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The PA said today that for some reason the operation is sometimes harder on younger folks than on older folks. He also said that the length of time a person has been in pain affects recovery time.
I was in pain for four years before I had surgery. I still have pain in the muscles of my neck and definite nerve pain and nerve damage (sensation only) in my right arm and hand; however, my left arm and hand are much, much better. I didn't even notice that until today. I was too focused on where the pain currently is. :) The neurosurgeon said that my right arm will probably get better. I'm sure my neck will, too.
After the operation, some people feel better than they did pre-op. This was not the case for me. Of course, I have other problems that contributed to post-op pain and fatigue: 1) long period of chronic pain, 2) diabetes, 3) sleep apnea and 4) major depression. I was not expecting to feel as badly as I did post-op. I wasn't prepared for the near total inability to care for myself. Yet, day by day, I got stronger. It's been three months now and I'm beginning to pull out of the fatigue. The pain is intermittent. Most likely I can start weaning myself from my cervical collar tomorrow...I just need a call from the doc saying, "Yo, go for it."
After the operation I was given a "bone growth stimulator" to help fuse the bones properly. It's an electrical device with two electrodes which are positioned on the neck. Supposedly, the magnetic field generated by the device induces red blood cells to stick around and do something useful, like make new bone.
The PA said that fusion with cadaver bone is nearly 97% effective for non-smokers (I don't smoke). Smokers have a much harder time healing. The operation itself has an 80% chance of bringing relief. I suppose I already have some relief, but there are still days when I wish someone would shoot me. :) I think some of that is related to muscle weakness, tightness, etc. from the surgery. I've been told that some people don't see positive results for nearly a year after surgery, but of course, that's something to ask your surgeon.
The nerve damage in my hand and arm may be permanent, but there is a chance it will reverse. It's nice to not have pain in my left arm. (Of course, in accordance with Murphy's Law, I am right-handed. :D) The "pinched nerve" sensation in my neck is also gone, even though pain remains. During the past four years, I kept wanting to stretch my neck to relieve the pressure on the nerves. I even did this with traction (under a doctor's orders), but as soon as the weight of my head returned, I was in horrible pain. It felt worse than ever.
Nerve damage takes time to heal, so I am not in any hurry to say, "This is as good as it is going to get." I still have hope it will get better.
As for the surgery itself, an anterior approach is used. The surgeon cuts through the front of the neck, moving major arteries, veins, the trachea and esophagus aside.
(I am a classically-trained alto vocalist, getting very close to professional quality--this is according to my cousin who has a BA in music; she heard me sing last week :)--so when I heard there was a 5-10% chance of vocal cord damage, I was not happy. It's one reason I put off the surgery for so long. I've practiced enough post-op to know that my voice is still there--VERY VERY GOOD NEWS! Obviously it's still there if my cousin thinks I'm professional quality. I nearly did a happy jig when I heard her say that. :) )
Once the surgeon teases apart the muscles to one side of the trachea and esophagus and exposes the vertebrae, he / she inserts a speculum to keep surrounding tissues safe from surgical instruments. The surgeon carefully removes the bulging / herniated disc(s), trims the anterior portion of the vertebrae and carefully inserts pre-shaped cadaver bone plugs (or bone from your own hip). The bone plugs are shaped to fit precisely and are secured to the vertebrae with a titanium plate and screws. I had two levels done...the X-rays are wicked...6 screws, man. No wonder it hurt afterward. :)
At least, this is how my surgery was done. My surgery took extra long--six hours--because the bone plugs were too large. I am very small-boned and the surgeon wasn't expecting teensy weensy vertebrae :). Had everything gone smoothly, the surgery would have taken 2-and-a-half hours, at most. Of course, I had a two-level diskectomy and fusion. A one-level would probably take less time. A three-level would take more. Again, talk to the surgeon to know for sure.
Orthopedic and neurosurgeons tend to take a different approach to cervical fusion surgery, so it's good to investigate both kinds. I settled on the guy at UC Davis because I don't trust local doctors and UC Davis has a good reputation as a teaching hospital.
I told you what I can as a recipient of surgery, but you'll have to talk to the docs, yourself.
Disclaimer: this post is not meant as medical advice. Always consult your doctor / surgeon.
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