4 weeks after cervical osteotomy and fusion

[jsewell]

I saw my surgeon today for my 4 week post op apt.
He is not worried about the loose screws. He said they had very little purchase (learned that from Mark) He put them in there , but that level is already fused . It was just to help stabilize the lower levels that had not been fused. They have not moved from last imaging done 3 weeks ago.

I reported still having moderate pain in shoulders . Said to be expected at only 4 weeks.
Then i reported lower back pain and hip pain which is back with a vengence since i started walking. He showed me the fracture on my lower vertebrae . So the plan is for lumbar injections in 3 weeks when i have done some more healing. He does cover the offending area really well. General anesthesia. I am not sure if he was going to try to inject the bone cement in the fracture at the same time or later if still needed.
Then he is so sweet, he is going to call the neurosurgeon after i meet with him to talk about his plan. He will also try to get some info on him . That is the neurosurgeon who thinks he can help me with my breathing do to phrenic nerve injury.

[Hooch]

Hi Judy, great news about the screws being ok. Sounds like a really good doc, taking an interest in getting you back to the best you can be.

[Maria]

Sounds like an excellent visit with a really good doctor that's on top of things. What does it mean "very little purchase" .. exactly? I get the idea of what it means but never heard or seen it used before. I have no hardware in my spine so perhaps this is why I've never heard it stated before.

I'm sure you must feel very relieved with the news and the plan of upcoming treatment. Hope the fractured vertebrae pain will be an easy fix (or heal and go away soon enough).

[jsewell]

Thanks for your replies. Always good to hear from fellow spineys. He is a great personable doc that really does care. He told me before i do anything with this neurosurgeon he will talk to him because he cares about me. It was nice to hear. Even though he was not the surgeon when the injury happened, he feels responsible as he sent me to him.
Nice to have a plan that is for sure.
Very little purchase would be the screws are not doing a lot of holding on. Hard for me to describe. Say a little screw in a huge piece of bone. Maybe someone else can help with the answer.

[cherylstewart67]

How loose is the screw? I would have someone else take a look. A loose screw could lead to a looser screw. If that comes out, not all the way, but even a bit more, it could rub on soft tissues; could cause some pain. I would keep an eye on it for a while...Once you have fused, IF, it becomes any looser, you may want to have it removed. It's shouldn't cause any life threatening issues, but definately keep an eye on it.

[mmglobal]

If the level is already fused, there would be no stress on the screws holding the plate over the fused levels. What might have caused them to become loose of there is no load?

On second thought... don't ask your surgeon that. You'll only piss him off.

It sounds like there is so much going on, but it's very soon after surgery. I'm looking forward to hearing of the great progress you'll be making. (your phone is ringing!)

Mark

[jsewell]

We will definately keep an eye on them. I figure they were not put in properly or the force of my neck trying to get to my chest (chin on chest deformity was what i had). I still have some kyphosis, he just said he could not get it any better. Reading an older thread Mark i saw you refer to this as swan neck deformity, nice way to put it. I just could not get my chest off my body and could not make eye contact or look up at all.
so this is a huge improvement and i am not paralyzed or dead,so am very thankful as is the OR staff.

Now back to the lower back which is why i first met this man. Although now i have a fracture in my vertebrae and i do not even know which level., I think the end of thoracic. That would be the one that was also positive on discography but DrRegan could only get to the back of it. So i have 1/2 a painful disc and 1/2 bMP.
thanks all for your replies

[jsewell]

Update at 8 weeks mostly for myself , but maybe someday someone will be needing a cervical osteotomy and will appreciate this.
I had the ESI's for my lumbar spine 3 days ago, not sure if i am still feeling pain from the injections or the lumbar pain. Jury is still out.

My neck is doing well , except for a little new pain caused by someone lowering my bed too fast the other day for the injections. I don't know what they thought the darth vadar like brace was still on me for. The shoulder pain is gone. I get a little twinge now and then when i carry something very light, so i have to watch that. He is keeping me in the brace for 2 more weeks until i have my next follow up visit. Then he said at that visit he will put me in a different brace. (i'm sure it won't be so cool as this one) I will probably miss all the stares. Especially from kids.
I still have pain if i touch the right side of my neck. I will ask my doc if this is where the loose screws are. Still using the shower brace too. I am looking forward to taking a shower and really being naked. I feel the back of my neck has never been washed!!!
overall doing quite wonderfully in that area .

I am going to meet the neurosurgeon on wed who thinks he can help with the nerve damage to my phrenic nerve which causes the diaphram muscle to work and sensation in the chest area. Since that was injured during DrRegan's surgery i have had constant pain (only if i touch it ) to my right upper quadrant and only have 45% lung capacity left. I used to run the mountain trails and am out of breath going up the stairs. The clock is ticking as the doctor's office said the 2 year mark is kind of the limit to trying to repair nerves. Not looking forward to more recovery , but the possible outcome is wonderfully exciting.
That's what's going on in the upper parts right now, its the lumbar that is a mess now.

[Loucleve]

Hi sjewell:

Please tell me, is this osteotomy a reversal of a prior fusion? I had a 2 level cervical fusion done 10 years ago, and it seems the surgeon put in too much bone.............lots of problems I did not have before.

If this is correct, I'd llike to know where you had it done.

Thanks! Lou.

[jsewell]

Lou i first in Sept. last year had surgery for scoliosis and kyphosis correction which involved fusion from T2 thru L2. Shortly after that my neck just broke. I had already been fused from the front on C4thru C7. It was starting to give me some pain but not all the time and not too bad. But the neck fracture was the reason for the Osteotomy (breaking of bone) and the fusion down to T4. So now i am fused with laminotomies and foraminotomies (sp?) down the whole fused spine. My neck had fractured causing a head on chest deformity and pain of course. I had it done in Los Angeles (Pasaena, Ca.) by my wonderful spine surgeon, DrWilliam Costigan. I only found one such surgery on line and it had taken place in the UK. My doc also did some training there as well as in Germany. He had not done that surgery in quite a while he said, because it is a rare presentation. I am very lucky to have him.
Although i am still in a brace all is fine in the neck dept.
Ask any questions, i have been through the ringer!!!

Are you having an osteotomy? Do you have too much bone grown in?
let me know
judy

[mmglobal]

Judy, I think it's great that you are here answering questions... you rock! I hope that the reason you aren't posting updates on your spine is that things continue to go well and you are not even thinking about it. It's been 3 months since your last detailed update... please let us know how you are doing. You have been through such an amazing ordeal.... I am so looking forward to great news!

All the best,

Mark

[jsewell]

that is funny Mark as i just updated last night!!!!

Dog park anyone?
judy

[jsewell]

Thanks for the compliment , Mark, i love helping people any way i can. I have been through quite an ordeal . Glad it is over. My spine in the cervical and thoracic areas are fine. My neck had to be out of the brace (ok for 2 hours per day) for my dentist and oral surgeon appointments yesterday and i can tell, muscle complaints for sure.
but overall i would say those 2 major surgeries were a success.
judy

[newhere]

Originally Posted by jsewell

Thanks for the compliment , Mark, i love helping people any way i can. I have been through quite an ordeal . Glad it is over. My spine in the cervical and thoracic areas are fine. My neck had to be out of the brace (ok for 2 hours per day) for my dentist and oral surgeon appointments yesterday and i can tell, muscle complaints for sure.
but overall i would say those 2 major surgeries were a success.
judy

woooooow im so happy when someone say: cervical/thoracic/lumbar area good
that is so good to hear

[jsewell]

Newhere,
My cervical and thoracic areas are great, the lumbar not so good. but only one left to fix.
so that is good for me.
judy

[newhere]

Originally Posted by jsewell

Newhere,
My cervical and thoracic areas are great, the lumbar not so good. but only one left to fix.
so that is good for me.
judy

im sooo glad to hear that...at least they could help and "fix" you
and how is breath problem going?

[jsewell]

Thanks for asking Newhere,
my breathing problem will remain the same. I thought a neurosurgeon could fix it , but when it came down to scheduling surgery, he said it was too dangerous and he could make it worse . So I am stuck with only 50%lung capacity, There is a surgery i can have (maybe ) on my diaphragm muscle which will improve my lung capacity by possibly 10%. My pulmonologist said that is in the future.
For now i will try to lessen my lumbar pain by injections and now i found out i need surgery on my big toe (it is arthritic and causing lots of pain). I will be back on crutches for a little while. Always something
judy

[dshobbies]

Judy,

We shouldn't underestimate the pain in your toe. Sometimes I'm amazed at how much pain a little papercut can cause. However, pain elsewhere, takes away from the pain we feel in our spines. Take for instance, the fall in the shower I had on Thursday - you'd be amazed at how good my back feels

What is being done to your toe? How long will you be on crutches?

And I'm still overwhelmed with your lung issues and the whole situation!

Good luck with your toe - Dale

[jsewell]

My toe, i am having a cheilectomy and osteotomy and removal of 2 bad toenails. The cheilectomy is like a cleaning out of the joint and getting rid of bone spurs that showed up on an xray as well as joiont space narrowing. Then he will cut out a wedge of bone to correct something else!!! He will also do a little microfracture if he finds a cartilage defect. ( He thinks he will for sure)I was just shocked that it wasn't a simple tendon thing that a shot of cortisone would fix. Surgery is on the 20th . After hiking yesterdy and the toe hurting all the way down hill, i am still in pain today so no hiking. I am going to try going to the gym and maybe riding a bike and the eliptical.
I also felt pain in my other big toe yesterday as i was limping down the trail and putting more weight on it. OMG
I know the first 3 days are totally in bed with foot raised and only allowed up for using the bathroom. Not sure of the whole schedule , but i will find out more at my pre op on friday. i think it will be a full 3 months before any sport will be allowed. UUUUUGGGGGGHHHHHHH!!!!!!

How are you after your bathtub fall? That sounds horrible, must be the week for falls, i fell going up the stairs carrying my morning coffee.

judy

[dshobbies]

Fall wasn't bad but to catch myself, stepped down on shower door frame and twisted my thigh, the bad one. Thigh feels better but the bottom of my foot - ouch!

My husband has had several knee surgeries and his pain was intense. He almost passed out the first time he put his leg down. I understand foot/toe surgery is just as bad and I'm sorry this is something else you must endure. My neighbor had bunion surgery and it took a year before she was glad she did.

I'm pretty sure I need knee surgery and I won't even go to the doctor. I'll probably endure until it's too late.

I'll be thinking of you on the 20th. Good luck -

Dale

[jsewell]

Hi Dale,
Yes i have had knee surgery too. Cleaning out the joint and microfracture to try to grow some new cartilage. It worked pretty good. I do sometimes have knee pain, but i think the combo of the surgery and all my down time with surgery on my spine has made it much better.
All morning my other big toe was hurting too. Now this is not even funny for me.!!!!
I had my pre op appointment with my primary today so i am on my way once more. The hip pain i haVe is still intense when trying to get up off an exam table. I can't get straight up, i have to roll on my left side first.
It is related to the spine and not my new hip. My doc is trying one more time with injections on Wednesday before taking care of it in surgery. I still think it is coming from the screws at L2 as i woke up with this pain after my September surgery on T2-L2.
Oh well who thought middle age would be so challenging, not me that's for sure
Judy

[Maria]

I've had 2 right knee surgeries and honestly the pain wasn't as bad as with the toe surgeries. My 2nd knee surgery recovery was quite prolonged however and required use of crutches while I was supposed to have a long leg cast on for 8 weeks but my low back couldn't tolerate sitting with leg extended straight out so ended up having cast off after 2 weeks resulting in noodle leg and had to use a brace for almost 3 months and a cane for several months.

Still the toe surgeries were brutal pain wise "for me." The recovery was worse involving the big toe than the other toes. It hurt more and recovery was longer in terms of weight bearing and use.

Still what has to be done has to be done! Now my right foot is having probs with one of my toes doing what one did on the left foot which is it is turning inwards towards the toe next to it and practically crossing it. It's a hammertoe defect but also involves a weird tendon prob.

When it starts to hurt and give me pain walking is unbearable. This and the tendonitis in both feet (posterior tibial) is quickly making my feet far more problematic than my spine.

Like Dale mentioned about one pain overriding another ... well that'd be good tho I don't really have that much back pain to deal with so I'd be pretty happy without any of this stuff going on. Oh well, what's an aging baby boomer to do.. just go with the flow and take care of it when I have to!

Good luck with upcoming surgery Judy~ I've just about talked myself out of the right foot bunionectomy and hammertoe surgeries! wishing you as little pain as possible!

[jsewell]

It just seems so funny to me to have all this for a toe. But as you said, we have no choice. I like to walk on my toe!!! And the pain seems to spread to the rest of my foot when i've been hiking and it has been horrible.

Today is my kind of perfect hiking day, warm and sunny. Didn't go i was afraid of the limping down hill!!!
but i love the ocean so tomorrow will cheer me up at the beach. Are you able to come Marie or anyone else?
judy

[jsewell]

My other new problem i wanted to ask about. I did have my steroid injections on Wednesday. The next day i felt like i was having muscle spasms in my upper chest. I had some short lived ones in my lumbar area, but they went away quickly.
The upper chest feeling came back the next day on and off. Now today more intense and spread to my thoracic spine. so more wrap around symptoms that i have not experienced in a while. Not sure if it ever felt like this anyway. I took a muscle relaxer and all is ok for now.
If they continue I will probably start a new thread after foot surgery when i am stuck in bed with an elevated foot.
judy

[dshobbies]

Judy,

ENOUGH! It's time to tell you body ENOUGH!

It should only be so easy

Hope all goes well tomorrow. Post when you can - Dale

[jsewell]

OK Dale i am working on talking to my body today. Surgery # 11 tomorrow . At least i don't get nervous. Only this time about the effect on my spine by using crutches and then walking funny. More worried about that than the actual toe pain ( which i hear is no fun from many of you)

Thanks, i'll post soon on my foot surgery
judy

[dshobbies]

Judy,

Stupid me, I hope it's not too late - please ask for the kind of crutches that attach to your forearm, not under your arm. You stand much straighter.

[jsewell]

Dale
I already had the other kind of crutches. I am only out of bed to go to the bathroom so it won't matter much this week. Until i go to my first class on sunday. i had signed up for a medical billing and coding program and it starts on Sunday (only on Sunday's from Pasadena community college). So one day before my post op on my foot i will be at class all day. Oh well, i have to go to the first class!!!

Foot is doing ok pain wise. I also had both big toenails removed as they have been a mess for like 20 years. I'm just laying in bed with the feet up. No big deal i guess the spine surgery helped, it hurt me so darn much!!!!
judy

[dshobbies]

Judy,

So glad to hear all went well and your pain in under control. You signed up for a big undertaking this Sunday - be sure to take some pillows to put on a chair for keeping your feet up. I fear keeping them down all day might be too much.

On a side note, you push yourself so much - how about pushing your family to give you some help? Just my 2 cents.

Dale

[jsewell]

Dale i am afraid i am way way too independent. I don't like asking for help at all. I am staying in my room and really in bed and don't need too much. water mostly . I did get everyone , except Becka with the newly broken arm, to get me something yesterday. Randy, my oldest , would have done it all, but i keep trying to get the others to help. I sent my daughter to subway last night so I have food to eat today!!!!

I am afraid keeping my foot in class all day Sunday will be too much too. Then i see the doctor on Monday. Hope it is not to swollen then. I can't ice it as the dressing is way too thick. Oh well just bad timing.
Judy

[Maria]

Judy,
I was living w/my husband during my first foot surgery tho he was working all day plus so it was like being alone. Not a good nurse at all either unfortunately. Oh well..

2nd foot surgery I was living alone. Hub took me for the surgery and had to leave that evening afterwards and man o man did I ever have a rough go of it.

Oh well.. that's life! I survived! Here's what I would say about the upcoming class on Sunday and that is ~ if it's going to potentially put more strain on the rest of your body and set you back because you had to do way more than you're ready for or able to do then it's not a wise decision whether you consider yourself independent/ a go getter or whatever..

We have to pay attention to our bodies and do what is needed at the time so I'd just caution you there to exercise caution. To me you don't sound ready for this at all tho then again I'm thinking back to where I was at one week after both of my foot surgeries and I couldn't have done that.

take it easy and heal as necessary and don't put the rest of your body in jeopardy because your mind doesn't need the rest that your feet or other bodily parts do!

[jsewell]

it has now been 8 months since my cervical osteotomy and fusion . I am still in a neck brace although i am down to a foam collar. I can take it off when i want if it is too hot or i am going somewhere special (that never happens) Also need to keep it off at least 3 hours each day.
I do have little moments of pain here and there, then if my collar is off, i simply put it back on. I am going to remain with the level of kyphosis i have . Nothing more can be done. The top screws have pulled out and some of the next level are as well. It may require some type of surgery in the future to put in some type of hook.
judy

[dshobbies]

Judy,

I could be wrong - but is taking a loose screw out, since it isn't needed anymore, a big deal? I would think just a very small incision with a stich or two. Then again, it it were that easy it would be done more often. Just thinking out loud.

Dale