Cervical fusion recovery stories?

My doc normally does artificial discs and he’s a peer (I’m primary care) so I doubt he has anything but my best interest at heart 

M L wrote:

My doc normally does artificial discs and he’s a peer (I’m primary care) so I doubt he has anything but my best interest at heart 

Seeing that your doctor does both, it sounds like your doc has tailored his recommendation to you. I have been to see three surgeons. Two of them do both procedures. The one who only does fusions recommended that. No surprises there. From the two who offer both fusion and artificial, they really won't weigh in, but highlight the benefits of both. Not weighing in is very German. In any case, I'd rather need no surgery at all, but I do. The additional mobility offered by an artificial is attractive, but having it redone down the line is daunting and I never considered total failure.
It'd be nice to look at some data on outcomes and play the odds. Does anyone know any good studies?  

All I know is a fusion is totally bombproof (after recovery). The only patients I’ve had get multiple have severe multilevel stenosis and my dog had to get a second a year later. I don’t usually get into how rehab is going, but again have never referred for a second 15 years in practice and seeing mostly geriatric as PCP.

 I saw my neuro surgeon again. He wants to do another round of PRT shots before committing to surgery. He wants to continue with the invasive pain therapy for now.

Afrer that? He says that he will measure my movement using CT in the effected area. If there is movement, worth saving, he'll recommend I receive an artificial disc. If there's little movement, then a fusion. Regarding fusions, e says the higher up the cervical spine the fusion is, the greater the loss in flexibility. At c5/c6 the loss is minimal, he says. Regarding long term stress to other areas due to fusion, he is not concerned because it's 1) a hypothetical and 2) he says the only thing that matters is being symptom free not having handsome discs. Hope that makes sense. He is systematic and seems very competent. Glad to have him.

I am curious why your surgeon said that long term stress to other areas is hypothetical. Adjacent segment disease is a post surgical clinical concern (at least in the USA).
I would have to research this a bit for up to date numbers. but off the top of my head I think it experienced by 1-3% of patients who have had ACDF.

This thread is a bit of an interesting read for me since it is coming more from the degenerative conditions side rather than trauma… you guys definitely benefit from getting to do your homework.

But I shattered C1 paragliding in December and now C1C2 is fused. I’m back to more or less the low 12’s now after being in the mid/high 12’s before. Lots more focus on sport climbing now rather than big mountains, huge alpine missions etc.; generally it’s forced me to be more conservative. Which is fine, I had a great run and got away with so much without injury before and still get to walk around after.

What I guess I would definitely say in hindsight is that I wish the surgeon (who did a fantastic job with the surgery itself) would have done as equally a fantastic job of educating me. I had a chance to maybe avoid the fusion (which took place 8wks after the accident) but with the assumptions I made about a neck injury being like every other injury, I overdid it and won myself some screws. The fusion very likely would have happened anyways so I can’t be too harsh but what it taught me was the neck heals NOTHING like ordinary bones. A LOT more time and babying is recommended. Had I laid down for 6hrs more a day, not gone and walked a bunch on a hill, worn the collar tighter… who knows maybe I’d be rotating my head fully again instead of halfway for the rest of my life.

Hey Michael- you don’t know me but I love your book. I hope it all goes well:)

Chase a C1 fracture is extremely dangerous and you’re lucky to be alive. I wouldn’t focus on the what ifs. You did the right thing

nic houser wrote:

Hey Michael- you don’t know me but I love your book. I hope it all goes well:)

Thanks! It’s not fun being on the receiving end and I’m trying my best to be a good patient. Maybe I’ll have time to write a 3rd edition 

SM Ryan wrote:

I am curious why your surgeon said that long term stress to other areas is hypothetical. Adjacent segment disease is a post surgical clinical concern (at least in the USA).
I would have to research this a bit for up to date numbers. but off the top of my head I think it experienced by 1-3% of patients who have had ACDF.

I can try to paraphrase how the surgeon charaterised surgery options to me: the main problem, for me as a patient, is the actual surgery due to its scope and where on the body it is. It's a complicated area. One way or other I will be opened up and the offending disc removed. The lion's share of the risk is the surgery itself. Once the disc is removed there is one of two items which replace the disc a bring about the needed decompression, a cage or an artifical disc. The cage's presence leads to fusion and the artifical doesn't. No matter what option is chosen for me, a successful surgery is the primary goal. I agree with this. The spinal centre, where he works has guidlines and there an artifical disc is only inserted if there is existing movement at the segment. He didn't quantifiy that, but it is looked at using CT. If there is too litte movement there, they fuse. He says this is the better option in that case because an artifical disc could, in the future, be prone to problems currently unforseen. The arficial disc has moving parts and the surgeon gets one shot. The point is, it has associated risks too, just different risks. Because it is a relatively novel treatment possible unknow risks too. When he says he doesn't wish to hypothesise about whether a fusion will speed up degeneration to other discs, he's not saying it can't happen, just that it typically doesn't and if it does then I have to count the time I have been pain free as a bonus and undergo a surgery. He advises pragmatism. His refusing to hypothesise is like saying he'd rather not speculate. 

The health centre exists within, a national health system. In Germany, those who don't slip through social gaps are insured. Health insurance is accessable to all and generally quite quickly too. This levelling effect likely plays a role and not every option is available to every patient. As it stands for me, all options are on the table for me. I have decided to trust him on two levels. One, he can carry out a good surgery, period, and two, he will make the right choice for me regarding fusion or prosthetic disc. I'd be interesed to hear anyone else's thoughts on trust and how they handed over the choice to their surgeon, or not.  

Your surgeon did a great job of describing these 2 options.  Typically, ACDF is the gold standard (USA) but the newer publications on artificial discs are showing good results at 10 years post op.

If you opt for the artificial disc, will your surgeon share the brand with you?
If you want, PM me and I can send you some links for publications. Or check out Pubmed to search for publications. 

https://pubmed.ncbi.nlm.nih.gov/

My surgeon told me if I do 3 level acdf that he highly recommends I don’t climb anymore unless I just want to keep getting fusions done.  In fact, he won’t do the surgery cuz he knows I’ll keep climbing. I’m trying to calm it down what I hope is just a flare up that can be calmed down. I have another surgeon i saw last year for this that I may ask his opinion…but just wondering with all the info I’ve seen here if anyone has anything positive for a 3 level fusion.  Thanks!!!!

Eileen Takeshita wrote:

My surgeon told me if I do 3 level acdf that he highly recommends I don’t climb anymore unless I just want to keep getting fusions done.  In fact, he won’t do the surgery cuz he knows I’ll keep climbing. I’m trying to calm it down what I hope is just a flare up that can be calmed down. I have another surgeon i saw last year for this that I may ask his opinion…but just wondering with all the info I’ve seen here if anyone has anything positive for a 3 level fusion.  Thanks!!!!

Id get a second opinion or explain what is actually involved in climbing. I bet he doesn’t say the same thing to skiers, MTBikers, backpackers 

Just had surgery yesterday. C5/6 discectomy with graft and fixation. Home same day. Very sore throat first night now it’s fine, no more soup. Wearing not too snug soft collar including at night with some breaks. Almost no pain except sleep positions that put pressure on the incision site. No pain meds needed. So far so good!

M L wrote:

Just had surgery yesterday. C5/6 discectomy with graft and fixation. Home same day. Very sore throat first night now it’s fine, no more soup. Wearing not too snug soft collar including at night with some breaks. Almost no pain except sleep positions that put pressure on the incision site. No pain meds needed. So far so good!

Thanks for letting us know Michael. I remembered that your surgery was planned for the 7th and thought about wishing you the best the day before. I decided against it just in case you'd rather not be reminded. In any case, I'm glad to hear that the surgery went well and that your immediate discomfort didn't last for long. I hope your recovery continues so auspiciously and that you can ease yourself back to climbing whenever the time is right for you. 

Sounds like it went well! Keep us informed

I had a cervical fusion C5/6 and a full disc replacement C4/5 in late November of last year just months after I started climbing, (2021). 

I was back climbing indoor and out only 4 weeks post-surgery and already back to where I left off in my progress, climbing mid-10’s at the time. I was told no exercise for 3 months, but my Dr. said to let pain be my guide, and I went forward keeping that in mind. Climbing puts no strain or pressure on my spine except liebacks. I can’t really do them at all anymore, which coincides with lifting much of any weight. Funny I can’t lift 5 pounds, but I can climb without an ounce of pain.
I recommend doing what I did and getting back to climbing quickly before you lose too much strength. I started by gauging myself on a 5.6 in the gym to see if it affected my spine at all, and was back to pushing at my maximum by the end of the session feeling no pain or pressure at all on any climbs. I’ve had zero issues climbing since. Feeling stronger and better than the ten years previous to the surgery! 

Also, I’m 46. Best wishes for a good recovery! Sounds like you are on the same recovery path I was. 

Jaime BB wrote:

Hey Michael,

I had a cervical fusion C5/6 and a full disc replacement C4/5 in late November of last year just months after I started climbing, (2021). 

I was back climbing indoor and out only 4 weeks post-surgery and already back to where I left off in my progress, climbing mid-10’s at the time. I was told no exercise for 3 months, but my Dr. said to let pain be my guide, and I went forward keeping that in mind. Climbing puts no strain or pressure on my spine except liebacks. I can’t really do them at all anymore, which coincides with lifting much of any weight. Funny I can’t lift 5 pounds, but I can climb without an ounce of pain.
I recommend doing what I did and getting back to climbing quickly before you lose too much strength. I started by gauging myself on a 5.6 in the gym to see if it affected my spine at all, and was back to pushing at my maximum by the end of the session feeling no pain or pressure at all on any climbs. I’ve had zero issues climbing since. Feeling stronger and better than the ten years previous to the surgery! 

Also, I’m 46. Best wishes for a good recovery! Sounds like you are on the same recovery path I was. 

Thanks! Yeah I don’t think my doctor understands climbing. It’s been 4 weeks now and I pretty much feel fine. Gonna get back on the rocks when the weather improves. 

M L wrote:

Thanks! Yeah I don’t think my doctor understands climbing. It’s been 4 weeks now and I pretty much feel fine. Gonna get back on the rocks when the weather improves. 

Yeah! Get to it! If you have a climbing gym nearby, that’s a great way to feel comfortable starting again. Just steer clear of lie back moves and stay on TR for a while. 

Do any of you also jog? I run on roads, so there's some tarmac pounding, but I wear good trainers and keep the distances moderate. Has anyone been advised or experienced first hand that jogging is a bad idea?