Spinal fusions aren't something most surgeons will jump into (from experience). I was diagnosed with Cranial Cervical instability (CCI) in 2017 once my PT didn't feel comfortable treating me and I was referred to a neurosurgeon. I saw neurosurgery end of 2017. He was conservative...In order to GET an appointment with him they needed all my medical history, genetics notes, a special MRI, CT scan, and other imaging. My MRI measurements showed CCI but he still had me do conservative treatments before surgery to exhaust all options.
If it helps show clarity for the process, this was my timeline:
December 2017: Initial appointment
(CCI - wanted to diagnose because of my MRI measurements were positive for CCI but suggested a different kind of PT and if it didn't help, THEN he would perform ICT)
January - May 2018: Completed Physical Therapy 3x week
May 2018: I had surgical Invasive Cranial Traction (ICT)
June 2018: Follow-up appointment
(Went over ICT results. Was prescribed more Physical Therapy and added a Cervical neck brace only for days where I passed out. Was told the neck brace would atrophy it further)
June- December 2018: More Physical Therapy
March 2019: Follow-up appointment with neurosurgery
(Was positive of CCI but I needed another MRI and an EMG to rule out anything else that could've contributed to the instability)
He also did 2 other things— he prescribed me a Cranial Traction device and I was to use it 1x a day for 3 months & log symptoms each day. Secondly, I was to do more PT and also get the Cranial Traction done at PT with their medical Cranial Traction machine monitored by PT & log symptoms daily for 3 months.
April- June 2019: I did PT and Cranial Traction + log symptoms
August 2019: Follow-up with neurosurgery
(Confirmed surgery was needed. Planned a 2nd surgical ICT procedure to get better measurements and gage where I stood versus 2018)
October 13, 2019: I had surgical Invasive Cranial Traction
(Determined my measurements and scheduled surgery)
October 17, 2019: Surgery for Cranial Cervical Fusion
This was a long road for me and it isn't a quick "you have CCI, let's do surgery asap". A surgeon should do most, if not all of what I had done before giving someone surgery. I'm not a doctor, but granted, someone could have a more severe decline than I had, but it still wouldn't warrant a scheduled surgery as soon as you see a new surgeon and are diagnosed something for the first time.