Tagged: myelopathy and cervical surgery
Patient1981ParticipantOctober 3, 2021 at 3:26 pmPost count: 14
Hello Dr Corenman.
I recently had a single level ACCF for severe myelopathy on c6.
My doctor informed me that he used a titanium cervical cage (expandable if I understood correctly) to perform the fusion, but he did not include a plate in order to avoid certain complications… eg dysphagia.
In any case I like to hear your opinion regarding cervical fusions without plating. Thanking you in advance.Donald Corenman, MD, DCModeratorOctober 4, 2021 at 8:34 amPost count: 8468
Generally, anterior cervical plating is performed to increase the stiffness and reduce the chance of pseudoarthrosis (lack of fusion). I don’t off the top of my head remember the percentage but it is around 20-40%. The plate also allows the patient to get out of the collar earlier. Maybe this metal cage has some mechanical way of embedding into the endplate of the vertebra to create more stability. I would have used an anterior plate.
Dr. CorenmanPatient1981ParticipantOctober 5, 2021 at 3:11 pmPost count: 14
I was diagnosed with CSM in 2017 but I refused surgery at that time. Big mistake I know. compression can cause permanent damage to the spinal cord especially if it’s left untreated for a long time. I have developed left side weakness (minor clumsiness in left hand fingers no loss of strength though) and gait unsteadiness with minor drop foot on left foot). I had the surgery last June. I work hard to regain my strength but I know there is still a long way to recovery. From your experience and statistics do you believe that there is hope for full recovery? Or shall I accept the fact that my chances are low to zero and whatever I gain from physical therapy is GOD sent 😀? Thanking you in advance.Donald Corenman, MD, DCModeratorOctober 5, 2021 at 4:15 pmPost count: 8468
Of course, waiting on cord compression is not to your benefit. I typically judge the recovery by both time of presence (in your case-long)/symptoms present prior to surgery and the time after decompression (not clear here as surgery could have been this last June 2021 or June of 2020. Generally its 1 1/2 to 2 years for best expected recovery from decompression.
Dr. CorenmanPatient1981ParticipantOctober 6, 2021 at 9:07 amPost count: 14
Thank you Dr. for your prompt replies. Yes I’m referring to June 2021. I’m 3 months post op trying to retrain my gait habits 😀. I m also treated with clonazepam (baclofen was useless to me) for spasticity. If it doesn’t help my symptoms my last resort are Botox injections.
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