How to survive a cervical spine fusion?

In My Humble Opinion
1

Remember those old TV ads where the guy with heartburn says My doctor said Mylanta?

Well, my doctor said spinal fusion. I’m looking at a cervical ACDF+P fusion at C5-C6, and possibly one level above or below. I know he’s planning C5-C6, but the person who sets up appointments made it sound like he was going to be doing a two-level procedure. I’ll be sure to confirm with him next time I see him. It won’t be until early or mid-December, so there’s no panic to find out.

Could be worse, back in 1998, when I was injured, a proposal on the table was a three level job. Since then, new procedures have been developed and refined - it’s still a fusion, but it’s at least less invasive than was was being done in the 90’s.

Has anyone here undergone such a procedure? I can get all the “rules” from my doctor, like “don’t lift more than xx pounds” and no listening to head-banging metal, but what I’m hoping to get here are tips and tricks for a fast, painless recovery.

Is there anything I should watch out for? Anything I should stock up on before the surgery? I have heard that I should think about getting a comfy recliner as it may be a while before I can sleep in bed, and that eating may be a minor challenge for a few days, so soft stuff like protein shakes may be my diet for a while.

2

C5-C6-C7 in 2008. Sat in my comfy chair in a neck brace for 12 weeks before I could move to a soft collar and go back to work.
Got really bored during the three months recovery. I recommend a lot of movies. I didn’t have the energy to do much of the reading I had stacked up.
Eating and swallowing was not an issue after about five days.
Don’t have much more to say about it. I can feel my legs now and actually have hand strength; I am told that if I had gone another three weeks without seeing a doctor I would be in a wheelchair still.

3

My dad had one last Tuesday. He’s 61.

I brought over an old recliner from my basement and he switches between that and a high-backed couch propped up with pillows. His doctor told him he’d want to switch positions and so far it’s been true.

The doctor said he can sleep without the collar but the first time he tried it, it sucked. Then he slept with the collar for a bit and it was good. He slept one night without the collar and woke up not being able to move, and was better with the collar. Today I was visiting and he was sleeping without the collar because he said the collar bugged him.

So uhm…you may get frustrated with the collar?

My godmother had the procedure a few months ago and didn’t take 12 weeks to heal (YMMV of course!) She says she sat propped up in a bed all day and also slept with the collar. I would definitely make sure you have plenty of pillows and plenty of options for sitting and lying down.

Make sure you have straws to drink out of. No way can you drink anything with that collar on.

Get yourself some Chloraseptic spray and some lozenges because you are going to have a sore throat and you aren’t going to be able to throw your head back and gargle.

Dad is having problems swallowing. Pills are getting stuck in his throat and liquid gets shot to the “wrong pipe.” I think it’s mostly because he has tonsils and they get irritated by the procedure and the intubation. So YMMV on swallowing. Our next step is to make sure he eats after his pills, so he doesn’t wake up with a pill in his mouth like he did today :-/

He’s been able to eat ok actually. But more like eggs and mashed potatoes, altho he did have me get him Wendy’s. Protein shakes wouldn’t be a bad idea but don’t think you HAVE to eat them. His post-surgery sheet says “normal diet.”

Make sure you recruit someone to help you. Mom and I have actually been watching dad like hawks since he came home, but he was sort of feeble before he went and since he has an opiate addiction he’s now on massively more drugs. So we put him to bed with a baby monitor and all that.

I was pretty amazed and pleased at how well he got up and walked around the day after the surgery. My mom said he was just in awful awful shape the day OF the surgery. By the time he got home, about 24 hours after the surgery, he was in less pain and doing “well.”

Good luck…it seems like a painful thing to go through with a huge payoff at the end! If you have more questions about how my dad is progressing, let me know.

Oh yeah, here’s an animated video (with no sound - it’s just a sample from a better site) of the procedure. I send it to people who inquire what sort of surgery dad had.

4

My husband had a C4-C6 fusion done almost a year ago. He spent one night in the hospital and did not have to wear a brace afterwards.

I would say the two biggest challenges for him were dry/sore throat afterwards, and a lot of stiffness in the neck/shoulder areas from the position he was in during the surgery.

Anticipating the sore throat I had made some chicken noodle soup ahead of time which was greatly appreciated, but it wasn’t long before he was ready for “real” food again. I second the idea of lozenges, the honey-flavored were very helpful for dry throat and mouth. Drink as much water as you can stand and then some.

As far as the muscle stiffness goes, hopefully you will not have that problem; it was not something the doctor warned him about ahead of time so perhaps it is not that common. Epsom salt baths helped somewhat but what really worked was one of those u-shaped vibrating neck massage pillows; we got one that also heats up and that went a long way towards loosening up his upper body. Of course, it is still nice to have and use when you have recovered! Other than that, we were pretty well prepared for everything else by the doctor, he has recovered wonderfully and undoubtedly has 100% better quality of life than before the surgery. Best of luck to you, and feel free to ask away if you have any other questions.

5

I had C5-6-7 fused about 3 years ago. It was less painful and disruptive than I anticipated or feared, but two things were worse than I expected.

First, my throat was more uncomfortable than my spine. The night after surgery (in the hospital) dryness in my nose and throat was really painful. I wish I had known to bring some saline spray for my nose. I had some choking and coughing in the several days following surgery, which reached its worst in an oxycodone-fueled nightmare about having a tracheostomy tube connected by wires and pulleys to the basement ceiling, where a bunch of young teens were fooling around with the wires and accidentally swept a little pile of sawdust and mouse droppings into the tube, which woke me up in a coughing spluttering mess.

Second, I had a 10 lb lifting limit for - I think - 6 months. Maybe it was 6 weeks. But it seemed like a long time. It didn’t occur to me that the muscles that lift the arms at the shoulders have to anchor to something higher than the shoulders to be able to lift same, and of course that would be the neck. So, whatever load you lift with the hands and arms has to be carried by the lower neck vertebrae as well. I would have cleared a bigger path through the garage if I had any idea how long I would be making how many trips with little loads, unable to move even modest obstacles.

Really, though, in the grand scheme of surgical experience, the cervical fusion was pretty easy and rewarding.

6

I’m seeing an amazing span of recovery times - one week to three months. I’m beginning to think the person who told me “one week” was maybe thinking of a micro discectomy, rather than a fusion. I did have a lumbar micro discectomy two and a half years ago, and that was one week lolling around, then back to work. It’s sounding like a minimum of one month is not unreasonable. Thankfully, I found out today that I’ve got up to 25 weeks of short-term disability coverage, so I don’t need to worry about financial survival.

There are at least a couple things in my favor - I’m in my early 40’s, not grossly overweight* and I don’t smoke. The surgeon did say it would probably be an outpatient procedure at their surgery center, rather than at a hospital.

I’m really looking forward to the surgery. My understanding is that the neck pain may or may not be resolved, but the hand and arm pain may resolve almost immediately. Right now, my left hand feels like it’s being crushed in a vise and it’s just not working well. I feel like I’m trying to type with snowmobile gloves on.

  • I’ll freely admit to being middle-of-the-road pudgy - probably 25 pounds heavier than I should be, but I feel positively skinny next to some of the people at my office.
7

I had this procedure done about four years ago; I believe it was C4-C5 but cannot recall for sure. In my case it was done in hospital (not surgery center) and took about 6 hours with an overnight stay for recovery. Prior to the surgery, I had tried various treatments…first chiropractic then at a physical therapy center. None of the alternative treatments worked, and may actually have exacerbated the problem. The condition had affected primarily my right shoulder and arm…hand and fingers were numb and largely paralyzed while the shoulder and arm were in constant cramp mode. Imagine having a violent charley horse that lasted for several weeks. I’m sure it affects everyone differently, but for my money, it was the worst pain I’ve ever experienced.

Prior to the surgery, the neurosurgeon told me “When you wake up from the anesthetic, the first thing you’ll notice is that the pain is gone”. And by gosh, he was right. There was some soreness and stiffness from the surgery, but the sudden relief from constant severe pain was remarkable. The surgeon had taken a bone chip from the collarbone for the graft, and that actually hurt more, and stayed sore longer than the surgical site.

The recovery was uneventful (I was in my late forties, maybe 20 lbs. overweight). There was a 30-day lifting restriction (ten lbs.) and I was warned to avoid sudden jolts or rapid head movements for awhile, but no neck brace, and told to sleep on my back for the first week (side or front sleeping puts a strain on the neck). Surprisingly, the biggest hurdle for me was psychological…for the first month I couldn’t shake the conviction that my spine was made of glass and was about to break in two. I mentioned this to the surgeon on a follow-up visit, and he seemed kind of insulted (the man was very smart, but utterly without humor). He informed me in no uncertain terms that the metal plate he’d installed made the joint far stronger than the original and I had nothing to worry about.

Best advice I could give is to pick your neurosurgeon carefully. It is a very delicate proceedure on an unforgiving body part. Done properly, it’s a relative breeze, done poorly, you could wind up with a lifelong disability. The surgeon who worked on me is considered the best in the region and actually had a hand in developing the procedure of going in from the front instead of working from the back.

Good luck!
SS

8

Just a bump with the hopes of more people seeing this.

ZipperJJ - got any update on your dad? Hopefully he’s making a splendid recovery.

My surgeon did have me get another epidural injection yesterday. Unlike any of the others I’d had in the past, this one came in from the front and was targeted to the C5-C6 root. Once I was in the recovery room, I noticed that my left hand felt warm. Half an hour earlier, it felt very cold. Also, the “cold fire” sensation that was in my arm almost constantly has decreased. You know that odd feeling of x-ray contrast - a sort of numb, cold, hot, fiery, tingly all mixed together? I’ve had something like that in my arm constantly. That too has been reduced.

So, it looks like the right level has been targeted three ways - visually by MRI, symptoms and releif from the injection. If past experience remains valid, the effects of the injection will wear off by this weekend. Oh well. It’s nice while it lasts.

9

It’s been 2 weeks now for dad. His throat seems a lot better. He hasn’t had another night of waking up unable to move - it was just that one time.

His neck sure does look swollen. But I haven’t seen him since last Thursday so it may be better. But he’s a really skinny dude so any swelling really shows on him.

Uhm…oh, so he got 60 Percoset after the surgery and took them “as directed” which was every 4 hours “as needed.” Well he is an extreme sort of dude and took them every 4 hours on the dot. His doctor was not very happy when he called a week later and said “HALP! NEED MORE!”

The doctor hemmed and hawed but ultimately gave him 90 more. But, knowing 60 only lasted him a week the first time dad has tried harder to space out the pills. He’s proud that he now goes about 11 hours between them.

Seems like he’s just very uncomfortable now. He went for a short ride in the car yesterday and being that we have bumpy roads, he ended up sore right away. The collar makes him uncomfortable but that’s more of a skin contact thing.

I rubbed his arms and legs for him the other day and he said it was great. I tried to get my mom to do it for him regularly but she’s not into it.

I don’t think there’s been any breakthrough in how he feels after 3 weeks. Definitely not worse. His attitude is better and I think he’s eating better. He was never a good eater before…I told him he’s got to eat to get better.

Seems like it’s going to take a while to get back to any sort of normalcy for him. But I am still anticipating that he will be better than what “normal” was before the surgery.

Hopefully I’ll remember to let you know how his dr. appt goes. I think that’s this week.

10

Best wishes on your upcoming surgery. It is amazing how we can be put back together! I am a 43 yr. woman and trashed my neck sledding with my kids last spring. I had an anterior fusion of c4-c7 last May, so I am 6 months out. I have spacers in all 3 disc spaces with my own bone fragments ground up and injected. 2 levels are 50% grown at 6 months and the top one is pretty ghostly. I am told 12-18 months (possibly 24) for full fusion. I am healthy and just happy to be here. I have the rest of my life to get on my bike and ski with the fam when this is done.
From your post about the injection, it looks like you are still headed to surgery, so here is your shopping/collecting list…
*a feather pillow - easy to smush how you wish
*a curved travel pillow - for support in the car or anywhere
*recliner that goes way back, move it where you want to be before hand
*applesauce (take your pills with it, then drink water), protein smoothies (my costco carries Naked smoothies in lg 2 packs by the produce- cut them with milk to make them less grainy)
*water bottles - bike bottle avoids straws, you can drink sitting up even with the hard collar though
*stool softener - early and often, the meds make this important
*vaseline - for your scar, just as good as the fancy stuff. Work your scar as soon as you can (2 wks), also you will want something for your lips so you can just use this. back sleeping strangely dries them out.
*tylenol - extra strength, capsules easier to swallow, no ibuprofen allowed, then Tylenol PM as a transition from heavier meds - hard to sleep on your back if you are not used to it, so one pm and one regular tylenol would send me on my way.
*more pillows - helps when propping up in bed
*help - if you are in the hard collar, you feel like a turtle stuck on their back. I don’t know your situation, but for the first week at least you will want someone around (though you will have lots of quiet time that you will not need them) you just get comfortable and then need something… after that, have help with life - food, laundry, etc. for as long as you can (work it!)
*a driver - no driving with the hard collar, and pretty sketchy safety wise without it, tough to feel like you are seeing mirrors etc. for me until 6 wks+ (you will have less levels, though, so hopefully better)
*reasonable expectations - somewhere I heard 6 months to fusion in my early stupor, I thought i was way behind until surgeon set me straight. I am doing daily life at 6 months but the yard needs raking etc. - growing bone takes energy and time. Chill.
*your rose colored glasses! - hopefully you will have great releif from this. It was a tough surgery with great results for me. While it is a long road, hopefully your life will be greatly improved. I was injured, but had shoulder and neck troubles for years before. It is a gift to have that comfortable now.
You will be in my thoughts! feel free to ask more. Best, A