought I had a prostate problem, because I had to urinat about every hour, so I went to my family doctor an he did an exam and had alot of blood work done, an the results were all normal, plus my sex drive has vanished into thin air for about the same amout of time.. Now since I have been reading up on this subject of nerve damage an spine problems, I find there could very well be a correlation between these added problems an the nerve problem.. I forgot to say, but I was diagnosed in l997 with Multilevel degenerative spinal stenosis with cord compression.  So anyway, for anyone thinking about this operation, make sure you investigate all the alternatives first, because once it is done, it's done.
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thanks for you insight.  I am really sorry that things worked out badly for you.

CCF Neuro MD
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I am having ant. cerv fusion on may 9th of the c6-7 I have a brother who is a chiropractor and believe in mua.  Can anyone give a decent comparison?
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October 14, 1996 I was unlucky enough to be ran over by a truck.  The resulting injuries included a bi-lateral fracture of  C1 and C2;  a compression fracture of T12 on L1 with torn ligaments;  my right humerous(upper arm) broken in two;  my right leg almost cut off at the knee with cartilege tears;  cuts and bruises from head to foot.  I was given less than a 2% chance of living with greater than 98% chance of being paralyzed from the waist down, if not the neck down.  My neck ultimately had songer cable with fusion and donor bone from C1 thru C3;  a metal plate holds my right upper arm together;  T12 thru L2 are fused.  Vagus nerve problems cause swallowing problems and constant heart burn.  It took several months for the vision in my right eye to go from everything it saw being at about a 45 degree angle to flat with depth perception close to what the left eye sees.  It has been all but impossible to get a doctor to explain the total nerve damage to my body as a whole.  Obviously I have been unable to work and things have begun to change since last fall.  After X-rays and a CT scan, bone spurs have shown up on C4, C5, C6, and C7.  Raising my left arm to shoulder level sets my neck to burning.  The pain in my neck, back, arm, and knee has gotten worse.  I had to quit the medication for pain as it was causing an ulcer after taking it for over three and a half years.  The crackling in my neck worries me, however it sure hasn't killed me.  I have had a problem with balance since the accident,  some say there isn't a cause while others say it is from all of the nerve damage.    The only thing I can say without reservation, get those second and third opinions before trying a treatment that just doesn't sound quite right.  I appreciate the medical help I've gotten, however the experience of healing and dealing with diagnosis's that seem to cover reputations without telling the patient straight out what is likely to come sure has caused me to wonder.  You see, I didn't get a day of physical therapy;  I learned to walk again and I do what I can around home.  Our Social Security  Administration says I'm not disabled;  none of them have spent a day feeling what I have though.               Thank you for your time.
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Hi, I was in a car wreck in 96.  At end of 98 had a posterior disectomy of one herniated disk.  That eliminated the radiating right arm pain, thank God.  Now, a short time later, numbness in that thumb and forearm reveal thru MRI that I now need an ACDF due to bone spurs on C5-C7, or else, says my surgeon, my thumb and forearm will become numb and immobile forever.  Surgery is scheduled for 7/5/00.  Of course, I'm scared to death - the 1st surgery was horrible enough, and now bone will come off my hip, too.  My surgeon is tops.  Thankfully he doesn't want to do instrumentation, since he might have to take it out later.  But is this ACDF the only way to go for me?  I wouldn't let the doc do a fusion on the 1st operation, as he wanted to do, because at the time I smoked, so now wonder if I made the spurs occur due to not letting doc fill in with bone and so maybe things shifted.  What do you think?  And will these operations go on and on?  What percent long-term success percentage? Surgery time is almost here and I'm shaking.  Thanks very much.
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thank you for much of your input.   I had an ACDF with allograft approx 21/2 weeks ago for C5-6 stenosis, spondylosis, cord impression, etc.  Am in hard collar for at least another 21/2 weeks (driving me nuts!).    How long will symptoms of left arm/shoulder pain, numbness, tingling of left havd (sometimes definite fingers, sometimes whole hand/arm,  ALSO REALLY BAD, BLINDING HEADACHJES AND RIGHT ARM NUMBNESS/TINGLING.
I HAD SO HOPED THAT THE SURGERY WOULD BE A "SILVER BULLET" BUT DON'T KNOW IF I AM JUST OVERLY IMPATIENT!     WHAT WILL I BE LEFT WITH?   WHAT WILL BE THE FUTURE?  (NO ONE KNOWS FOR SURE!).    I HAVE BEEN ON PREDnisone FOR 30 YEARS FOR PRETTY SEVERE ASTHMA, ETC., AND ALL MY BONES ARE IN PRETTY bAD SHAPE DESPITE TAKING LOTS OF CALCIUM WITH VIT D, FOSAMAx, ETC.   AM  so discouraged at slow/lack of progress!   Any info would be appreciated!
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I had ACF surgery late July. I am still very stiff and sore across my upper back.  However, there is no pain in my arm like I had before.  I do the exercises recommended but i am still miserable most of the time.  I am a hairdresser and need to get back to work. Can anyone suggest some help?
   Thanks
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I am scheduled to have an anterior cervical W/fusion sugery procedure and I need to say I am VERY scared.  My doctor has tried to reassure me but I guess maybe if I heard from some others this would ease my fears.  MY biggest fear is waking up in recovery roon with a hard collar on and feel like I am choking, (I can't even wear a turtleneck shirt!!) and post surgery...what are my limitations, will my vocal cords be affect? Please if anyone has had this surgery let me hear from you.  Thank you
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I am scheduled to have an anterior cervical W/fusion sugery procedure and I need to say I am VERY scared.  My doctor has tried to reassure me but I guess maybe if I heard from some others this would ease my fears.  MY biggest fear is waking up in recovery roon with a hard collar on and feel like I am choking, (I can't even wear a turtleneck shirt!!) and post surgery...what are my limitations, will my vocal cords be affect? Please if anyone has had this surgery let me hear from you.  Thank you
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This forum replies had scared the hell out of me!.  I will be having anterior cervical diskectomy & fusion on 10/11/00 (this week).................  I know of the hard recovery period, I know of the risk and I also have visited with people that have had POSITIVE results. Only connecting to this forum have I heard horror stories.   I trust my surgeon, I trust my internist and I trust my decision!   Let's hear some success stories...  Pennie
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Have you considered Massage Therapy. I am having great results with a client of mine. He had a fusion at C4-C5. He was taking pain killers,still having pain, and headaches. Part of his problem is that he never received Physical Therapy or any therapy, for that matter, after surgery. The surgern just sent him home. I have been working with him for a month now and he is almost off pain killers. He told me the headaches have almost disappeared, and he "sees a light at the end of the tunnel." There are still relapses, but if we catch it in time, the pain is decreased sugnificantly. I see him once a week, and his whole outlook on life has been boosted a step up. It maybe something you want to consider.
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I had fusion and plating c5-c6 sept,99 dr. allowed me to go back to work nov.99.Although i had discomfort constantly in my upper back and shoulders, i thought that was normal from surgery. My job working with off road tires is very physical, and on aug17,00 I reinjured my kneck.X-rays show my plate is no longer straigt ,It looks like the back slash ' \'on a keyboard, don't know what's in store for me 'till i see my surgeon next wk. Needless to say i have not been back to work since,Constant pins & needlesin whole upper back, both shoulders ache, arms are very weak,numbness in hands.
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I was misdiagnosed for five years before the doctors found that I had spinal stenosis.  I was a Court Stenographer and fairly quickly lost the strength in my hands.  I had extremely bad headaches and pain and numbness in both arms and hands.  In 97 I had cervical fusion at three levels from the front of my neck.  There is also a rigid plate with screws in there.  When I woke up from surgery my left arm would only raise to shoulder level and I had no feeling in the left hand.  The orthopedic surgeon said he didn't know why that happened, but that it was probably the way I was laying on the operating table!  I eventually got the full motion back, but the feeling never came back in the hand.  I had some relief of headaches and pain for about six months and then the pain and headaches began to creep back.  At this point three years later the pain and numbness has all come back full force, and my headaches are like migraines.  What is frustrating is that all the test results, MRI, CAT Scans, EMG, all are normal.  The doctor says the surgical site healed well, and there is nothing more he can do for me.  I am next going to a physiologist.  I don't know where to turn.  I have a friend who has had almost the same surgery, his test results are normal, and he also has most of the same symptoms I do.  Are there others out there who suffer pain and headaches post-cervical surgery, but show normal test results?
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A related discussion, neck cracking after fusion was started.
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A related discussion, is spinal stenosis a permenant conditon was started.
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A related discussion, is spinal stenosis a permenant conditon was started.
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Aug 28 by Roger Gould, M.D.Blank