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Questions for the Neurosurgeon before I sign up for surgery

This is an interesting time, because a lot of elective surgeries are going to be postponed due to Coronavirus. I believe my option for surgery that I was given, is elective (replace 2 discs in neck due to severe and moderate stenosis). That being said, I have follow-up questions with the neurosurgeon and wondered if it is out of line for me to ask if I can due a "Teledoc" with him rather than come in for the appointment since it's not somewhere I *need* to be. As for my questions, I have the following, and wondered if anyone can chime in with some of their own that I may have missed:

1. Why are we replacing these discs?

2. Do they both get done at the same time?

3. Is this surgery considered a fix or just to slow the progress?

4. Will it keep me where I'm at today with my symptoms or will it improve/resolve them?

5. What is the success rate and your success rate of this surgery?

6. How long is recovery time?

7. What hospital is this procedure done in and how long is the stay in the hospital?

8. How long does the surgery take?

9. How long before I can go back to driving and all my other normal activities (physically active a lot in yoga, hockey, hiking, etc.)

10. Will I have full range of motion with the movement of my neck after surgery?

11. What will out of pocket cost of surgery be and how much does insurance cover?

12. Do I risk any paralysis with this surgery?

13. Do I risk any damage to vocal chords with this surgery?

14. How do I start the procedure to get this surgery scheduled?

15. How long do I have to decide if I want to proceed with this surgery?

16. Do I need another MRI if I wait too long?

17. Are there any medications necessary and how do they affect the liver? (I have liver disease)

18. Can I take my normal medications immediately after surgery is done?


This is all I have for now, please please feel free to list anything I may have missed so I can ask the neurosurgeon. 

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Comments

  • Sounds like a well thought out list of questions to me.

    Chip

  • memerainboltmemerainbolt IndianaPosts: 4,169

    There may be a few in the link below to help you out.

    Questions to Ask Your Spine Surgeon Video

    Sandra


     
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  • Thank you all for the suggestions. I have about 25 questions to ask now, but some may get answered in other questions I ask so it may reduce. I actually am able to get in with a "Televisit" because they are not taking any in person visits at this time unless it's an extreme emergency. Fair enough and makes it easier for me since I only have follow-up questions and not an urgent need to be at the office (which, depends how I feel that day, could be difficult to get to with my struggle on driving because of this). If anyone can think of any more, please feel free to add between now and Wednesday. Thanks!

  • memerainboltmemerainbolt IndianaPosts: 4,169

    luckyman316

    A couple more to add to your list.

    Will I have to wear a collar? Do you recommend PT?
    Sandra

  • luckyman316 - Just had a thought, you'll likely need clearance from the doctor managing your liver condition before this surgery.  Also, you should point out your liver condition in the presurgery anesthesia interview.

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  • Thanks @stiffneck7 and yes, I will be talking to my liver doctor in 2 weeks before I proceed with anything.

  • So I got MOST of the answers I was looking for. The neurosurgeon was impressed with my ability to ask the questions and how well thought out they were. 

    -He went over my condition, basically describing to me that YES, my spinal chord is being compressed and that is happening at level C5-6 & C6-7.

    -When asked about disc replacement surgery, I could not make out what he was saying, because at first it sounded like he wanted to do a total disc replacement at these levels when I last spoke to him but now it sounds like he wants to do a fusion at these 2 levels. But I could not make out if it was telling me the discs will be removed, replaced and then a fusion. I need to ask him more but the way he described it to me is that the procedure he wants to do, would be much easier on me. He did mentioned he'd rather do 2 levels than 4, since technically 4 solves all the problems, but he said that the other discs weren't compressing on the spinal chord so he did not feel it was necessary just yet but could be considered down the road. The surgery is considered minimally invasive.

    -I asked about my neck not having it's natural curve now, and how the surgery would be with that.. would it help or would it help restore the natural curve. He said yes, at that levels he'd be working on (which have a disc out of place) it would.

    -He was very upfront and honest in telling me that I'd probably feel like someone beat me up for 2 months after the surgery but once I hit that third month, I'd see improvements and very quickly... I'd feel best at 6 months and fully healed from the inside at 12 months.

    -He could not answer if the surgery would resolve symptoms but he did say I'd be 80% better than I am today and it could be considered a fix for the problem.

    -According to him, he performs a little over 100 of these types of surgeries a year and his success rate is considered 100% since nobody has had any complications or failures.

    -My symptoms and condition is considered progressive  so he'd consider it permanent.

    -There are no real alternatives to surgery short of "wait it out and see if anything will improve or just stay where it's at". His alternative was to present another surgery going through the back of my neck, instead of the front, which he said would be more difficult to perform.

    -Recovery time would be expected to be about 2 months, and while I'd have to wear hard collar and use a bone stimulator every day, he did say I could return to driving normally in about 2 weeks and then light activity such as a light workout within those 2 months. Full recovery/heal time would be 6-12 months.

    -Normally the procedure is an outpatient procedure but, he'd still keep me there for a 1 night stay. He gave me a choice of 3 hospitals, including the one he was most comfortable with (which unfortunately is in a horrible neighborhood). However, since this surgery is considered elective, with the recent pandemic... I could not get it done for AT LEAST a month. However, I have until August to decide on this. Once August hits, I'd need another MRI but likely this would not be an issue since my condition is severe enough to warrant one.

    -He did suggest that if the condition got much worse, he could convince the hospitals to get me in within 2 weeks should I need it and at that point it's not considered elective.

    -The surgery would take 1 1/2 hours for him to perform. I asked what other staff would assist him and he said just a physician's assistant, unless one of the other neurosurgeons was available to assist but usually they are too booked up to do so. So basically it's him and one other person. Not sure how I feel about this one.

    -Regarding range of motion, he said I would not have full range of motion but I'd have better range of motion than I have today because I'm limited on that with my current condition.

    -He could not answer the question about cost, and told me to check with their billing department.

    -There is less than an 8% chance of paralysis with this surgery. He mentioned I'm more at risk for paralysis WITHOUT surgery should I let this go too long and it gets much worse.

    -There is a risk that vocal chords could get damaged, but he said they do everything they can to try and avoid that and said going through the front will be easier to move some muscles around.

    -He mentioned no medications would be necessary after the surgery, not even pain killers, just the bone growth stimulator. He did say to stay away from the anti-inflammatory stuff (including Fish Oil) as it could slow down the healing tremendously. My concern here is the medications I am for my liver, which is known to cause some bone density loss in some patients, hence why I need to run it by my doctor.

    I think I covered everything but still have questions concerns on a couple of things. The main one being about the artificial disc replacement vs fusion. If he is suggesting a fusion now, then what made him change his mind over telling me I needed an artificial disc replacement at the first appointment. Obviously the concern of 1 neurosurgeon working on me is there with only a P.A. with him, but I have more comfort knowing the success rate is 100%. And the last concern is how I react being on medications and with a liver condition (meds are for the liver condition). 

    Anyway, lots to think about over the course of the next 2 weeks to start. I'd like to get my life back to be honest. This neck issue has been hindering me for far too long.

  • Luckyman,

    Thank you for your thorough writeup.  I’m in the same situation as I need to have ACDF at C5-C6.  I was scheduled to have surgery in a few days but it was cancelled last week due to COVID19.  Your post actually cleared up a few questions that I would’ve had.  I’m just looking forward to surgery and it can’t happen soon enough!  My level of discomfort as well as anxiety is a 10/10 all of the time.   I’ll keep my fingers crossed for the both of us.

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