I began having symptoms of cervical spine problems while in high school. Sometimes I would turn my head, hear a “snap,” and my neck would lock up. Sometimes it would release within a few moments, sometimes it would do so within an hour or two, and sometimes it would take several days. I never thought much about it. I was young and naive and didn’t think anything could actually be wrong.
Fast forward to graduate school. I was at the 4Cs conference in Nashville (College Composition and Communication Conference), and about an hour before I was to give a paper, my neck locked up and my lower back went out. I
couldn’t stand or walk without assistance. Somehow I managed to deliver my paper, and spent the next few days of the conference in bed and in agony. The flight home was the most excruciating thing I had ever experienced.
Once home, I went to a doctor who said I’d strained my back and that all I needed to do was take muscle relaxants for a week. Great, no problem. Except, once I stopped the meds, my symptoms returned with a vengeance.
After doing some research, I ended up seeing a chiropractor and learned I had some severe degeneration in my c-spine, specifically between C5 and C7. I began doing yoga, seeing a chiropractor on a regular basis, and taking supplements that helped keep vertebrae strong, disks lubricated, and muscles healthy. I had stretches when the pain was really bad, but for the most part, I was able to maintain my condition.
Fast forward six or seven years. I was working at big desert U and reached to open a door. I heard a loud crunch, and down I went. I couldn’t move. A wonderful colleague took charge, found a local chiropractor who could see me immediately, and somehow got me there. She examined me, took some x-rays, did some tests and concluded that the severe degeneration in my c-spine, specifically between C5 and C7, was now extreme and I might well need surgery. Specifically I was looking at spinal fusion. I’d been reading about such a procedure off and on since the incident in Nashville, and what I’d learned wasn’t promising. So I asked the chiropractor if she thought we could manage my condition and avoid the need for surgery for as long as possible.
She said we could try, but at some point surgery would be necessary. Between her fantastic care, physical therapy, yoga, acupuncture, epidural injections, home traction devices, supplements, and lots and lots of stretching, we managed my condition for close to 9 years. Once the burning, numbness, and pins and needles in my hands and fingers turned to involuntary spasms, we knew it was time for me to see a surgeon.
After many tests to determine the best course of action, I had a multilevel c-spine
fusion from C5-C7. Basically, the surgeon went in from the front, retracted my arteries, vocal cords, airways, etc to expose my spine. He then removed the disks at C5 and C6 and C7, replaced them with cadaver bone, and screwed it all together. The result looks something like this (although the image shows fusion from C4-C6). The surgery took about 6 hours, and the recovery took months. The results were fabulous: all my pain and symptoms were gone. I was thrilled. I was, however, fully aware that the structural changes to the spine would eventually present a problem. Once part of the spine is fused, the work those fused areas would do is transferred to the areas above and below the fusions. This places additional stress and pressure on the areas above and below the fusion, stress and pressure which eventually result in structural changes in those areas. Disk bulges, bone spurs, further degeneration, and instability are likely to develop overtime.
That time for me was a little over six years. I’d begun to develop problems about 4 years after surgery, but those problems were easily addressed by chiropractic care, specific stretches, resting my neck muscles when possible, and other kinds of minor intervention. However, about 5 months ago, those remedies no longer helped. I would get a day or two of relief, but that was it. I was disappointed. I’d hoped that I could avoid the statistical average. I was just about 20 years younger than the average c-spine fusion candidate when I had the procedure, so I’d hope that would translate into a longer pain-free period. And I did beat the average, but not by much.
My chiropractor and I discussed the options. The best one available would be to once again go the route of epidural injections. I’d had good pain relief from them years ago, but as we both knew, that would be a temporary fix at best. We’d each done some reading about laser surgery and decided to do some more. After lots of research, we opted to find out if I was a candidate. My last MRI was over 6 years old, so I had a new one and sent the results to the Laser Spine Institute.
After reviewing my MRI, I got a call saying I appeared to be a candidate and asking me to come in for an consult. Thankfully, they are located in Scottsdale (as well as Philadelphia, Tampa, Oklahoma City), so it was a quick trip up the 101. At the consult, we went over my symptoms and my MRI, and the doc recommended a course of action. We agreed. This past Wednesday, I began their 5 day process.
Day 1: consultation and tests including blood work and an Electrocardiogram. I also meet with the anesthesiologist, and the physician who would perform the nerve block. Day 2: nerve block procedure to ensure the nerve was the root of the problem. Day 3: surgery. Day 4 and 5 included rest. Because I began the 5 day process on a Wednesday so I could teach on Tuesday, I had surgery on a Friday and so my post op appointment is scheduled for Monday.
Basically I had what is called Foraminal cervical stenosis which means that the small canals between each vertebra, become narrowed in the cervical (upper) region of the spine. The nerves from the spine must pass through these small canals, or spaces, as they travel from the spinal cord to the rest of the body, so constriction of the spaces can lead to undue pressure on nerve roots. Symptoms include neck pain as well as numbness, weakness, and a “pins-and-needles” feeling. Some of the things that cause this condition include:
- Herniated disc and/or bulging disc
- Disc degeneration
- Osteophytes or bone spurs
In my case, all three were at work. So what the surgeon did was to go in from the back of my neck and then use a small tool to clean out tissue and other blockages that have narrowed vertebral passageways through which nerves pass when they travel out of the spine and toward the rest of the body. This passageway is called the foramen, and when it’s narrowed, it squeezes nerves, causing pain. He also worked from outside the vertebra to relieve pressure on the nerve by removing a portion of bone on the top of the vertebra called the lamina to create more space inside. If only a small portion is removed, it’s called a laminotomy. And that’s what I had done. Check out the video by clicking on the link above.
Following surgery, I was a little sore. I felt like I had a strained muscle in my neck. This is because they move the muscles away from the spine to do the surgery. That neck strain pain was moderate to severe at times during the afternoon and evening following surgery. Today, the pain is occasionally severe, but for the most part it is pretty mild. I am taking antibiotics to prevent any kind of infection, valium to prevent muscle spasms, and percocet for pain. I am following the docs instructions for these meds even though my pain is minimal. As he pointed out to me, what they have discovered is that managing pain–i.e. preventing it from developing–is easier than trying to address it once it develops. I’ll be on these meds for 4-5 days at most, so I don’t foresee any problems.
I feel good about my surgery and recovery thus far. My goal is to maintain a strong, flexible and healthy spine for as long as possible, and I think this procedure will help me do just that.
Here’s my surgeon describing the sorts of procedures he preforms. The second one he discusses is what I had done on Friday: