T Nation

Cervical Spine Fusion

Hey guys, 3 years now since I really hurt my neck training bjj and now it looks like I’m considering the final option. a discectomy/fusion at c5-6 and 6-7.
Anyone have experience with this?

My sensei had two of his cervical vertibre fused. It kind of made his neck a little shorter. One of my other teachers was a chiropractor he explained that it makes it difficult adjust the spine afterwards. I have seen a new prostetic device that they can clamp around two vertibre that will keep them seperated so nerves done’t get pinched while allowing them almost a full range of motion.

[quote]Scrappy wrote:
Hey guys, 3 years now since I really hurt my neck training bjj and now it looks like I’m considering the final option. a discectomy/fusion at c5-6 and 6-7.
Anyone have experience with this?[/quote]

Yeah man I deal with this kind of problem every day. Where do you live PM me if ya want and I’ll give you some more hopeful options. You see once your neck is fused…NO more moving it, therefore, all other joints in the C-spine will have to make up for the loss of the fused area, thereby, wearing down faster, also if your posture isnt “tuned-in” then the abnormal gravitational loads on the joints no matter what you do will cause it to get worse. Also noted is that 99% of all spinal surgeries have to be “redone” mainly to fuse more once more are damaged by wear and tear or overcompensation, usually within 10 years. Write back and we’ll see what we can do for ya.

I had fusion of C5/6 at age 38 due to a ruptured disc which was pinching nerves along with spinal chord. I put off surgery for 8 months primarily due to back-surgery-gone-bad horror stories but couldn’t stand the 24/7 pain that goes with pinched nerves. After speaking with several DRs and rehab therapists it appears that the most complications result from chronic disc degeneration, lower/lumbar disc problems, and multiple adjacent disc problems. Age was given as the biggest determining factor.

I shouldn’t have waited in my case. I was “better” the second I woke up after surgery. No injury related pain at all. There was slight hip discomfort that resulted from the bone chip they harvested from the pelvis for the fusion.

I had no metal pins or screws installed. The bone chip was simply installed to replace the disc and a rigid neck brace was worn to keep the neck motionless for 8 weeks while the 2 vertebrae and chip healed (fused) together like a broken bone. A soft collar (like for whiplash) was then worn for an additional 6 weeks.

In the end all I lost was a lot of pain and a couple of degrees from my head turning ROM.

I’m not sure how they plan to handle your problem, but good luck.

Hey Scrappy,

I haven’t had this procedure done but, my wife did a year and half ago. She had the same surgery that you are about to have I think.
The doctor takes part of your hip bone and replaces the damaged disc with the piece of hip bone and the bone fuses to the spine.
It was very tough for my wife but, she is glad that she did it. The only problems she’s had is decreased ROM, and tight neck and upper back muscles.
If your insurance covers it rent a bed that helps lift you. Like the hospital ones do, just call up a medical supply store. That way you won’t put pressure on your neck when your trying to get up.
I know this will be tough but, you may have to consider not doing any more bjj. If you were to get stacked up it could get ugly. Unless, you train with guys that are real technical. Even then it is still going to be really dangerous.
Anyways, good luck in whatever you decide to do.
“Sancho”

Thanks guys, I live in the NYC area and have good insurance so that’s not a big problem. I hear many horror stories but so far everyone I know who has actually had it done says they could kick themselves for not doing it (reassuring if I try it).
In the end I just have to make a decision. Thanks for all the feedback and keep it coming. I’m still interested in non surgical options.

Hey Scrappy,

 The only other non-surgical option that I know of before surgery is spinal epidural injections. 

 About three years ago I also hurt my neck doing bjj.  I got stacked up doing a half-ass arm lock from my guard.  I suddenly felt this electrical pain shoot from my neck all the way down to my right hand. 

 After some MRI's, I found out that I had two bulging discs in C5 and 

C6. The doctor said that surgery was the very last option if at all.

 I had three sessions of 4 shots and after that have been pain free ever since.

 I don't know if your doctor has given that option to you or if that's even possible in your case.

 Another thing I learned is if you don't have a submission 90 to a 100% let it go, instead of trying to force it and don't get tunnel vision.

"Sancho"

Thanks Sancho,
I had an epidural and it provided relief but only for about 3-4 months.
Maybe I should consider getting more of them.
I also had a cervical spinal nucleoplasty with coblation which is supposed to be a new succesful technique. In my case it didn’t help.

I had this done just over a year ago at C4-5 and C5-6. The ruptured disks were causing weakness in my right hand so it was important to relieve the pressure or risk permanent loss of function. The worst part about the whole thing was having to wear a collar for 6 weeks. Post op pain was minimal for me. Since they go through the front of your neck in this procedure, for 2 days afterwards I felt like I had a lump in my throat. Also, they used donor bone rather than taking bone from my hip so I avoided the hip procedure. From what I’ve read, extracting the bone from the hip will leave you very sore for several days.

Overall, I am very happy with the results and am glad I decided to go with the surgery.

Scrappy,

In May of '03 I abandoned the desk, to go out and help one of my technicians in the field. It was our busy season, and, as usual, we were running behind.

Sparing you the long story, at the end of the day, I jumped in the truck, and when I looked over my right shoulder, to back up to the trailer, I felt what seemed like electricity run down my neck.

When I got out of the truck and walked across the parking lot, I noticed that my left toe of my boot was dragging.

I had two ruptured, and two slightly bulged disc in my neck. The one between C5 and C6 had my spinal cord mashed flat, thus the left leg that was not responding.

I had the disc between C4, C5, and C6 removed. I used donor bone, and I had a titanium plate installed over the vertebrae where the disc where removed.

One thing I would tell you, before you get the bone grafts. I had this surgery in June '03. At the time, my suregeon said that the synthetic disc was not that far away. Perhaps you should look into this, before you get fused. If you get fused, use donor bone, there is no reason to have an unnecessary wound.

It may sound odd, but I didn’t have any pain before the surgery, only loss of motor control.

My surgery was a great success.

I did have loss of flexibility in my neck.

Best of luck to you. If you want to ask any questions, feel free to PM me, or just post them on the board.

If anyone else has any advice on how I can avoid surgery on the other disc that are not ruptured, I am all ears.

I have a great doctor, but he is a surgeon.

Scott

Scott,

I had the exact same experience. My disks were so ruptured that they smashed my spinal cord to half of what it was supposed to be. That’s why surgery was the only option - steroid epidurals would not have resolved the issue. Initially I felt a tingling pain down my right arm - like the electricity you were talking about. Then the pain went away and I actually thought the injury resolved itself. Then I began experiencing the weakness in my hand.

My disc was ruptured and pinched both nerves and spinal chord. The chord was mashed just like MikeTheBear’s. After seeing my MRI I was surprised that I had no loss of motor control.

In my case the pinched nerve was the problem. For all I knew, there could have been a 12" carving knife sticking out of my shoulder all of the time. Pain from a pinched nerve doesn’t go away, not with heat, not with cold, not with massage. The major risk is that if you wait too long there can be permanent nerve damage even after the situation is remedied. That is what convinced me to go under the knife.

Thanks for all the replies guys,
I feel better about this already.
My surgeon will be using synthetic bone graft and a titanium plate. He’s done this procedure a lot and his patients seem happy. I’ll be out for a little bit but it’ll be a memory soon.
thx again… I think I’m going with it.

Scrappy,

When it comes to deciding whether or not to have surgery there are several factors to consider:

Symptoms vs. Diagnostic test results
Most surgeons base their rec. of surgery on a couple criteria

  1. Intractable pain to a point where one cannot live with it and has a surgical lesion which seems to correlate with the pain syndrome.
  2. Motor weakness with a documented surgical lesion which correlates with it, and/or
  3. A lesion present, which poses a risk to a patient’s neurologic well being.

Without knowing your symptoms and seeing your MRI results, it would be wrong to advise you one way or the other.

Also, most surgeons would advise you to exhaust other conservative measures prior to undergoing sugery, unless they felt there would be greater neurologic damage by waiting.

Have you tried chiropractic? What type of rehab exercises have you done? Without knowing where you’ve been (other than the ESI and disc ablation), it would be difficult to suggest where to go next.

Also, it is usually advised to get a second opinion if you are having doubts. If the second doc rec. the same thing, then at least you will have some reassurance.

Take care
Ryan

Hey Scrappy,

 Looks like you have made your decision.  Since you have tried everything else and it failed I think this is your best option.

 It's a good thing you are not going with the bone graft.  My wife said she had no pain in her neck and arms right after the surgery but, her hip kept on bothering her for months.

 Good luck to you Scrappy and in no time you'll be back in the gym pumpin some iron and back on the mat tappin people out left and right.
 "Sancho" 

Well Guys,
I had the fusion on Jan 6.
Turns out I had some significant herniations and ligament damage and the surgeon also said he shaved down some bone spurs. Now i’m in a hard collar until feb.
Still have radiating pain which surprised my doc but because it was severe damage and I didn’t get the surgery until almost 4 years after symptoms he said it may take time for the nerve to heal. I actually have radiating tingling not pain.
I’ll keep posting as I recover. Should be a long road back. Right now I’m walking for exercise, eating Low-Carb Grow!, loading my essential fats and taking a green and red formula. I feel pretty good all things considered

I had my 2nd cervical disectomy & fusion on July 22, 2004. The first one was April 29, 1999. I was 34 yrs old for the 1st one, and 39 the 2nd time around.

At the time of the first problem my symptoms were significant twitching of the right tricep, pec and lat, some minimal numbness and progressive loss of strength in the muscles that I mentioned. I had no pain.

The MRI revealed a herniation at C5-6, and a bulge at C6-7. The bulge was asymptomatic, so the neurosurgeon removed and fused 5-6 and left 6-7 alone. I tried to talk him into fixing 6-7 while he was in there, but he did not want to do it since it was not causing a problem. I asked the doctor how many times he had performed this procedure, and he said “a few hundred”. That made me feel better.

I put off surgery (well, not the surgery, but seeing the doctor) that first time for a couple months as it happened to be my final semester of grad school. When the twitching began waking me out of a sound sleep, I went to the doctor, and he insisted on operating within just a few days.

Fortunately, a guy at work had a friend who had been through the procedure a couple months before, and I talked with him before making the decision. He was recovering well, but recommended that I go with bone bank bone rather than the hip graft.

Recovery from that first operation took a while because I put it off for so long. I had lost a lot of strength, and had significant atrophy in my right tricep, pec, and lat. Rehab was slow and quite painful.

I asked the doctor how I would know if the bulging disk herniated, and he said that based on where it was threatening my spinal cord, I would experience similar symptoms, but on the left side.

During the interim 5 years, I resumed workouts, and regained a significant amount of strength. There is no visual difference between the right and left sides, but the right side is now my weak side.

This past June, while doing overhead presses on a Hammer Strength machine, I felt something peculiar in my neck. Within a couple days, there was numbness and weakness in the left side. Just as the doctor had suggested.

I called the doctor to ask for a referral (since I had moved out of the state) and he hooked me up with another group of neurosurgeons in Chicago.

The MRI revealed a severe impingement at C6-7. I asked this doctor how many times he had performed the procedure, and he said “4 or 5 a month for the past 9 years”. Good answer.

I told him that I was pretty concerned about having two fusions, wouldn’t that put additional stress on the other cervical disks? Doc #2 didn’t think so. He said that the MRI from 5 years ago and the new one, revealed no deterioration in any of the surrounding disks. He also said that he would have fused them both 5 years ago.

I am now 6 months post-op from the second fusion. Since 5-6-7 are now one big-ass vertebra, I have lost a bit of up and down mobility, but no appreciable side to side movement. I was able to resume working out in October, and feel great now. I did not lose much strength this time since the operation was done much sooner.

Sorry to have been long-winded, but I wanted to relay my experience with ACDF, and let you know that recovery is sweet!

Eric