I haven't frequented the forum regularly in a long while, but I just found it moved and the old archives are not accessible. The archives are incredibly valuable for future patients, so I'm reposting the report of my surgical experience from 3 years ago with Dr. Jho:

On Monday 4/7/03 I flew to Pittsburgh for a pre-surgical consultation with Dr. Jho. I developed symptoms one year earlier and MRI revealed broad central herniations at C5-6 and C6-7 and significant stenosis (6mm) of the spinal canal at both levels. The intense left-sided pain subsided within a few weeks but I was left with constant numbness in 3 fingers of the left hand, and some left triceps weakness. Of major concern was the significant spinal stenosis at both levels. My neurologist and 4 neurosurgeons I've consulted all agreed that surgical intervention was advisable due to vulnerability to significant future spinal issues due to the marked stenosis. Also, I am an avid cyclist and surgical intervention held out hope to resume spirited cycling, although this was a secondary concern.

Aided by information gleaned from the great folks on this forum and my own research (including in-person consultations with 3 other neurosurgeons), I felt that Dr. Jho's procedure held out hope of potentially correcting the problem completely, with minimal recovery, low risk, and leaving options open for any other future procedure. Although Dr. Jho was quite responsive from a distance (amazingly so compared to other doctors), he couldn't answer a few questions about his surgical intentions for me until examining me personally. A surgical appointment with him includes a personal consultation on the previous day, so I went off to Pittsburgh to meet with Dr. Jho and possibly undergo surgery. By the way, I was fortunate to find an excellent neurologist soon after my symptoms first developed who served as the focal person , and he endorsed my eventual decision.

I was overwhelmingly impressed by Dr. Jho and his staff. Dr. Jho seemed to have all the time in the world for me when I met with him and his P.A. Frank. I had done a bit of research and have some medical background, so I asked a lot of questions and received thoughtful, respectful responses. In addition to discussing my personal case, Dr. Jho shared many anecdotes and discussed the whole gamut of disc procedures. He carefully explained what he wanted to do and why: a two-level anterior microforaminotomy ('Jho Procedure'), principally for general decompression of the spinal cord but also to free up the two nerve roots. My understanding was that based on MRI films showing cord compression posteriorly as well as anteriorly (disc side), Dr. Jho felt that there were bone spurs involved which he readily deals with in his procedure. A big unresolved question before I went to Pittsburgh was whether Dr. Jho could and would perform general decompression caused by central hernation from such a lateral approach. Dr. Jho assured me that this was exactly his intention.

The procedure was performed on Tuesday and took 2-3 hours under general anesthetic (with intubation). I awoke groggy and with some soreness and stiffness, but no real pain. When I asked about when the pain medication would be wearing off, I was told that I hadn't been given any, and haven't needed any since. Dr. Jho said the procedure went very well and he had to remove a lot of bone spicules (spurs). Dr. Jho made a single 1-1/2 inch horizontal incision along a natural fold of my neck, so the scar shouldn't be too bad after the incision heals, and it's already looking much less noticeable. My throat was very sore from the intubation, and it is still pretty sore as I write but slowly getting better (cold pumpkin pie and fruit smoothies help ;-). I am fairly sensitive to medication, and effects of the general anesthetic still seem to be lingering and slowly going away. I had no problem driving two days after the surgery, although I was pretty gentle with the head turning (BTW, no collar is worn after the Jho procedure). My neck can stiffen up a bit depending on how I am sitting, but I'm noticing that this is also improved from yesterday. I've been told that many of the acute issues will resolve over the next week and I'll be pretty much healed up from the surgery in 4 weeks. In the big picture, these post-surgical symptoms are shockingly trivial considering the work that was performed. My experience of Allegheny General Hospital was also overwhelmingly positive (except the food).

The numbness in my fingers seemed to have improved slightly right after surgery, but another noticeable chunk came off the numbness on the third day perhaps it's 25% resolved already. I believe Dr. Jho will be proven correct the numbness will resolve eventually. [postscript added 11/9/2003 - I'm sorry to report that the numbness did NOT resolve any further than this]

Another comment - due to the very sore throat and effects from the general anesthetic, I didn't sleep more than a few minutes at a time until the 3rd day. I'm not entirely clear on what was going on, but perhaps some combination of 3 possible issues kept waking me up every few minutes: a constant need to swallow to clear the small amount of phlegm that constantly invaded my throat, side effects of the anesthetic on my diaphragm or inflammation from the intubation causing my windpipe to slightly close in relaxed sleep [9/27/06 postscript - I believe this last possible explanation, a temporary form of sleep apnea due to the surgery, was correct]. On the 3rd night I discovered somehow that I could sleep well on my side (I've only slept on my back for years) and this was a huge relief. By the way, I noticed a dampening effect on other smooth muscles besides the diaphragm, affecting my ability to swallow, belch, urinate, etc which improved by the 3rd day.

I am very grateful to Dr. Jho for his pioneering work developing his procedures and being so accessible to new patients. I'll have a follow-up MRI in 6 weeks and hope to see amazing improvement on the films. I plan on taking one more week off from work, just to pamper myself a bit.

Cheers,
Barry

9/27/06 postscript: I have had no further issues with my neck in the 3+ years since the surgery. I had a followup MRI one year after the surgery and my neurologist was happy with what he saw. I still have numbness in 3 fingers, but no pain at all and fairly good range of motion in my neck. I was able to resume normal activity soon after the surgery and eventually built up to 100-150 miles of weekly bicycling. I still avoid extending my neck for long periods of time – that's probably the only thing that might bother me – eg., when I get my haircut and they shampoo me, I won't lean my head back over the sink – I turn the seat around and lean forward over the sink. In retrospect, I'm very happy with the surgery.