2023年五月中的一天清晨, 我因為不明原因暈倒, 把自己的後腦勺跌破, 傷了頸椎. 這後半年恢復期, 經歷了傷口感染, 嚴重頭暈, 頸椎疼痛與吞嚥不適, 手術傷口附近的神經抽痛, 還有手臂的刺痛, 心情也從擔憂害怕, 焦慮鬱悶一直到現在可以接受嘗試著跟這些術後症狀共存. 現在再回想起來都覺得那是多痛苦的過程, 但也感到萬幸這次意外沒有傷到下半身. 也是有了這次經歷, 才知道這個頸椎手術是甚麼. One morning in mid-May 2023, I passed out for an unknown reason, resulting in a fall that caused a wound to the back of my head and an injury to my cervical spine. During the six-month recovery period, I have been through complications such as wound infections, severe dizziness, neck pain, difficulty swallowing, Neuralgia near the surgical incision, and tingling and numbness in my arms. Emotionally, I transitioned from feelings of worry and fear, anxiety and depression, to the present as I learned to accept and attempt to coexist with these postoperative symptoms. Thinking about those days that I suffered, I still feel fortunate that the accident didn’t cause me to be paralyzed. Because of this accident, I had a chance to get to know what the ACDF surgery is about.
由於跌倒時壓碎了頸椎幾處的椎間盤, 導致我左右手臂跟雙手出現非常嚴重的麻痛與刺痛. 醫生緊急替我做了ACDF 頸椎前路椎間盤切除及椎體融合手術, 把摔碎的椎間盤取出, 放入人工椎間盤再以鈦合金的金屬片固定好 , 差不多就像上面從AllSpine Surgery Center借用的圖例一樣, 只是我受傷的頸椎位置不同. 所以基本上會需要施行ACDF手術的理由, 除了跟我的情形相同, 也有的人是頸椎有椎間盤突出, 嚴重的話可能也會藉由這個手術來改善出現的頸椎病症狀. 以下為摘自Asia Medical Specialists 對ACDF 手術的簡單介紹. Due to the impact of the fall, several intervertebral discs in my cervical spine were crushed, causing severe numbness and tingling in both my left and right arms. The doctor urgently performed an Anterior Cervical Discectomy and Fusion (ACDF) surgery for me. This involved the removal of the shattered intervertebral discs, replacing them with artificial discs, and securing them with titanium alloy metal plates and nails. The result of my procedure is similar to the illustration borrowed from the AllSpine Surgery Center above. The only difference is the location of my injured cervical spine. The reasons for undergoing ACDF surgery include situations similar to mine, where the intervertebral discs are crushed. Additionally, people with cervical disc protrusion may also opt for this surgery to alleviate severe cervical spine symptoms. The following is an excerpt from Asia Medical Specialists providing a brief introduction to ACDF surgery.
“椎間盤切除術就是把椎間盤切除。此術可於脊椎任何一個位置進行，亦即從頸部(頸椎)至腰背(腰椎)。在頸椎位置，醫生會由頸部前面進入，通過喉部抵達破損的椎間盤。把頸部肌肉、氣管和食道撥開，就能接觸椎間盤和脊椎骨。對於頸部位置，由前面進入的方案會比從後路著手較為安全及方便，因這樣無需干擾脊髓、脊椎神經及強壯的後頸肌肉 . 視乎個人的情況，醫生會建議您進行一個 (單一)或以上 (多個)椎間盤切除及融合。”The intervertebral disc excision procedure involves the removal of intervertebral discs. This procedure can be performed at any location along the spine, from the neck (cervical spine) to the lower back (lumbar spine). In the cervical spine region, the doctor enters from the front of the neck, reaching the damaged intervertebral disc through the throat. By displacing the muscles, trachea, and esophagus in the neck, they can access both the intervertebral disc and the vertebral bone. For the cervical region, entering from the front is considered safer and more convenient than approaching from the posterior route, as it avoids disturbing the spinal cord, spinal nerves, and robust muscles at the back of the neck. Depending on individual circumstances, the doctor may recommend performing single or multiple intervertebral disc excisions and fusions.
切除椎間盤後，在兩脊椎骨之間會有空隙，為防止脊椎骨塌下及互相摩擦，一般會利用移植骨或代替品填滿該位置。移植骨成為兩個脊椎骨之間的橋樑，以進行脊椎融合。移植骨和脊椎骨通常會以金屬板及骨釘固定在一起而不能調動。手術後身體會開始自然癒合，新的細胞也於移植骨周圍形成。三至六個月後，移植骨會與上下的脊椎骨融合成一塊堅實的骨頭 . 在儀器及融合術運作下，骨頭有機會沿著金屬板及骨釘生長 – 類似鋼筋混凝土般 .”After the removal of the intervertebral disc, there is a gap between the two vertebral bones. To prevent the collapse of the vertebral bones and friction between them, it is common to use transplanted bones or substitutes to fill this space. The transplanted bone serves as a bridge between the two vertebral bones, facilitating spinal fusion. The transplanted bone and vertebral bones are typically fixed together with metal plates and bone screws, making them immovable. Following the surgery, the body begins the natural healing process, and new cells form around the transplanted bone. Three to six months later, the transplanted bone solidifies into a firm structure, fused with the adjacent upper and lower vertebral bones. With the aid of instruments and fusion techniques, the bone has the opportunity to grow along the metal plates and bone screws, similar to the process of reinforcing concrete with steel.”
我的脊椎外科醫生非常專業, 手術執行很順利, 只是術後的恢復以及神經受損程度畢竟因人而異. 加上我原本就有頸椎發炎的情況, 術後頸椎疼痛不適的程度跟頻率也會比沒有頸椎發炎的人嚴重一些. 術後我整整戴了近兩個半月的脖圈, 期間也只能坐在沙發上睡覺. 頸部肌肉軟弱, 必須在日後用復健治療 (Physical therapy)的運動幫助恢復.加上開刀傷口復原不順, 膠帶引起的過敏與細菌感染讓我在那段要帶著脖圈還要擔心化膿發熱發紅的傷口以及周圍的皮膚, 還有因為手術造成的吞嚥困難讓我幾度差點因為食物卡在喉嚨窒息, 想起來還是心有餘悸啊. 不過還好, 在邁入第四個月之後, 這些感染以及傷口沒有癒合的問題都痊癒了.My spine surgeon is highly professional, and the surgery went smoothly. However, postoperative recovery and the extent of nerve damage vary from person to person. Given my pre-existing condition of cervical arthritis, the postoperative neck pain and discomfort are more severe compared to those without it. After the surgery, I wore a neck brace for a full two and a half months, during which I could only sleep on the sofa. The neck muscles were weakened, and I would need physical therapy for recovery. Besides, the surgical incision did not heal smoothly, and allergic reactions and bacterial infections caused by the adhesive tape slowed my recovery. Also, the swallowing difficulties caused by the surgery, at times, put me on the brink of choking when food gets stuck in my throat. Thinking back, those complications still give me chills. Fortunately, after entering the fourth month, these infections were gone and the incision had finally healed.
後來我按醫生的建議做了為期一個半月, 一共六周12期的復健. 主要在加強頸部肌肉, 舒緩頸椎疼痛還有解決我24/7一直伴隨我的頭暈. 復健醫生在前半期集中復健肩頸部. 透過復健醫生每回的按摩以及固定做的復健運動, 我從原本不太能左右轉頭還有抬頭, 到後來已經可以慢慢地做這些動作. 等到我頸椎有進步之後, 他就’嘗試替我做耳石歸位的復健. 結束療程之後, 我的頭暈症狀已經減緩了80%, 以前起床起身都會暈上個20秒到後來已經到差不多五秒就可以章眼下床走路, 平時暈眩的頻率也少了不少. Later, following the doctor’s recommendation, I underwent full physical therapy sessions lasting for a month and a half, a total of 12 sessions. The focus of the treatment was primarily on strengthening my neck muscles, alleviating neck pain, and hopefully the constant dizziness that accompanied me 24/7 can go away. In the first half of the therapy, the physiotherapist concentrated on the shoulder and neck. Through massage and specific rehabilitation exercises in each session, I progressed from having difficulty turning my head and lifting it to being able to perform these movements gradually. After I had some improvement in my cervical condition, the therapist started vestibular rehabilitation. After completing the treatment, my dizziness symptoms have reduced by 80%. Before this, I would experience dizziness for about 20 seconds upon waking up and getting out of bed every day, but now it’s down to around five seconds. The overall frequency of dizziness has also decreased significantly.
現在已經是術後七個多月了, 在電腦前做事幾個小時過後就會頸椎不適的疼痛程度也小了不少, 其他的症狀每個月都在緩慢一點一點的減輕. 唯一遺憾的是我的左手臂因為受傷造成的神經受損導致麻與刺痛的症狀, 雖然手術緩和了它的程度, 但是過了半年了症狀未見改善. 只要溫度一降低, 手臂刺與麻痛的感覺會越發明顯. 每晚睡覺有時會痛醒. 進入開著冷氣的室內也會瞬間讓我更加的疼痛. 由於這個術後恢復是因人而異, 對於我目前的情況, 醫生也只能安慰我說這些不適也有不少人 是在術後一年或兩年才完全痊癒. 手臂的問題則是問我是否能與它共存. 我想了想, 接受它是我目前最好的選擇. 我安慰自己, 這次就差那麼一點點就癱瘓了, 想起急診室醫生們在當時一直跟我說我真的非常非常幸運, 很多人一摔就傷到下半身了. 所以, 手臂麻與刺痛又算的了甚麼呢? 好歹我還能自己走路, 開車, 切菜, 洗頭, 做家事. 已經很幸運了呢.
It has now been over seven months since the surgery. The discomfort and pain in my cervical spine after working on the computer for a few hours have significantly decreased. Other symptoms are also gradually alleviating a little bit each month. The only thing is the lingering symptoms in my left arm, the numbness and tingling due to nerve damage from the injury. While the surgery alleviated its severity, there has been no improvement since then. The sensations of tingling and numbness in the arm become more severe when the temperature drops, and there are times I wake up in pain during the night. Entering air-conditioned rooms will instantly exacerbate the discomfort. Given the individual variability in postoperative recovery, the doctor can only reassure me that these discomforts may take one or two years to completely heal in my current situation. As for the issue with my arm, the doctor asked if I could coexist with it. I recall the emergency room doctors emphasizing how exceptionally fortunate I was, as many people end up having lower body injuries from a fall. So, what are numbness and tingling in the arm compared to being paralyzed? At least I can still walk, drive, chop vegetables, wash my hair, and do household chores. I already had so many blessings and would accept my current conditions.
經歷過這次意外, 真的沒有甚麼比身體健康更重要的事了. 也希望藉由這篇講講ACDF手術, 讓大家了解到頸椎的重要. 我也常常提醒必須經常抱著3C產品做是跟寫作業的家人們, 千萬要注意頸椎, 過度的彎曲都會造成頸椎壓力, 久了會頸椎發炎, 到時候復健幫助不了就得動手術了. Having gone through this accident, I have realized that there’s truly nothing more important than one’s health. I hope that by sharing my own experience and the ACDF surgery, everyone can also understand the importance of cervical spine health. I often remind my family members who frequently use electronic devices for work or study—to take good care of their necks. Excessive bending can cause pressure on the cervical spine, leading to arthritis afterward. If physical therapy or other chiropractic therapy does not help, surgery might become necessary.
術後一年半更新：想在這邊紀錄一下一年半後頸椎手術後後遺症還有哪些．目前脖子已經可以平穩地左右轉，轉頭的時候可以感覺的到微微的肌肉拉扯，但是都是算平順而且無痛的．仰頭沒有問題，只是因為暈眩問題我盡量不做這個動作，低頭只能低到一定程度，再往下點就感覺到手術的地方有種哽住不舒服的感覺．但是總體來說，做這些動作都已經不會疼痛了．使用電腦的時間可以拉長到五六小時，脖子出現痠痛就得休息．手臂麻痛情形也有顯著進步，只是當溫度變低，這手麻以及無力握不住東西一樣會出現就是了．最後開車情況，如果開車開超過半小時就必須得戴脖圈減低頸脖不適．One and a Half Years Post-Surgery Update: I want to document what issues I still have after the surgery. At this point, I can turn my neck smoothly to both sides and while I can feel a slight muscle pull when turning my head, it is still smooth and painless. I can look up without issues, though I avoid doing so due to my history of vertigo. I can only lower my head to a certain point—if I try to lower my head a little further, I immediately feel discomfort like a blockage at the surgical area. But overall, these movements are no longer painful to me. I can use the computer for five to six hours and need to rest due to the ache in the back of my neck. The numbness and pain in my both arms have also significantly improved, though if the temperature drops, I still experience numbness and weakness in my hand, making it hard to grip things. The last issue is neck discomfort during extended driving. I need to wear a neck brace like the neck pillow used for flights if the trips are longer than 30 minutes or so.
Although I still have these issues with me now, they all have improved significantly, and I’ve also found ways to alleviate the physical discomfort. Overall, things have been moving in a positive direction and I feel so grateful. I’ve also gotten used to coexisting with them. As long as they don’t affect my daily life, they’re not a big issue anymore. 🙂
As the year is towards the end, I sincerely wish you all a safe and happy holiday season!
雖然不是完全痊癒，不過這些問題已經有很大程度的進步跟改善，也找到合適的方式減輕身體的痛感．總之，這一年半都在往好的方向走．我也已經習慣跟他們和平共處．只要不影響到平日生活，這些就不是甚麼大問題．：）
歲末將至，祝大家都平平安安．佳節愉快．
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