Injuries and skiing - Cervical Vertabrae Fusion

[skibug]

 I read often and post sometimes at this site; so, I know there are a lot of serious skiers here.  I hate dumping any personal issues on everyone out there; but, I was wondering if anyone out there has had Anterior Cervical Discetomy and Fusion (ACDF) surgery, succesfully recovered, and continued skiing.  My neurosurgeon is recommending the surgery due to a bulged C5 disc that is compressing my spinal cord. The compression is causing numbness in my legs, fingertips, and bottom of my feet.  My motor skills are gone.  It is all I can do to walk without looking like I am drunk.  Can't run or balance to save my life.  I fear my skiing days may be over.

[skibug]

Nope, no pain; but, barely any coordination of my muscles from my waist down.

[ktm300]

I have C5 and 6 fused together.  However, my body fused em not a surgeon.  X rays revealed old compression fractures of the vertebrae.  My body's response was to fuse them.  Solid bone.  I remember when I did this.  Some well meaning skiing know it alls told me to pull harder.  That is about the only advice that I got for some years.  Out the fronts hard enough to break my f*(&) neck.  While I am unsure of the strength of the hardware in a surgical fusion, I think that you will be able to ski again.  I would also consider seeking out alternatives to surgery.   How long have you been symptomatic?  Neurosurgeons tend to think surgery is the answer and they are often correct.  However, the physiatrist from whom I sought help with my neck said that there is a growing body of evidence that fusion surgery is not always the best option.  The fact that your disc is not herniated is good.  Perhaps targeted physical therapy focusing on some cervical traction?

 I hope it goes well for you.  If you get back on the water, spend money on good coaching.   I can run passes now with about half the energy recommended by the well meaning know it alls.   You may have this figured out already but slalom skiing is a dance not a tug of war.  The dance falls are manageable, the tug of war falls can break your neck or otherwise maim you.  You can learn more in 30 days of skiing with a good coach than you can skiing a decade with well meaning but ignorant skiers.  Sorry if this is all something that you know but, at one point I sure didn't and have suffered for the ignorance; hence my sharing this with you.  Good luck.

[skibug]

KTM300, thanks for the info.  I have had the symptoms for about 2 months, not sure what I did.  I have learned to read my own MRI's so I can see what the docs are talking about.  It is great that you can get the MRI's on disc and they are self extracting executable packages for viewing the images.  I can see the area of compression on the spinal cord.  I am going to an orthopedic spine surgeon for a second opinion on Monday.  Just so happens he studied under some doctors who were some of the first to do artificial disc replacement as opposed to fusion.  We shall see what he says. 

[Thomas Wayne]

 

You might also want to research "chemonucleolysis" - ( http://medical-dictionary.thefreedictionary.com/chemonucleolysis ) - I don't know if it's applicable to cervical vertabrae, but it is touted as a viable alternative to fusion in other areas of the spine.

TW

[skibug]

TW, thanks for the information.  I have read up on this procedure.  I was planning on discussing it with the doc; but, what I read scared me a little bit about the inherent risks and benefits associated.

[Thomas Wayne]

 

Like anything else of this nature the best you can do is research it throughly, get multiple professional opinions, determine who the top guy in your price range is, and then trust the rest of your life to him.  The first lesson they teach in medical school is: "God heals the patient, but the physician collects the fee."

TW

[eddie_roberts_jr]

I had to have C5 and C6 fused with a hunk of my hipbone back in '93. Anterior laminectomy is what they called it. I don't think I had many options at that time as I had herniated the disk. MRIs showed that the spinal cord was pinched down to 30% of its original diameter. I still ski, but a bit more carefully.

[auskier]

sorry for the slightly off topic post but anyway..

Has anyone had any sacro-illiac pain from skiing?  For whatever reason it flares up now and then to the point where i cant take any load and hold a half decent position behind the boat. Even doing a deep water start hurts! First set today i couldnt even run my opener.. 

Seeing a Physio and probably get a massage this week, see what they say...

[RichardDoane]

I suffer from S I problems from time to time. My sacrum joint will feel "stuck" and I won't be able to stand up staight, or get my hips "up". Core strengthening has really helped, and the massage practitioner is a must.

[skibug]

Bruce55, thanks for all the feedback.  Lumbar puncture - NO; EMG/NCV- YES = negative, MRI of Lumbar (w/contrast) and Cervical (no contrast); but, no Thoracic.  Lumbar showed mild stenosis at L2-L3; but, deemed normal.  Cervical showed stenosis at L5-L6 disc compressing the spinal cord; this is where the neurosurgeon says I need the single level fusion.  I am going to see an Orthopedic Spine Surgeon tomorrow for a second opinion.  He did his fellowship under a doctor who helped pioneer cervical disc replacements (Bryan disc); so maybe he will have some better answers/insight.

No loss of musclature, I am still working out as much as I can; I just have to alter some of my routine to accomodate the lack of coordination.  I can still do my cardio on an eliptical; it is just more of a robotic motion that the normal smooth motion and I can't let go.  No tremoring or spasms.

I am 38, in pretty good cardiovascular shape as well as better than average strength (one of my downfalls when it comes to skiing because I tend to muscle it when I get in trouble).

[skibug]

Bruce55,  EMG was about 6 weeks ago; which was 4 weeks after the symptoms started.  The compression of the spinal cord is from the anterior pressing towards center; with a slight favoring of the left side.  The research I have read on the clinical trials of the disc replacement show quicker recovery with better anatomical resemblence of the natural disc.  It also does not put stresses on the adjacent discs.  Can't stand on one leg for any length of time (i.e. maybe 3 seconds) without losing balance.

The neurosurgeon was very quick to say I need the surgery and there was no other course of action that would apply.  I asked him repeatedly about other options; but, his response was the same.  He did suggest to get a second opinion; so, that is what I am doing.  Your suggestion of an MRI of the Thoracic is one I will ask about tomorrow. 

 I do emphasize to my doctors that I participate in a competive form of waterskiing that is very strenuos with a high probability of impact to the head and body.  I may take you advice and show them a video so they can understand the level of recovery I am aspiring.

[Roger]

I had c5-6, c6-7 fused with hip bone in 1996 (42 years of age at the time). My PB at the time was 2 @ 32 off. My current PB is 2 @ 38 (4 @38 in practice) if that gives you hope. The doctor said I could do anything I did before since only two disks were involved. I ski with a girl who had C4-5, 5-6, 6-7 fused and a plate screwed in place. She is in Women 4 and averages 2 or 3 @35 and has skied into 38 several times since her fusions.

My advice is get more than one opinion (make sure you actually need a fusion vs. theropy). If you decide to proceed, do research on who is the best surgeon for the job. Besides the web, asking Nurses at the local hospitals will usually result in the same Doctor's name coming up over and over; use that guy if you can.

These days, it's rare to fuse with hip bone as cadaver bone is now of such good quality and readily available. My surgeon just did the same fusions on my brother and used cadaver bone where on me he used by hip bone.

Keep us posted!

 

[skibug]

Roger,  Thanks for the feedback, it lends encouragement and comfort to know if I have to have the surgery; i can go back to my regular activities.

I saw the ortho spine surgeon today; he does not concur with nerosurgeon's recommendation of fusing my c5-c6.  He says (and explained to me his rationale while we viewed the MRI's together) that the amount of compression does not concern him; especially in regards to the problems with my legs.  He has ordered an MRI of the thoracic spine just to cover all areas.  The nuerosurgeon did not go over the reports or view the MRI's with me in person.

[Roger]

One thing is for sure, c5-c6 would effect your arms, not your legs...

[Roger]

I now know 5 people who have had this surgery and none of them (or me) had leg issues. However, my doctor tells me my sample group is too small and that you are correct, so I stand corrected :)

 

[skibug]

Bruce55, The ortho spine surgeon did explain to me the difference of what you have stated and found no evidence of lesions or tumors.  In his opinion, all looked relatively normal with a slight anterior bulge, off center to the left, causing slight stenosis; but, nothing he would attribute to the probelms with my legs.  He further explained, after he ran some physical examinations, that the results of the exam did not present any evidence to leading him to the c5-C6 disc bulge being the issue.

Thanks again for all of your gentlemen's input.  It helps me to gain some perspective and make sure I am heading down the right path.  

[rawly]

Skibug,

  Did you get the surgery?I've seen you on the B.O.S.,so I figure you're still skiing.I have what the doctor considers severe cervical spinal stenosis,and he is recomending laminoplasty surgery.I am getting a second opinion to make sure that is the right way to go.My symptoms aren't as bad as yours were.I've just got the numbness,slight loss of balance,and loosing dexterity in my hands.The worst part is when the Dr. said no skiing for a year.Lets hear how your story ended.

   Thanks   Steve

[rawly]

Thanks for the reply Skibug.I'm going to get a few more medical opinions before I go ahead with a surgery.I'll give the ortho spine surgeon a shot.Glad you're doing well.And I will keep skiing in the forefront,it might be the offroad motorcycle racing I'll give up.That will give me more ski time.       Thanks

[gates n 1]

Rawly......sorry for being "late to the party". In '05, I was having some pain down my arm, and problems sleeping. I continued to ski 4 days a week, until the end of the season....I was 53 at the time. When I finally got to see a neuro, he diagnosed that a c4-5 fusion was necessary, and pointed out that I had lost nearly all of my left tricep, and most of the muscles around my scapula. Had the surgery, and after 4 months of HEAVY pt, got back about 50-60% of my strength. Started skiing about 6 months later( mostly just hanging behind the boat). It took that season, and most of the '07 season to regain the lost musculature. The neuro thought I was a lunatic for continuing to ski, but I think that position is due, in large, to the physical condition of the average guy my age, with little/no cosideration to the physical conditioning of water skiers. My advice......You don't want to be 80 yrs old, thinking back and wondering if you could have continued....

Good luck

[gates n 1]

Sorry again.....my previous post was meant for Skibug

 

[skibug]

gates n 1,

Thanks for the response.  I am sure the neuro surgeon was wrong and the ortho spine surgeon was correct.  All of my symtoms have subsided except a little bit of my balance issues.  The symtoms were coincidental and the unfortunate results of some other medical issues and treatments.  I have been back skiing since July 1st after some time and intense PT.  I am not back to 100% (I would call it 90%); but, that is a lot better than where I was earlier in the year.

[ToddL]

So, I am just now reading this thread...    I have AS (Ankylosing Spondilitis) - or arthritis of the spine.   It was diagnosed in my late teens.  It started off as deep hip pain that was related to unspecific movement (movement from any single static position to a diff static position).  SI joints were the root cause.  Severe inflammation and eventual fusion.   Thankfully, drug treatment has been sufficiently effective to avoid the "bambo" spine level of fusion.   I took all sorts of NSAIDs, but about 5 years ago I started on Embrel (1/wk self injections).   Before the pain was manageable, but always there.   Now, the pain is gone.  Embrel stops the chemical triggers of inflammation way up stream... so much so that future calcification and fusion are completely prevented.   Once the pain went away, I started realizing that my limited range of motion wasn't just guarding and inflammation.  Today, I have limited range of motion by about 10-20% of normal in all directions, but no fusion in my lumbar or thoracic spine.   However, my cervical spine's facet joints have arthritically fused in several locations (C2-3, C4-5, and C6-7).   I can turn my head 45 degrees to each side, barely look up, and tilt about 40 degrees.   I can look down fully.  There's no pain.  Rather, when I turn or tilt my head, it just stops sooner than normal.   

My doc said, stop skiing.   I said no.   I ski with a Scarpa Bull Collar to further support my neck and minimize moving beyond my limited rang of motion, and I throw the handle often.   I love skiing and still aspire to one day get past 35 off (currently struggling in the deep 28 off range).   I ski smart, safe, and live to ski another day.    For you guys with SI joint pain, ask your doc about AS.  If I could have started on Embrel sooner, I may have never had the cervical fusion.   

[h2odawg79]

Wow, there is some REALLY Great info in this thread... I broke my back in 2001. (compound comp. fracture t-10 vert.) it has certainly altered everything I do physically. It even complicates or aggravates other isues at times...

Last May I got yet "another" (happens A LOT) Spasm in my Rt. scapular region and that turned into a second spasm that further aggravated a degenerative problem with my C5-6 verts. I lost a lot of strength and motor skills in my Rt. Tricep, arm and fingers. I spent the 4th of July wk. on vacation at the Lake and could not ski! The nerve pain from these was as debilitating as the Numbness @ times.

I went back to the course on Labor day and just shadowed buoys. After 2 mon's of Chiropractic and enuf Nasaids to need a Liver transplant, I'm still not perfect. But, a lot better... Apparently, these cervical problems are very common for athletic types in there 40's from prior assaults in their past. I really need some imaging and proper diagnosis. But, $$$ is very short and ded. + 20% is very expensive... (I have a slight numbing even as I'm sitting here and typing...)

Thanx to all those above who took their time to add to this post! -Great info!    

[dvskiing]

Ski Bug I too am late for the party.   I just finished my second surgery in 3 weeks.  My symptoms started in Feb as neck pain, followed soon after with no use of right tricep.  Both symtoms I had 7 years ago and never stopped me from skiing.  It went away after some alternative treatments.  This time within a week I was unable to open  a pair of sissors or lift my fingers, I was freaked out.  Went to the first ortho after a MRI he wanted a 2 level fusion a week into it.  Second opinion from a respected nuro was he did not see enough damage in my MRI to justify a fusion and definately would not commit to being able to correct the problem.  I finally got to the right doctors 2 emgs and a ct scan before they had a plan.  First was ulner nerve decompression and second was a 2 level laminectomy c7 &c8 nerve roots.  Had improvement after both.  I know several people with multiple level fusions that are doing great.  However, new school is moving towards artificial disc which have an easier recovery etc.  As of now they are only approved single level in the states, but Europe blogs show that multi level has been going on for awhile and it is only a matter of time before we catch up.  My ortho doc has done several and was willing to clean out 1 level and do an artficial disc on the other.  I lucked out for now and did not need hardware.  Hope you are doing better. 

[ForrestGump]

My long time ski partner had a bad head on wreck 8 weeks ago.  After 3 weeks he was able to ski again for a week. Then he started having loss of muscle strength in his left tricep. Turns out he had a spinal impingement at C6-C7.  The neurosurgeons first thought was fusion. But then changed his mind and recommended a cooling off period and then PT.  He just noticed a week ago that he's got left pectoral loss of muscle control now, so it's looking like he might have some damage at the next two vertebrates also. We'll see where they go with it now. 

[6balls]

Pec, tricep and wrist extensors will ALL be hit by C6/C7 level.  While in med school I took a barefoot fall where I didn't get rid of the handle in time, forced chin to chest hard in the fall and blew the C6/C7 disc left.  After initial muscle strain went away no pain.  Was competing in bench press competitions at the time, and slowly began losing power on the left side.  Initial MRI was misread as nml, was told I would stablilize, then improve.  Continued to get weaker (hard to believe, but went from 400 plus bench presser to s'one who could barely press 135).  Went for re-eval and had posterior micro-discectomy without fusion the next day. 

Muscles fired again right away post-op, but took some real work to regain strength.  In '08 re-set the MN State Bench Press record at 440.7 lbs in the 198 lb class and ran thru 38 on occasion this year...so for time being good to go.  Prob not so good as I age.

[rawly]

Thanks for the info guys.You're not late for the party,it just moved over to Rawly's house(skibug is on the mend).I got a second and third opinion,so it looks like surgery(laminoplasty) will be taking place soon.I've actually gotten better info on this sight than on my desert racing sight where severe injuries are more common.Thanks again,hope to be skiing by next fall.Or should I change that to autumn? 

[skibug]

rawly, sorry to hear it has to come down to that; but, at least you have a path back to health and skiing again will be a major motivator.  Good luck and may process be short and successful.

[danbirch]

post deleted.

[ForrestGump]

Ease up, Dan.  This thread has nothing to do with your binding injury database and Ed O has not even posted in it. 

[danbirch]

Thanks, ShaneH. My error on the thread. I will post at the appropriate thread.

[Stevie Boy]

Auskier Ref: your sacro-illiac I suffered for three years prevents you from skiing properly, cured it with really good acupuncture and inversion table, worked for me.

Regards

[RichardDoane]

stevie boy - what type/style/brand of inversion table did you get ?  I've had an SI issue for years (working on cars for the past 25)

[Stevie Boy]

Hi Richard, not sure of the make I brought it off of ebay for little money, if you do get one, go easy do not fully invert straight away, start off with around 45 degrees, slowly move around a bit its not recommended to just hang for long periods, try laying on the floor arms out like a crucifix, bring your knees up and rotate both knees together to the left 20 times and then to the right, try and keep your arms and shoulders flat on the floor, this should release the small muscles close to the spine that have tightened up (popping or clunking when releasing) this should help release tension in the sacro-illiac ( I,m not a doctor but I continue this exercise everyday and especially after skiing . it has helped me)

The other thing that helped me was changing my deep water start, two feet in I used reach forward to the front of the ski ( which overstretch my lower back) and pull my hips forward once the ski was on the water, my method now is to bend my knees place my hands level with them, keep my back straight, and let the boat pull me onto the water and then stand, pretty basic stuff but it takes the strain away from the sacro-illiac.

Hope some of this maybe of some help, I know how frustrating it can be, for me it was particulary awkward to get position and take the load on the offside.

Regards Stevie Boy 

 

[rawly]

Had the surgery last week,everything went OK,now for the long healing process............Richard,if you get the table,try to get the inversion boots.Without them your feet really hurt.And if you have lower back problems,don't do the sit-ups while inverted.That is the worst back pain I have ever given myself.

[h2odawg79]

rawly, Hope you heal well and sooner then later...http://www.ballofspray.com/vanillaforum/js/tinymce/jscripts/tiny_mce/plugins/emotions/images/smiley-smile.gif

[gates n 1]

Rawly

 Hope your surgical discomfort is already gone, and you're on your way to the re-hab dance. As for the length of time before you can ski again, remember that most doctors make these recommendations based solely on the average physical condition of those in your age group. As a slalom skier, you are NOT the average. We are all far stronger, bodily, than any group a doctor is likely to have experience with. Therefore, you should blend his advice with your own intuition as to when to start skiing again. When you do begin you might do as I did, and do about a month of  " hangin' behind the boat " skiing. There, you can work on arm pull-ins, squats and back-muscle exercises to gradually increase your strength and endurance. Of course, this advice comes complete with a disclaimer; these are the views of an addict, and should be considered as such.

Get well soon..........and SKI !!!!

[rawly]

Thanks guys,good points Gates.As stated,if you take a good look around the docks,you notice very fit people of all ages.Maybe my season will begin before the end of summer.As of now,I am 5 weeks post surgery,most of the pain is gone,my symptons have been cured,and I can finally drive my car.Awesome sight,thanks for all the advice while I was walking through the fear.

[h2odawg79]

Rock on Rawly! -the worst is behind you... and the Future is looking Better everyday!

[rawly]

Ral, Figured I'd bring this thread to your attention.Lots of good stuff from our waterskiing buddies.As far as me,I got back to skiing with a barefoot brace after 8 months.

[ral]

Thanks for that!