My Surgeon operated my 4 cervical discs in one surgery - I feel much better now.
4 Level ACDF
Spinal Stenosis had been part of XY family history for decades. Both his mother and father had experienced the degenerative condition that leads to a painful narrowing of the spinal nerve root canals and an enlargement of facet joints in the spine.
"I wasn't experiencing any signs or symptoms prior to January 2019," XY says. After a heavy day at work about one or two days afterwards, I started having severe neck pain and pain in the shoulder blades. I thought maybe I had aggravated some muscles.”
The pain continued, and about a week later XY began experiencing severe numbness and tingling in his left arm and forefinger. He scheduled an appointment with his orthopedic surgeon, who ordered X-rays
With XY seated in the examination room, the orthopedist asked him to look up toward the corner of the ceiling. "I tried," XY recalls, "but I couldn't get my neck turned enough to look up without severe pain." The orthopedist sent XY for a MRI and, the same day, referred him "right away" to India.
The stenosis in XY cervical spine was severe, causing spinal compression at four levels. A week later, XY arrived for Spine Surgery Team headed by Dr Hitesh Garg, Artemis Hospital, Gurugram. By this time, he was feeling numbness and tingling in his right leg.
Spine Team met her, discussed MRI and did a thorough clinical examination, XY was told “we need to discuss about the surgical option for treatment” said Dr HimanshuTyagi.
"That was kind of shocking, because I thought maybe they'd have me try physical therapy," XY says. "But Dr. Hitesh said physical therapy or injections would be temporary and would not do anything to fix my problem." XY was scheduled for surgery a month later at The Artemis Hospital. During the weeks prior, he took gabapentin, a medication that eased his nerve pain.
In early April 2019, over a period of about 90 minutes, Spine Surgery Team performed a four-level Anterior Cervical Discectomy Fusion (ACDF). The incision was made in the front of XY neck, reaching the damaged discs by moving aside the neck muscles, trachea, and esophagus. By operating from the front of the neck, Dr. Hitesh avoided disturbing XY spinal cord, spinal nerves, and strong neck muscles.
After removing the discs, Dr. Hitesh inserted spacers filled with autologous bone grafts and fixed them in place with metal plates and screws. Over the next several months, new bone cells would grow around the grafts, eventually joining together in solid pieces of bone.
"XY had severe degenerative changes of the cervical spine, causing not only his neck pain but also compression of the spinal cord, which is very concerning," says Dr. Tarun Kukreja, Associate Consultant, Spine Surgery Team, Artemis Hospital, Gurugram. "We like to take care of compression of the spinal cord before it is a problem. Once the cord is damaged, we cannot make it better, so we like to treat people early in the myelopathy course".
"His surgery is a common surgery, and our technique is efficient. We get in and get out in a time frame that avoids swelling and bleeding. He did very well from surgery, as most people do.”
XY felt better immediately after surgery. "When I came out of anesthesia, all the pain in my neck and back was gone," XY says. "The numbness was still there, which was expected. It may or may not ever go away; it depends on how much damage was done to the spinal nerves before the surgery. Still, it is 100 percent better and continues to improve. The numbness is definitely not as noticeable.”
XY surgery was on a Friday. He spent two nights in the hospital and was discharged on Sunday. By Monday, he was taking only tramadol for surgical pain. By Tuesday, he was working from home. He was unable to drive, of course, and he was required to wear a neck brace because of the extensive fusion.