Spine surgery stories
February 20, 2021 10:23 PM   Subscribe

I'm considering spine surgery (fusion) for cervical myelopathy. If you've had this or know someone who has done this: what was the progression of symptoms like prior to surgery and what was recovery like and how long did it take?

I'm not looking for a medical advice. I've doctors but just data points as nobody I know has experienced this and I'm currently symptom free (issue was discovered during incidental MRI).
posted by anonymous to Health & Fitness (6 answers total) 1 user marked this as a favorite
I have both a cervical fusion and a lumbar fusion. As for the cervical fusion my symptoms were pain down my arm, tingling in certain fingers and most importantly to both me and my surgeon, weakening in the arm. Losing strength in the arm over time. Surgeon said that at some point reversing the weakness would be difficult and might not be possible. I waited a year and during that time I could notice the progression and notice the difference between my right and left arm. My dominant arm was the one with the issues.

I ultimately had three levels fused. Came in through the front. Recovery was steady. I can only compare it to my lumbar fusion and overall it was faster in my neck. I would say recovery was in several stages. First was week 1. Immediately, I was sore. Surgeon said that I was taller my millimeters, but it was stretching my existing muscles. I also had a hard brace. I had to move my head, neck and shoulders as one. Sleeping was very uncomfortable. After a week or 10 days I went to a soft brace. Still very sore. After about a month I was brace free and starting to be normal again. Still instinctively was being gingerly with the neck and movements. Somewhere after about two months I realized that I was not thinking about it anymore. I started playing hockey and basketball around the 5 month mark.

I would add that I was living alone when I had the surgery and I was able to deal with it by myself. I spent one night in the hospital but there was a point where I was going to leave that day. When I told them I was alone they got my insurance to pay for a night. It wasn't nothing, but I was medicated and slept for the first day or two home. A friend who drove me home came by daily to check on me. I have a high tolerance for pain but am in a grouchy mood when I am sick. That first day in the hospital and the first day at home I was second guessing the decision but by day 3 I was all in.

As for the symptoms, my pain was gone immediately. My strength came back pretty quickly too. I would say around day 3 or 4, I had relief of all of the symptoms. At that point it was simply recovering from the trauma of surgery and having the fusion start to take.

Now about 7 years on, I never think about it except when chugging a beer out of a can. Hard to toss the head back. Luckily, I am older and past most of my chugging days.

I would do it again. With my lumbar fusion, L4-L5, that is about 12 years old and it is now putting pressure on L5-S1. That is likely to need to be addressed. My concern is that the same sort of thing will happen to my neck.

If you have any questions feel free to me mail me.
posted by AugustWest at 12:17 AM on February 21 [1 favorite]

I had a C6-C7 fusion in the summer of 2001. Can confirm everything AugustWest has written above.

The progression of symptoms for me were: occasional twinge in neck/shoulders that felt like a slightly pulled muscle, then regular twinges in neck/shoulders, then occasional twinges down my arm, then regular twinges, then occasional numbness, then constant numbness, all the way to constant pain from my neck through my shoulder through my arm. The last 6 months pre-surgery, I went to regular physical therapy to get my neck and back vertebrae pulled apart from each other. But when I started losing noticeable arm strength, it was time for more invasive action.

Immediate post-surgery recovery was relatively quick - hard brace for less then a week, then a soft neck collar for another 5-7 days. Then I couldn't take the feel of the collar anymore (it was a really hot summer) and ditched it after that. Longer-term, it took about a year for me to really feel like myself again.

I did about 6 weeks of twice-a-week physical therapy, where I learned exercises to strengthen my back and neck, and also tips on improving my posture long-term.

I did permanently lose some range of motion in my neck. The only time I notice it is when I'm backing my car out of a parking space. I can't just turn my head to look back, I have to turn more of my upper body.
posted by SuperSquirrel at 5:59 AM on February 21

You asked for no medical advice, just experiences. I cannot give you my experiences with cervical fusion but I can with lumbar - along with my brother’s experience, and that of quite a number of friends and former patients.

If you are truly asymptomatic, do not do anything. Not to be flip, but you can’t do better than asymptomatic. As we age, various disk bulges develop as seen on CT or MRI, but few require intervention. Further, while surgery to relieve neurologic symptoms (muscle weakness, radiculopathy, etc.) is usually effective, surgery has a poor record (~50%) at ameliorating pain. And, on occasion, surgery makes local pain worse, not to mention the possibility of surgical complications which, in the case of cervical spine surgery, include paralysis.

So, I would not recommend surgery given your stated symptom-free status. Cervical myelopathy is a clinical diagnosis, not a radiologic one. If you have a surgeon recommending surgery, get a second (or third) opinion.
posted by sudogeek at 6:51 AM on February 21 [3 favorites]

Seconding sudogeek--spinal surgery can be very good for ameliorating nerve pain, but if you're not having pain or weakness, why bother?
posted by kingdead at 7:53 AM on February 21 [1 favorite]

I know you said you didn't want medical advice, but!

Cervical myelopathy refers to compression of the spinal cord resulting in neurological symptoms - these will be changes in sensation or strength. It is diagnosed through a clinical exam of your symptoms in addition to MRI. If you are not having any of these symptoms, you do not have cervical myelopathy - you have spondylosis or arthritis or stenosis (age-related wear and tear or narrowing of the spinal canal). These findings might eventually lead to some sort of myelopathy, but also they might not - because it is extremely common for people to have spines that look gnarly on imaging but have no symptoms whatsoever. This study found the rate to be around 24.2%. Spinal surgery is extremely invasive, has a long recovery, and will permanently change the way your spine moves - I would be very cautious if you are not having symptoms.

The guidelines for degenerative cervical myelopathy say surgery is indicated after 6-12 weeks of conservative care to treat symptoms (so again, if you're not having symptoms, surgery is not indicated). The recovery and things like a brace depend on how many levels they want to fuse and whether it's an anterior or posterior fusion, but expect somewhere around 6-10 weeks of not being allowed to move your neck, and 3-4 months for full recovery. Posterior fusions will take longer to heal, and the more levels involved, the longer the recovery.

Source: am a physical therapy student
posted by autolykos at 8:36 AM on February 21 [1 favorite]

Do not have surgery if you are not having pain or other symptoms. You can't have myelopathy without symptoms, basically by the definition of myelopathy.

I have treated several people who had cervical fusions while working in chiropractic and physical therapy settings and almost all of them reported more issues after the surgery than before. Two women in particular were in VERY severe pain prior to the procedure and genuinely needed it, in their opinions and their physician's opinions. If you asked them today, they would probably tell you they wish they'd never gone down that road first and tried every less invasive treatment for their pain before resorting to surgery, because their experience after the procedure was tough. One guy I can remember would tell you he felt better after the surgery. The reason he had the fusion was a traumatic whiplash injury caused by a car accident. He didn't get it because someone just saw something on his imaging and he was symptom free!

Surgery, of any kind, is risky, can complicate things, and creates scar tissue that can limit motion and put pressure on nerves, causing more problems. If you're not in pain or otherwise experiencing symptoms that impair your day to day life and ability to function, please don't have surgery. At some point in the future if you have symptoms, the option will still be there for you to consider.
posted by zdravo at 1:36 PM on February 21

« Older Text one number from one app, other numbers from...   |   Scholarships for non-trad or older students Newer »

You are not logged in, either login or create an account to post comments