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Getting rid of the pain in my neck

Posted: May 16, 2014 10:28 a.m.
Updated: May 19, 2014 5:00 a.m.

Since the end of August, I have been the pain in my own neck. I suffered whiplash at that time, aggravating a pair of already bulging discs that had bothered me the year before. I’ve been in pain ever since.

About a month later, I wrote a column warning of the dangers of acetaminophen dosages. I did so because Tylenol and its generic equivalents are about the only thing I can take to deal with the pain. Acetaminophen has a small margin of error for overdosing, causing liver damage. I’m allergic or have other negative reactions to almost every other kind of pain killer, so I have to be careful. Also, muscle relaxants certainly aren’t the answer -- think my columns are weird on occasion? I don’t think any of us want to see what I write while on those.

I underwent physical therapy and then interventional radiology using steroid injections. Nothing’s worked.

So, I have two choices: put up with and manage the pain as best I can, or agree to a surgical procedure that might make more than a few of you wince.

I thought about it, consulted with my doctors and have decided to have the surgery. Just about a month from now, I will undergo a micro ACDF. That stands for anterior (front) cervical (neck) discectomy (removal of a disc) and fusion. Sounds fun, doesn’t it?

Full disclosure: I’ll be having this surgery in Florence and not here in Camden. My local doctor referred me to my local orthopedic who, in turn, referred me to a spine center in Florence that specializes in these things. They, in turn, are affiliated with McLeod Regional Medical Center. So, that’s where I’ll be.

So, how does a micro ACDF work?

Basically, the surgeon will make a small incision -- essentially a small hole -- on one side of my throat and use very small instruments to gain access to the front of my spine. He will completely remove two offending discs and any bone spurs that have resulted. Those bulging discs and possibly the spurs have been pressing on my spinal cord and/or nerves causing the pain. There’s a good chance he’ll fill the now empty spaces with artificial material or a bone graft. Either way, though, he’ll -- somehow through that small hole -- attach a titanium plate over where the discs were in order to allow that area to fuse.

I bet you’re wondering if I’ll be able to move my neck after this. Amazingly, I should only lose no more than 20 percent mobility. Right now, the amount of pain I feel from looking over my shoulder and performing certain tasks around the house has already hindered my mobility. If I lose about the same mobility but I’m pain free, the surgery’s worth it.

Very early one Friday morning in June, I’ll check in to the hospital. I should be under about two hours later, the first surgery on the doctor’s schedule. The surgery can last between one and three hours. Going in so early should keep my hospital stay to only one night. After that, I’ll take a week off to recover at home (I won’t be allowed to drive), but should be able to return to work the following week.

I’ll wear a neck brace for about a month, perhaps longer, to ensure my spine stays in the proper alignment and fuses properly. It’ll be very interesting to see how I handle taking a shower and driving a car while wearing it. I’ll likely end up back in physical therapy for a while to help strengthen the surrounding muscles.

Are there risks? Of course. There’s a minimal chance of nerve damage, causing numbness or even paralysis. My research shows that rarely happens. Sometimes the vertebrae fail to fuse -- unlikely in my case, since the usual cause for that is smoking. There’s a chance the fusion will stress out the discs and bones above and below the ones being fused. I’ve been told some patients require additional therapies, perhaps even additional surgeries, to deal with those as they age.

The most immediate side effect, aside from whatever loss of mobility I may experience, is hoarseness and difficulty swallowing. My surgeon joked during my first visit several weeks ago that I probably won’t feel like eating a porterhouse steak afterward.

I guess I can look forward to a lot of smoothies, Jell-O, butterscotch pudding and soup. Actually, I haven’t been told exactly what I can and cannot eat yet. Maybe, if I’m real good, I could have pasta and shrimp alfredo.

The really good news is that the rate of success is pretty high.

Although I don’t have much pain in my arms, ACDFs relieve arm pain associated with this type of problem in 92 to 100 percent of patients. Neck pain is relieved in 73 to 83 percent of patients. That’s still a very high percentage and, since all my neck and upper back pain is being caused by the bulging discs, I have every expectation this will work.

The goal is to be pain free for the first time in more than nine months. If I can achieve that, even with my neck being less mobile than before, I will consider the surgery a success.

I’ve always felt that writing about my own life has the potential to be helpful to others. That’s not hubris speaking; it’s a simple fact of human existence that we rely on others’ experiences to help make decisions about our own lives.

ACDF is not for everybody. As one website I used for my research put it, most cases of cervical pain don’t require surgery. But, if your neck, upper back and arms are in real chronic pain, this might be an answer. As always, talk to your doctors and explore your options. If you can avoid surgery, do so, but don’t rule it out, either.

I’ll let you know how things turn out.

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