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  • ashley
    Member
    Post count: 25

    Hi Dr,

    I have a large (neorosurgeon said it was the largest he had ever seen) extruded c6,c7 markedly impinging my spinal cord. Weakened muscles on right arm, numb fingertips on right side too. Nerve pain is bearable. I also have a small disc bulge at c5,c6 with neural foraminal stenosis. No signal cord changes.

    I am otherwise in excellent health, female and in my late thirties. I have tried conservative treatment but am told by a neurosurgeon here that I will definitely need surgery. I am in complete shock.

    It takes a month here in Canada to get a copy of my mri report. I have also had a ct scan and both neck and back xrays.

    I will be having an acdf. I have not been in an accident of any kind. So I am wondering how I caused this?

    The only thing I can think of is I had a small fall off a chair a year and a half ago. But I had no symptoms. I was fine until now. Then 2 months ago I went to pick up my 15 lb baby and felt the disc herniate. I feel really guilty if my small fall almost 2 yrs ago could have caused this to happen. Is that possible?

    And after surgery once someones fusion is strong and has fully fused, how careful do you have to be? I ask because I play soccer and in soccer you have the occassional fall.

    If someone had a fully fused fusion and had a small fall would they be paralyzed? I am just trying to see how careful someone has to be after fusion has taken place.

    Thank you for your time, you are providing some answers to people like me, a bit in shock to need surgery.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    Once you have a fusion of that level and it becomes solid (time to fusion depends upon the method and graft used) you will never have another problem with the fused level. The levels below or above will still have about the same risk or slightly higher risk of herniation as before the surgery. You could go play in the NFL (US) with a one level fusion.

    Genetics is the best answer for why this hernation occurred. Trauma and other problems can produce herniations but by far, the most common cause of herniation is genetics.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    ashley
    Member
    Post count: 25

    Thanks Dr Corenman,

    The 1st neorosurgeon that I saw said he had never seen such a large extrusion and he said it looked like I had suffered massive trauma. I told him I had not. So I am just making sure I am understanding you correctly.
    So a small fall with no neck symptoms 2 yrs prior would not be the kind of trauma for such a massive extrusion?

    And most likely unfortunately my genetics were the culprit?

    As far as recovery goes, my baby boy is now 6 months old, barring the surgery goes well, how soon after an acdf do you think I could pick him up again? He is 20 lbs now.

    Thank you so much for your time. I really appreciate not only your knowledge but also your kindness.

    Thanks again,Take care.
    Ashley.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    I cannot tell you how long it will be to pick up your baby boy as this depends upon the surgeon’s technique and particular requirements for rehab. I would say that in my practice, you could hold him while you were sitting on the couch immediately but could not pick him up for about 5-6 weeks.

    Genetics tends to be the culprit. The tensile strength of the collagen is the factor at play.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    ashley
    Member
    Post count: 25

    Thank you for your great explanations. You put things in clear, concise context for me.

    And yes I am sure genetics plays a huge factor in my injury. I am also only 5’3 inches and weigh only 100 lbs and I was repeatedly lifting my 15 lb baby with my upper body only 4 to 5 times a night when I was nursing.
    I guess my neck just eventually gave way. I wish I had been more careful but hindsight is 20/20.

    The first neurosurgeon I saw reviewed my mri but only said I would be needing a 1 level fusion. My extruded c6,c7. Yet I have a small bulge at c5,c6 also.

    Do you think a 1 level fusion would be sufficient?
    I guess what I’m really wondering is if you think I will eventually need the adjacent c5,c6 level fused inevetably?

    Or is that just a matter of wait and see?
    Obviously I want to avoid any further surgeries. If possible of course.

    Also for the last 5 yrs I have had some difficulty swallowing, sometimes double swallowing to get food down. Other times a pill may get stuck. It has been constant these past five years though. Not something that comes and goes like with MS. I have been to an ear nose throat specialist who found nothing.

    I did however get sent for the radioactive iodine test and they found a benign thyroid nodule in my neck. They thought this may be causing my swallowing difficulty. They also thought it may be due to GERD as I do have frequent heartburn.

    Anyway,I never had the nodule removed because it wasn’t too bad, however I know one of the side effects after acdf is difficulty swallowing.
    Do you think swallowing will be even more of a difficulty for me?

    Here in Canada it is quite a wait to get an appt with a neurosurgeon. My 2nd referral went in a month ago and I havent yet got an appt date for the initial meeting. It is very helpful to be able to ask you a few questions.

    Lastly, the first neurosurgeon said my c6,c7 extrusion has not only pushed my spinal cord off to the right but said the extrusion is also ascending and descending. I think he was concerned it might turned into a sequestration.

    Am I at any real risk of paralysis while I wait for an appt with the second neurosurgeon?

    I basically lie in bed propped up all day and no longer lift anything. Anything else you would recommend?

    Again, thank you for your valuable time. I appreciate it more than you know.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    Picking the number of levels required for surgery has to do with both the pathology at the level and the symptoms the patient has. By your description, the problems lie at the C6-7 level and the C5-6 level is either not causing significant symptoms or is non-symptomatic. If the C5-6 level does not need surgery, it is not likely that it will in the future but without reviewing the images and seeing you, there is much speculation here.

    Dysphagia or difficulty swallowing is not uncommon after an ACDF surgery but in most patients, disappears within the first month.

    I cannot comment on a risk of paralysis without seeing you as a patient.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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