Alternative pain treatments and lifestyle changes after anterior cervical fusion

[Susan Logue]

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.

[CCF Neuro[P] MD, RPS]

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

[Jo-ANN]

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

[Susan Logue]

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

[CCF Neuro[P] MD, RPS]

You are welcome.

CCF Neuro MD

[Sandi on Oct. 20,1999]

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.

[Susan Logue]

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

[CCF Neuro[P] MD, RPS]

thanks for your comments.

CCF Neuro MD

[Elaine]

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.

[Annette]

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.

[debbie]

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

[CCF Neuro[P] MD, RPS]

thanks for your comments.

CCF Neuro MD

[Jack Smart]

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

[CCF Neuro[P] MD, RPS]

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

[Marty, [email protected]]

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

[CCF Neuro[P] MD, RPS]

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

[Vicki [email protected]]

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?

[CCF Neuro[P] MD, RPS]

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

[Jennifer Joyner]

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.

[CCF Neuro[P] MD, RPS]

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

[cheri]

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.

[CCF Neuro[P]MD, RPS]

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

[Jamie Shytle]

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

[CCF Neuro[P] MD, RPS]

I hope you get alot of responses to your posting.

CCF Neuro MD

[Richard Conley]

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