Good evening, friends. I have had two appointments with neurosurgeons over the past two days. I had mentioned the first surgeon I saw, a week ago, suggested I do posterior cervical fusion from C2-T1. See my original post here: Getting Old Isn’t For Wimps. I saw him again yesterday, and he corrected me. The fusion he was proposing was from C2-T2. So even more invasive. I inquired about getting other treatments like artificial discs, physical therapy, injections and ablations. He immediately said he didn’t do artificial discs, but I could try injections and physical therapy. But he stressed that they would only delay the inevitable.

Today, a different neurosurgeon examined me and reviewed my MRI results. He is a very reputable surgeon in Nashville and was even in charge of the neurosurgery unit at Tristar Health. Interestingly enough, I was also seen by his PA before I saw him. The PA remained in the room for nearly 90 minutes. They did the same motor skill tests and asked the same questions as the other neurosurgeon. But the surgeon and PA both suggested they start with a less invasive surgery: anterior cervical fusion, laminectomies and decompression using artificial discs – fusing C4-C7. While no one wants their neck opened up, this is a far less invasive surgery. And as this image shows, there is way less hardware (aka a CAGE):

After being told this, I told them what the first neurosurgeon wanted to do:

I could tell he was a bit surprised, but after thinking about it a minute, he said, “That’s a good surgery and I have done hundreds.” He went on to say that this is like making a Hail Mary pass to win the game when you have plenty of time on the clock – in so many words. Essentially he didn’t believe this approach balanced the preferred outcome with the risk (reducing the pain to a manageable level while protecting the spinal cord). This procedure leaves the spinal cord exposed on the back of the neck and doesn’t leave many options for revisions. The patient is stuck with all that hardware forever. And if the symptoms come back there is not much which can be done to help.

The surgery he is recommending will:

1. Have less recovery time since he won’t have to cut through all the muscle structures on the back of the neck
2. The patient loses less neck motion
3. You can go through airport magnetometers without the police being called (I am joking!)
4. There are opportunities to do additional revisions at later times

I believe this surgery is what I will choose to do. I like the approach being balanced and not being the irreversible Hail Mary out of the starting gate. I have an appointment with a third neurosurgeon in two weeks. I like this physician and will probably have him do this surgery. But I also believe that one can’t go wrong with multiple medical opinions.

The Original Grey Beard Biker™
Email: gbb@TheGreyBeardBiker.com
@AlchemyShootist on X