Wow, what a difference a day makes. Those of you who've been on the forums for a while will already know a lot about my situation. I'll be having this very unique surgery on Tuesday. For anyone facing large multi-level cervical issues, I'll blog too much here.
I have been avoiding the surgery for several years because it was a 3-level procedure that spans 4 levels. C3 to C7 (leaving C4-5 alone). I've maintained that "I'm too high functioning to consider such a big surgery." When things would get worse, I'd seriously consider the surgery, but before pulling the trigger, they would always get better. While my pain has rarely been more than mild to moderate, it's been pretty constant and really has impacted my life in a serious way. Last fall, I scheduled the surgery for late January, but by the time December rolled around, I chickened out and cancelled.
About 7 weeks ago in mid February, I had a setback that really kicked up the symptoms, including substantial L chest and L arm pain. (Yes, I had my heart worked up.) New cervical MRI showed that everything in the known bad 3 levels has advanced. It also turned up a thoracic disc herniation with spinal cord compression. (For those of you with too much time and not enough to do, or if you are particularly interested in this type of case, here are some relevant threads:
http://www.ispine.org/forum/ispine/6...y-results.html and
http://www.ispine.org/forum/ispine/1...hest-pain.html.)
I had already been planning a trip to Germany with clients for their surgeries in mid May, so I scheduled my surgery for the end of May. Spinal cord compression can be severe and completely asymptomatic, or it can be mild and highly symptomatic. I've been lucky as I apparently have a lot of room in my spinal canal, so even though my films have looked pretty ugly, I've not been in severe pain and don't (didn't) have any of the scary neuro symptoms. A couple of nights ago, I had my entire L leg go numb and experienced very large patches of numbness that moved around my upper body. I’ve been watching the difficulty I have standing on my L foot w/eyes closed for some time, but recently when the symptoms are worse, I cannot even come close to maintaining any balance for a second. R foot is not great, but I can manage to do it.
With the rapid onset of more symptoms and knowing how quickly things can go bad in a hurry, I realized that I could not manage a trip with clients and I should not consider waiting 2 months for surgery. With spinal cord compression, the risk of permanent damage is not insignificant or tiny. After some conversations with Dr. Baumbach (neurologist) and Dr. Fenk-Mayer, we decided that I was not an emergent case, but I was urgent. I’m now scheduled for surgery on Tuesday.
As we’ve been watching the pathology worsen for years, there have been borderline contraindications that I hope have not progressed too far. I don’t know how much my odds of success have changed over the years. The only relevant data will be known in a few weeks or months. We are here… it is what it is. I made my decision to wait, because we did not know what the timeline was. I believed that I would have surgery, but imagined that it might have taken many more years to progress. Now, I believe that things could get better, but even when things are ‘good’ my life is still too severely impacted. As things have progressed, I believe that there is no realistic way to avoid this, so now, sooner is better than later.
The thoracic herniation is new. We don’t know (and will never know) which symptoms are related to the new pathology, but it’s clear that T1-2 must be included. The only question is C3-4. I believe it’s got to go, but would love to shorten the construct by 2 levels if possible. With cervical ADR, coming back for a later operation is not as problematic as it is with the anterior lumbar surgeries.
Oh well… here we go. I’ll post too much detail here. I hope it’s not too boring. (Actually, I hope it’s very boring… go there… get surgery done… come back… all is well… END OF STORY!)