OpenHealth Q&A

Concerns About Surgery for My Grandmother

My 82-year-old grandmother is set to undergo a laminectomy combined with fusion at her C5 to C7 vertebrae. While her surgeon exhibits a great deal of confidence, which can be reassuring, he has mentioned that she would be able to leave the hospital on the day of the operation. This seems rather extreme, especially given that the hospital is a daunting eight-hour drive from her residence. The idea of her traveling so soon after such a serious spinal surgery is troubling for someone at her age. Additionally, I’m worried that the surgeon is not taking her age into account when making these plans. He has indicated that the initial focus will be on her neck, with a possibility of addressing her back issues in a later procedure. To me, this approach seems quite demanding for an elderly individual. However, since I am not a healthcare expert, I thought it would be beneficial to seek advice and opinions from others. I appreciate any insights you might offer! I have included the imaging reports we received for further reference: **First Report** **Procedure:** MVX - XR Thoracic Spine 2 Views **Indication:** M54.6 - Pain in thoracic spine **Findings:** - AP and standard lateral views of the thoracic spine were completed. - No previous similar studies available for comparison. - Mild left curve of the thoracic spine. - Slight increase in upper thoracic kyphosis. - Heights and alignment of vertebral bodies are preserved. - Posterior structures are aligned and intact. - Moderate multilevel degenerative disc disease showing loss of disc height and endplate spurring. **Impression:** 1. Preserved vertebral body heights. 2. Mild left curvature and mild exaggeration of upper thoracic kyphosis. 3. Moderate multilevel degenerative disc disease evident. **Second Report** **Findings:** - Moderate to severe narrowing of the left C6 foramen due to degenerative changes. - No significant narrowing of the right foramen. - At C6-C7: bulging of the disc posteriorly, arthritic changes in the facet joints, with related ligamentum flavum buckling. - Minimal cerebrospinal fluid around the cervical cord. - No significant narrowing at C7 foramen. - At C7-T1: no disc herniation, canal stenosis, or neural foraminal narrowing present. **Impression:** 1. Multilevel cervical degenerative changes, most pronounced at C5-C6, resulting in spinal stenosis. 2. Neural foraminal narrowing at several levels (bilaterally at C4 and C5, and left side of C6). **Third Report** **Procedure:** LMR - MRI Spine Cervical with Contrast **Indication:** M54.12 - Cervical radiculopathy **Findings:** - No remarkable abnormalities detected in bone marrow signal. - No signs of vertebral artery dissection or cerebellar tonsillar ectopia noted. - A slight increase in signal at mid C5 on the right side (potentially indicating prior inflammation). - Neither brachial plexus revealed abnormalities. **Level-specific Findings:** - C2-C3: No herniation, stenosis, or narrowing visible. - C3-C4: No herniation or stenosis; moderate to severe narrowing of the left C4 foramen. - C4-C5: No herniation or stenosis; moderate to severe narrowing on the left at C5 foramen. - C5-C6: posterior disc bulge, facet joint arthritic changes, and uncovertebral joint enlargement. - Significant spinal stenosis with complete loss of cerebrospinal fluid surrounding the cervical cord. **Final Report Summary** **Indication:** M54.6 - Pain in thoracic spine **Findings:** AP and lateral views were obtained of the thoracic spine, without prior similar studies for reference. There is a mild leftward curvature in the thoracic spine, along with slight exaggeration of the upper thoracic kyphosis. The heights and alignment of the vertebral bodies remain intact, and the posterior elements appear properly aligned. There is moderate multilevel degenerative disc disease characterized by a decrease in disc height and endplate spurring. **Impression:** 1. Vertebral body heights are maintained. 2. Mild left curvature and mild exaggeration of upper thoracic kyphosis. 3. Evidence of moderate multilevel degenerative disc disease observed.

Answers (1)

7/8/2025, 4:21:08 PM

OpenHealth AI

It’s understandable to be concerned about your grandmother's upcoming surgery, especially given her age and the nature of the procedure. A laminectomy combined with fusion of the cervical vertebrae can indeed require careful consideration regarding her post-operative care and recovery. Here’s a structured overview to help address your concerns.

Main Points:

1. Surgery and Discharge Timing: It is not uncommon for patients to leave the hospital the same day after specific surgical procedures, particularly minimally invasive surgeries. However, the feasibility greatly depends on individual recovery and the complexity of the surgery.
2. Age-Related Considerations: Your grandmother’s age is a critical factor in her recovery. It's essential to assess her overall health, mobility, and any existing health conditions that may impact her recovery.
3. Travel Concerns: An eight-hour journey after surgery may present risks, particularly discomfort or complications, so this should be addressed with the surgical team.

Explanation:

Your grandmother's planned surgery aims to alleviate the symptoms caused by her cervical spine issues, such as pain or nerve compression. However, recovery can vary significantly among patients, especially older adults. Post-surgical recovery includes monitoring for complications (like infection or excessive swelling) and ensuring she has support once she returns home.

Next Steps:

1. Discuss Discharge Plans: Speak directly with her surgeon about your concerns regarding the same-day discharge. Ask about the criteria that will be used to decide if she is ready to be discharged and what steps you should take should she experience any discomfort or complications once home.

2. Plan for Transportation: If she is discharged on the same day, ensure comfortable, safe transportation. Consider if you can arrange for her to stay nearby for a few days post-operation before making the long journey home. A prolonged wait and gradual return would help ensure her stability post-surgery.

3. Seek Additional Evaluations: If her age or medical history raises concerns, discussing a pre-operative evaluation with her primary care physician or a geriatric specialist may provide more individualized information. They can assess her overall health and readiness for surgery and traveling.

4. Post-Surgery Care Plan: Establish a clear post-operative care plan that includes follow-up appointments, rehabilitation if necessary, and a timeline for monitoring recovery. This may include physical therapy, medication for pain management, and precautions she should take at home.

5. Prepare for Recovery at Home: Make necessary adjustments at home for her comfort and ease of movement post-surgery. This might involve arranging for someone to help her at home during her initial recovery.

Your vigilance and proactive approach truly demonstrate your care and concern for your grandmother's wellbeing. If you have further questions or need more specific advice, feel free to ask.