Saturday, March 06, 2010

spinal surgery



So I finally will be getting my surgery in a few days, on Tuesday. They will be doing a laminoplasty on C3-C6. Here is an animated video. The short story is that they cut through four of the vertebrae in my neck, cut a notch, swing it open, and create a larger spinal column so the cord has more room to move around.


As I've been told, I have a complicated neck. I have bone spurs, a herniated disc, a very narrow spinal column to begin with, and another term or two I can't translate into English. I mentioned before that I first had symptoms last summer, culminating in the Trauma on the Beach, and that I had been asymptomatic since then. However, in the last month or two, I've had twitching in my calves most of the time, and after exercise I feel unnaturally warm. The calf twitching has been with me for many years, but previously only showed up after a full day or two of ultimate in hot weather. I had always thought it was due to depleted electrolytes, and maybe it was, but perhaps it's due to this. I've also had calf cramps at night dating back to at least last fall, and a few other things that I won't bore you with.

I ended up getting three official opinions. The first two were from neurosurgeons and recommended the laminoplasty, which goes in from the back of the neck. The third was from an orthopedic surgeon and recommended a complicated anterior-and-posterior approach, but after consultation with his neuro team, he too switched to this procedure. I recently read a medical article online where the study was to send the same five cases to 30 spine surgeons and see how much variation there was and whether that variation was predictable. For the case that seemed most similar to mine (Case 4), all recommended surgery, 22/30 recommended fusion (20 of which wanted to use plates and screws; mine wants to use thread), and about half wanted to go in from the back. What that means for me, I don't know, other than there isn't a single right answer. (In the simplest case, a one-level herniation, there was almost complete agreement. The others, less.)

I'll be in the hospital (New England Baptist) for about 2 days, out of work for 2-3 weeks, then will have various shades of green lights at 6-8, 12, and 18 weeks (on average; my mileage may vary). I have had precious little contact with the doctor himself, and interactions with the office were less than perfect. I mentioned this to the hospital during my pre-op screening, and they said they had frequently heard that about this doctor's office (which is run independently from the hospital). My final opinion on this office will depend on the success of the surgery, but these people are clearly used to being in a seller's market and don't have to worry about their next meal. {Insert right- or left-biased comment about American health care system here.} {I find it informative that in none of the three consultations or in my decision-making did the cost ever enter the picture. The cost to me is the same, and I have no idea what the full cost will be (well, I have some idea, maybe $20K). And since I'll have maxxed out for the year, I might as well get that Botox I've always wanted.}

And here are some additional pictures. One is the MRI, side view and a slice through the 5/6 disc. The other is a CT scan through the sixth vertebra, I think.

PS. HoF comments still welcome.

12 comments:

Robert said...

Good luck, Jim, hope to see you out doing the stuff you want to do again quickly.

Phil said...

Good luck!

itchy said...

Best of luck, Jim.

Anonymous said...

Best Wishes

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gingerlyn said...

Qs: how do u post x-rays on your blog? i've been wanting to post all my x-rays and mri's for ages but don't know how.

hope to hear from you and pls get well soon!

thanks!

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