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After Neck Surgery

 

What are my chances for success?

The chances of your arms and hands feeling better are greater than 90%. The chances of you fusing are also greater than 90%. The chances that your neck pain will be better is greater than 80%.

What are my risks?

Risks can be separated into minor risks and major risks. The minor risks for the most part are treatable and reversible and occur less than 5% of the time. The major risks are for the most part difficult to treat and may be irreversible and occur less than 1% of the time. The minor risks include infection (can be treated with antibiotics), hoarseness (usually transient), bleeding, (can be treated with blood transfusions), and cerebrospinal fluid leak (can be treated with repair and drainage). The major risks include nerve damage leading to worsening pain and weakness, or spinal cord injury leading to quadraparesis or quadriplegia.

When will I be back to my normal activities? Driving?

You will require 2 to 4 weeks prior to resuming normal activities. And most surgeons like to wait 1 to 2 weeks prior to allowing the patient to start driving. The time period to resume normal activities will be longer for those with several level surgeries or for those that are older with more medical problems.

Will I have pain after surgery?

Immediately, yes. Your neck and throat will be sore if you have anterior surgery. The muscles of your neck will give you pain if you have posterior surgery. We, now, have disposable subcutaneous pain pumps that will make postoperative pain much less. And once the operative pain wears off which can be one to two weeks, then most people have very little pain.

Will I have to wear a collar after surgery?

Collars are rarely worn after surgery because of the widespread use of plates. Collars are still worn when you do not get a plate placed or you have multiple level surgeries.

Will the surgery lessen my mobility?

Yes, but by only a few degrees such that you will hardly notice it at all if you only have one level surgery. If you have two or three levels fused then you will most likely notice loss of mobility. However, many people state that their neck mobility is better after a fusion as they have less neck pain and can move their neck better.

 

About Your Back

 

What is flat back syndome?

Flat back syndrome is when you lose the normal curvature of your lower back which is between 40 to 60 degrees to the point that it is flat. This will cause you to have back pain as the day goes on. If severe, you many need to have back fusion surgery to correct this and to restore the normal curvature.

Do I need to wear a brace after surgery?

It depends on the surgeon’s preference and what kind of patient you are. Some surgeons brace everyone, some surgeons brace no one, and most surgeons brace some patients depending on the certain criteria. If a patient is obese, older, smokes, or has very bad arthritic changes bracing is often used.

Does it matter what screws and rods my surgeon uses?

No. There are many companies that make excellent screws and rods for spinal surgery, there are no published reports that suggest one company’s screws and rods are significantly better than another company’s implants.

Does my insurance cover low back surgery?

It should. Some of the newest implants coming into the market such as artificial discs and dynamic stabilization implants are still considered experimental and may not be covered by insurance plans. But everything else required for your back surgery should be covered. You and your doctor office staff should investigate all this prior to surgery.

How did I herniate my disc?

Disc herniations in the lower back often occur with everyday motion of the lower back. People herniate their lumbar discs twisting, bending, and turning often to pick up something heavy or playing sports such as a golf or basketball. The pressures in the disc spaces are extremely high when the spine moves in such ways and lead to disc herniations. Trauma is a rare cause of disc herniations.

How do disc injuries cause back pain?

A tough covering surrounding the discs called the annulus has nerve fibers innervating it. The annulus can tear leading to disc herniations. The tear itself can be quite uncomfortable. As we get older we develop degenerative changes to the disc space, which can alter the rest of the spine causing wear and tear on the vertebral endplates, the facets, and the ligaments. All these changes can lead to back pain as the body tries to accommodate the injured disc and lead to chronic changes that are unhealthy and painful.

How does INFUSE™ Bone Graft compare to the bone taken from my hip?

INFUSE™ Bone Graft is a soft sponge like substance that does not offer any structural support. Therefore it must be placed inside of or around a cage-like graft. As for the ability of INFUSE™ to stimulate bone growth, if will act like your own bone if not better.

How is INFUSE™ Bone Graft made?

The INFUSE™ Bone Graft protein is manufactured in a laboratory. It is placed onto the sponge in the operating room and allowed to be absorbed by the sponge for at least 15 minutes prior to placing it into the patient’s body.

How many times will I need to see my surgeon after surgery?

Three to four times. You should see the surgeon at one to two weeks after surgery. You should then see him about one month after surgery. Another visit is needed at about three months which is the length of time we believe is necessary for a fusion to take place. After this, the surgeon should see you one or twice from the six month to one year window.

How quickly can I expect to recover from surgery?

This depends on what you get done. Decompression surgery such as laminectomy is a shorter procedure with shorter recovery. Patients usually take a few weeks to recover from a laminectomy procedure. This means that you will be up and walking the day after surgery but will feel sore and not walk very well. Every day you will feel better and by the end of couple of weeks you will feel almost back to yourself and be walking fairly well. A fusion is a more extensive procedure and a patient may require a month or two to recover. The recovery time also depends on the number of levels you have surgery. Each additional level laminectomy or fusion adds time in the operating room and adds to the number of days you many need to recover. If you are also older and have many medical problems require longer recovery. The recovery also does not mean being in the hospital the whole time or being forced to rest in bed the whole time. Patients are expected to move around, ambulate and become more and more pain free and normal over the course of the recovery time.

I have heard people talk about hip pain after harvesting lasting up to 2 years or longer. Is that true and are there any other possible complications with harvesting bone from my hip?

Yes. In a few patients, the hip pain can last a long time. This, however, was seen when large grafts were taken. Now, only small amount of bone is taken and fewer and fewer patients suffer from great pain for long periods of time. Numbness in the groin and thigh can arise from injury to the nerves near the hip. Infection can also set in requiring further surgery.

I have heard people talk about less invasive back surgeries. What are these? How do I know if I am a candidate?

Surgery is performed with smaller incisions and less destructive exposure. Surgery is performed through tubes and small fine retractors. You will know if you are a candidate for less invasive surgery by talking to a surgeon who does these procedures. In my opinion, there really is no one who is not a candidate for minimally invasive spine surgery. But the final decision on this matter must be made on a patient-by-patient basis.

I have heard people talk about the pain associated with harvesting bone from the hip. Does this happen to everyone and how long does it last?

If a large incision is made and large graft is taken, the pain can be tremendous and long lasting. Hip grafts, however, are no longer taken that way. Most surgeons make small incisions and take small amount of bone. Pain usually only lasts a few days and are tolerated fairly well by most patients.

I hear that men should not have fusion surgery. Is this true?

No. Men can have fusion surgery as much as women. A procedure called anterior lumbar interbody fusion procedure requires the surgeon to approach the lumbar spine through the belly. The sympathetic nerves in this area go to the sexual organs. If these are injured in men, it can cause sexual dysfunction called retrograde ejaculation. This is seen in approximately 10% of the time in these cases. If you are a man and this procedure if proposed to you, make sure you are well counseled prior to giving consent for this procedure.

If I have a fusion does that mean I will never be able to bend?

No. Once you have recovered from the fusion surgery, you may actually feel as though you have more flexibility because you will experience less pain when bending. In actuality, you lose a few degrees of motion for every level you are fused. The more levels you are fused the harder it will be to bend.

If my doctor uses INFUSE™ Bone Graft will I get as strong of a fusion as if he used a bone graft from my hip?

It is very likely that your fusion with INFUSE™ Bone Graft can create a fusion as strong as graft from your hip.

Is INFUSE™ Bone Graft the same as the natural protein found in my body?

INFUSE™ Bone Graft is exactly like the natural protein in your body that helps bone grow and cannot be rejected by your body.

Is it true that a bulging disc can be normal?

Bulging or herniated discs are not normal if you think that a normal back is a completely healthy back without any changes of aging. Bulging discs and even herniated discs, however, are fairly common. So these things can be seen in the backs of patients without any symptoms. Your herniated disc will only be in need of medical or even surgical treatments when they cause symptoms at which time they can certainly be called abnormal.

My doctor said he would be using a bone graft. What does this mean? What is a bone graft?

A bone graft is a piece of bone either from yourself called autograft or from a bone bank called allograft that will be placed in the disc space after all the disc is removed to cause the vertebrae to fuse. An autograft is superior to an allograft to cause fusion to take place. This is particularly true if you are a smoker. However, getting an autograft usually from your hip can result in a very painful hip. Therefore, most surgeons are using allografts with bone growth stimulating agents internally, externally or both.

My doctor told me that I have arthritis of my spine and that I should learn to live with the pain. Is this true?

No. Health professionals of many different backgrounds have many different ways to treat arthritis of the spine. Spine surgery is only a small part of the available treatments for patients that have pain related to their aging spine. Although arthritis of the spine and the pain from these changes are difficult to treat, they are often very treatable. It is to your benefit that you seek out health care professionals who specialize in the care of the spine and become educated about treatment options available to you.

My spinal specialist said he will take the bone graft from my hip, how big is that incision compared to the spine surgery?

The incision for the most part will be much smaller than the incision required for your spine surgery.

My spinal specialist said he would be using implants in my spine. Is this really necessary?

Yes, only if you need a fusion. Spine implants have come a long way and are becoming better and better all the time. There are very few spine surgeons that are doing lumbar spine fusion without using implants. My feelings are that current implants are so helpful in producing successful fusion that if your spine surgeon plans to fuse you without any implants, you should seek the counsel of other spine surgeons. Not all spine surgery requires fusion and therefore not all spine surgery requires implants. Again, get second and third opinions about your condition.

My spinal specialist said I need a fusion. Is that true?

It depends. There are many different ways to treat the lumbar spine and not everyone agrees as to whether a patient should have a fusion or not. There are certain conditions that virtually everyone will agree should be fused. But there are many patients that some spine surgeons would fuse and others would not. There are also different ways to fuse for which there is again much debate. My best advice to you is to talk to several different spine surgeons and make an informed decision for yourself.

My spinal specialist said that he will perform the fusion from my back and will harvest bone from my hip without a separate incision. Will I be able to tell the difference between that pain and the main procedure pain?

The pain should be less, as no separate incision is required. However, if a large graft is taken then the pain may be as much or worse than the main procedure pain.

What are common causes of back pain?

There are many different reasons why one can have back pain. It can be as something as simple as muscle strain to something as serious as broken back from trauma. The most common reason for back pain probably falls into the catchall group of conditions called musculoskeletal injury whereupon a person has caused strain to the musculoskeletal support of the back. This is probably self-limiting and should go away with short time and with conservative treatment. It is when back pain does not go away within matter of days or weeks and if you have pain running down your legs, you should seek the help of a doctor. The other reasons for back pain, which are more specifically related to the spine, are injuries to the disc.

What are some of the complications associated with fusion surgery?

Pseudoarthrosis is a medical term that refers to a patient who underwent fusion surgery but did not fuse. This may require second revision surgery to try to cause fusion. Sometimes, excellent fusion can lead to adjacent disc disease which means that the motion that used to occur at the fused segment now must occur at the level above or below the level fused. This can lead to rapid degeneration of those levels requiring another surgery to fuse the adjacent level.

What are the differences between bone taken from my hip and donor bone?

There is nothing better than your own bone to lead to fusion. But this difference is becoming less and less with advancing material being discovered and developed for spine surgery. Donor bone alone is not as good as your own bone. However, the bone growth stimulating agents that are available to us today are leading to results that are as good as or better than your own bone.

What are the risks associated with spinal surgery?

Risks can be separated into minor risks and major risks. The minor risks for the most part are treatable and reversible and occur less than 5% of the time. The major risks are for the most part difficult to treat and may be irreversible and occur less than 1% of the time. The minor risks include infection (can be treated with antibiotics), bleeding, (can be treated with blood transfusions), and cerebrospinal fluid leak (can be treated with repair and drainage). The major risks include nerve damage leading to worsening pain and weakness, or paralysis with or without bowel, bladder, and sexual dysfunctions.

What are the risks from going in from the back?

The risks of surgery from the back include injuries to the covering of the nerves leading to leakage of cerebrospinal fluid leak, injuries to the nerves leading to pain, burning, weakness, paralysis and bowel and bladder and sexual dysfunction.

What are the risks from going in from the front?

The risks of surgery from the front through the belly are injuries to the bowels, urinary tract, large blood vessels, and in men injuries to the sympathetic nerves that may cause sexual dysfunction.

What are the symptoms of a herniated disc?

Disc herniations first cause back pain and then can be followed by pain going down one side of the lower back often into the buttocks. If the herniated disc is large enough to press on the surrounding nerves then it can cause numbness, pain and even weakness down your leg sometimes even down to the foot. This is usually on one side but sometimes can be both sides.

What is a laminectomy?

The lamina is the bony roof of the spine overlying the nerves. Laminectomy is the removal of this bony roof to release pressure on the nerves that are being compressed. This is a common and highly effective procedure to treat spinal stenoses that are causing severe symptoms.

What is a Prolotherapy?

Prolotherapy (“Proliferative Injection Therapy”) involves injecting an otherwise non-pharmacological and non-active irritant solution into the body, generally in the region of tendons or ligaments for the purpose of strengthening weakened connective tissue and alleviating musculoskeletal pain. Dozens of studies show benefits of prolotherapy for people with chronic pain, as well as those with sports injuries.

 

Dr. Yoo does not personally perform this method of treatment.

What is degenerative disc disease (DDD)?

This is a term applied to a disc space that has undergone a lot of wear and tear most commonly from aging. It can be seen in younger patients if they have had active lives such a professional athletes or if they are genetically predisposed to developing early wear and tear of their spine. DDD can cause back pain and may need to be treated with surgery.

What is INFUSE™ Bone Graft and how does it compare to the natural protein in my body that helps bones to grow?

INFUSE™ Bone Graft is exactly like the natural protein in your body that helps bone grow and cannot be rejected by your body.

What is lumbar instability?

Instability is the inability of the spine to tolerate normal daily stress applied to the spine without causing pain, changes on x-rays and or leading to some deficit. Instability can arise from herniated discs, degenerative disc disease, or trauma. A detailed interview and a careful examination by a spine specialist with appropriate imaging studies will determine if you have lumbar instability. This is a condition that will more likely than not require surgical treatment.

What is spinal stenosis?

As we get older our bone, joints and ligaments degenerate. They tend to break down, get inflamed and try to repair themselves often inadequately and inappropriately. This leads to bone spurs, overgrown joints, and fattened ligaments. The same thing takes places in our spine leading to the nerves and the spine becoming over time slowly compressed and pinched. This can lead to you developing pain, burning, weakness, and loosing control of one or both of your legs.

What is the difference between a herniated disc and a bulging disc?

Bulging disc can be considered a mild variant of a herniated disc or the precursor to a herniated disc. A bulging disc is a small protrusion of disc that is most likely still contained in the covering of the disc and often so small that it does not cause any symptoms. A herniated disc can be considered a disc that has bulged out so much that it causes symptoms or has actually ruptured out beyond coverings of the discs and often cause symptoms by pinching nerves.

What is the treatment for herniated discs?

The majority of herniated discs do not need surgery. There are many alternative non-surgical therapies to help with pain from a herniated disc. The following list will start from the least risky and least invasive non-surgical treatments to the most risky and invasive ones.

 

  1. Cold or hot compresses
  2. Over the counter medications and prescription steroids and narcotics
  3. Physical therapy
  4. Chiropractic, acupuncture, massage or prolo-therapies
  5. Spinal injections

What is the treatment for spinal stenosis?

Not all spinal stenosis leads to symptoms requiring treatment such as surgery. However, if you have symptoms, you can undergo some of the conservative treatments such as pain medications, physical therapy, spinal injections or other alternative treatments to avoid surgery. You must remember, however, that these measures cannot reverse the aging process of the spine and usually only provide temporary relief. And if you have moderate to severe symptoms you should consult a spine surgeon so that you can make an informed decision about your condition as to whether you should have surgery. There is a simple surgical procedure that is highly effective for symptoms of spinal called lumbar laminectomy.

What keeps INFUSE™ Bone Graft from growing bone in other places in my body?

This is an unfortunate complication with this material. This can be avoided by placing the INFUSE™ Bone Graft carefully inside of cages and away from vital structures such as nerves.

When is surgery necessary for patients with spine problems?

You need surgery for your back if you have the following two conditions. One, you have tried conservative treatments over the course of 3 to 6 months and continue to have symptoms that are difficult to tolerate. This is most true if one of your symptoms is weakness that persists or is getting worse. And two, if all the reports such as X-rays, CT scan, MRI and EMG studies show abnormalities that correlate with your symptoms.

Why do some surgeons approach the spine from the back and others through the abdomen?

It is a matter of preference but there are some good reasons for either approach. Some surgeons believe that being able to take out almost the entire disc from the front through the abdomen and having a greater surface area to fuse gives the best results. Going through the abdomen also does not put the nerves in the back at risk of being injured. However, most patients’ problems cannot be solved with only a front procedure but requires a back procedure as well. Other surgeons believe that the fusion and the decompression of nerves can all be done from the back. Therefore, they believe that going from the back avoids the risk having to perform a front and back procedure. Going only through the back also avoids injury to the bowels, urinary tract, and the sympathetic nerves so important to sexual organs.

Why is my doctor using a sponge with INFUSE™ Bone Graft? What will happen to the sponge, will my body adsorb it like suture?

The sponge is necessary to hold the INFUSE™ Bone Graft in place. The sponge will be absorbed by your body like an absorbable suture.

Will fusing my spine cause damage to adjacent areas?

Possibly. The unfortunate consequence of developing such good techniques and excellent implants that make successful fusion more and more possible is that all the stress from the motion that the fused disc space used to experience prior to fusion now must go to the level above or below. This can accelerate the wear and tear of the lumbar spine at other levels such that you may need second surgery to fuse that additional level.

Will I have to have physical therapy? If so, for how long?

Yes. After you have recovered adequately which will be about 3 to 4 weeks, you should undergo physical therapy for several weeks. This will help you in your recovery to strengthen your back and body. It should be a part of a successful recovery for any lumbar spine surgery patient.

Will I have to take medication for pain? Are there any medications I should be concerned about?

Yes. You will have pain more so earlier on in your recovery phase that will require pain medications. Most patients are able to wean off of the narcotic pain medications over several weeks. Many patients will need some pain medications albeit in small doses for long time and maybe forever. One class of pain medications that you should avoid if you are trying to fuse for up to six to eight weeks after surgery are the class of drugs known as non-steroidals such as Advil, Motrin, Alleve, Naprosyn, ibuprofen, toradol, etc. You should also not be given any steroid containing medications unless you are already taking them for such conditions as asthma and COPD.

Will INFUSE™ Bone Graft cause any side effects?

Two major side effects can occur. One, bone may grow so well that bone may grow into areas that will cause pinching of important structures such as nerves. Two, INFUSE™ can cause a lot swelling in the surrounding soft tissue but this is rarely a problem in the lumbar spine.

INFUSE™ Bone Grafts

 

How is INFUSE™ Bone Graft made?

The INFUSE™ Bone Graft protein is manufactured in a laboratory. It is placed onto the sponge in the operating room and allowed to be absorbed by the sponge for at least 15 minutes prior to placing it into the patient’s body.

How does INFUSE™ Bone Graft compare to the bone taken from my hip?

INFUSE™ Bone Graft is a soft sponge like substance that does not offer any structural support. Therefore it must be placed inside of or around a cage-like graft. As for the ability of INFUSE™ to stimulate bone growth, if will act like your own bone if not better.

If my doctor uses INFUSE™ Bone Graft will I get as strong of a fusion as if he used a bone graft from my hip?

It is very likely that your fusion with INFUSE™ Bone Graft can create a fusion as strong as graft from your hip.

Is INFUSE™ Bone Graft the same as the natural protein found in my body?

INFUSE™ Bone Graft is exactly like the natural protein in your body that helps bone grow and cannot be rejected by your body.

What is INFUSE™ Bone Graft and how does it compare to the natural protein in my body that helps bones to grow?

INFUSE™ Bone Graft is exactly like the natural protein in your body that helps bone grow and cannot be rejected by your body.

What keeps INFUSE™ Bone Graft from growing bone in other places in my body?

This is an unfortunate complication with this material. This can be avoided by placing the INFUSE™ Bone Graft carefully inside of cages and away from vital structures such as nerves.

Why is my doctor using a sponge with INFUSE™ Bone Graft? What will happen to the sponge, will my body adsorb it like suture?

The sponge is necessary to hold the INFUSE™ Bone Graft in place. The sponge will be absorbed by your body like an absorbable suture.

Will INFUSE™ Bone Graft cause any side effects?

Two major side effects can occur. One, bone may grow so well that bone may grow into areas that will cause pinching of important structures such as nerves. Two, INFUSE™ can cause a lot swelling in the surrounding soft tissue but this is rarely a problem in the lumbar spine.

Neck Pain

 

Are bulging or herniated discs normal?

Bulging or herniated discs are not normal if you think that a normal neck is a completely healthy neck without any changes of aging. Bulging discs and even herniated discs are fairly common. So these things can be seen in the necks of patients without any symptoms. You and your herniated disc will only be in need of medical or even surgical treatments when they cause symptoms at which time they can certainly be called abnormal.

Are there alternative therapies available to help me deal with my pain?

There are many alternative non-surgical therapies to help with neck pain. The following list will start from the least risky and least invasive nonsurgical treatments to the most risky and invasive ones.

 

  • Cold or hot compresses
  • Over the counter medications
  • Physical therapy with cervical traction
  • Chiropractic, acupuncture, massage or prolo-therapies
  • Spinal injections

All the above therapies will benefit each individual differently and the success of these treatments depends mostly on what is wrong with your neck. And you should always have alternative therapies in consultation with a physician especially the more and more risky they become.

Does whiplash cause herniated discs?

Whiplash or trauma does not usually cause neck herniated discs. What is more likely to happen is that the already non-symptomatic neck disc bulge or herniation that you already have will become bigger or become symptomatic after a whiplash injury. Discs in the neck most commonly herniate when already weakened and aged disc simply undergo normal daily movement usually with upward motion of the arm. For instance, some patients developed herniated neck discs by reaching up for the soap in the shower.

Should I have a MRI if I have pain?

MRI should not be ordered for anyone with neck pain. If you have had trauma, you should first have plain X-rays of your neck and maybe a CT scan if the X-rays are inconclusive or suspicious for a fracture. If you did not have trauma, you should first be evaluated by a physician or his staff prior to having an MRI. If you have pain radiating down your arm then an MRI should be ordered.

What can I do to avoid surgery?

In order for you to avoid surgery, you should try to keep your self as healthy as possible and avoid activities that cause significant wear and tear to your neck. This is easier said than done as any normal daily activities lead to wear and tear of your neck and puts you at risk for disc herniation. More severe neck spine problems, however, are seen in people who have been overly active such as professional athletes including skiers, horseback riders, etc. Lastly, some us are genetically predisposed to having herniated discs or neck problems. But all is not gloom and doom because only a very small minority of patients that have neck herniated discs need surgery. Most patients either do not have symptoms or only mild symptoms, which can be treated successfully with a host of other conservative measures.

What causes neck pain?

There are many different reasons why one can have neck pain. It can be as something as simple as muscle strain to something as serious as broken neck from trauma. The most common reason for neck pain probably falls into the catchall group of conditions called musculoskeletal injury whereupon a person has caused strain to the musculoskeletal support of the neck. This is probably self-limiting and should go away with short time and conservative treatment. It is when neck pain does not go away within matter of days or if you have pain running down your arms, you should seek the counsel of a doctor.

What is a herniated disc?

The disc is the soft non-bony structure that sits between each vertebral body and serves as the joint between the two vertebra allowing movements in the neck. It also acts as a shock absorber and bears the weight of our heavy heads. A disc herniates when there is a weak point on the outer coverings of the disc that may crack, open up and allow some disc material to protrude out of the contained disc space. This can lead to pinching of a nerve or the spinal cord.

What is the difference between a herniated disc and a bulging disc?

Bulging disc can be considered a mild variant of a herniated disc or the precursor to a herniated disc. A bulging disc is a small protrusion of disc that is most likely still contained in the covering of the disc and often so small that it does not cause any symptoms. A herniated disc can be considered a disc that has bulged out so much that it causes symptoms or has actually ruptured out beyond coverings of the discs and often cause symptoms by pinching nerves or the spinal cord.

Neck Surgery

 

What effect does a fusion have on the rest of the cervical spine?

Fusion helps with neck pain but it has a bad side effect in that the stress from motion that the fused disc space used to experience prior to fusion now must go to the level above or below. This can accelerate the wear and tear of the cervical spine at other levels such that you may need second surgery.

Is a plate necessary? Will I set off metal detectors?

Plate is not always necessary but the use of the plate has provided us with two distinct advantages.

 

1. Using a plate increases the fusion rate by a few percentage points by holding the bony graft in place and not allowing it to come out.
2. The plate serves as an internal brace so that the patient does not need a collar after the surgery, A collar can lead to weak neck muscles from not moving the neck and could set up for future neck injuries.

Should I have allograft or autograft bone?

Now days we have good allografts and bone stimulating proteins such that fusion rates are reaching almost 100%. Therefore, you do not need to have your own bone such as from the hip unless you are a heavy smoker. In this case, I would recommend that you have your surgeon use your own bone as well as bone stimulating proteins.

When do I need a fusion?

You need a fusion of your neck when all of the disc or much or the entire vertebra in your neck need to be removed to relieve the pressure on your nerves and your spine. Not all surgeries of the neck for herniated disc need to be fused. There are certain conditions that could be treated without fusion. You should talk to your surgeon about neck spine surgery without a fusion.

When do I need surgery?

You need surgery for your neck if you have the following two conditions. One, you have tried the above conservative treatments over the course of 3 to 6 months and continue to have symptoms that are difficult to tolerate. This is most true if one of your symptoms is weakness that persists or is getting worse. And two, if all the reports such as X-rays, CT scan, MRI and EMG studies show abnormalities are able to explain your symptoms.

Why is surgery often done through the front of the neck?

This is the easiest and safest route to get to a herniated disc. Some disc herniations can also be reached safely from the back of the neck as well but many disc herniations are impossible to remove from the back without too much risk for injury to the spinal cord.

Will I have irreversible damage if I delay surgery?

 

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It is hard to say if you will have irreversible damage if you delay surgery, but clinical experience shows that the longer your nerves or spinal cord is compressed, the less likely surgery will be successful. For nerves in the neck part of the spine, some clinicians report and I happen to agree that if you have significant pain, numbness or weakness at 3 months after the symptoms started that you should consider surgery seriously.

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