ACDF Surgery Anyone?

[NY65912]

I have had neck/arm strength problems for around 12 years. Two years ago I was hit from the rear while at a traffic light and my pain and symptoms have increased greatly.

The MRI shows that all levels of my cervical spine have problems, herniations, arthritis, bone on bone.

I have a difficult time sleeping, I'm up a few times a night. I have tried every pillow to no avail.

I saw a surgeon who said, " your neck is really messed up, you need surgery". An insurance company doc who pulled me on the side and told me to get the surgery as I needed it.

My pain management doc has done multiple epidurals which do help for a while,but he too said that my neck is "fuched up".

Has anyone here had the surgery? The docs say that I need Anterior Cervical Discectomy & Fusion at C4-5, C5-6 & C6-7.

I had a lumbar laminectomy 22 years ago and had post op pulmonary emboli and I am terrified to get another surgery, but I am getting tired of the arm and neck pain and loss of strength besides the sleep problems.

Any input appreciated. Thanks

[greglepore]

Get a second opinion on whether a laminoplasty is an option. I'd try to avoid fusion.

I had laminoplasty c4-7 after years of symptoms followed by a m/c accident that resulted in a cord contusion and temporary quadriplegia. My surgeon initially wanted to fuse me, but because of an active lifestyle I asked him to consider other options. I've been happy with the results, I have pretty much full mobility and only lack overhead strength.

[Craig T]

Mike, I had the surgery in 2000, but only the C6-7 fusion. I took a risk and did a "Allograft" (cadaver bone) fusion rather than "Autograft" (your own bone). The Autograph has a MUCH better chance of fusing, but requires they harvest a chunk of your iliac crest (hip). That can be painful in itself. I was a heathy non-smoker, so the odds of allograft fusion was pretty good. If I was to do it again, I'd do the autograft.

I also elected to get a titanium plate "fixation". The surgeon told me the fixation stabilizes the fusion so that I can be more active earlier.

I've had a VERY good outcome and was working out with weights, golfing, and back to racing cars within a year. I had some trouble in the first 6 months, but physical therapy fixed that right up. If I'm inactive for a couple months, I can get stiff and sore, but I go back to the neck strengthening exercises and it clears right up. I do have arthritis around the fusion now 18 year later, which is common, but it doesn't seem to bother me that much.

18 months ago my SIL ruptured a disc in the sheriffs academy and got the artificial disc replacement. He is not doing well. He's going to UCLA this week for an MRI and re-eval. Apparently, his bone is growing up around the artificial disc plates in an attempt to fuse itself. Artificial disc replacement is still pretty new, and many are having this same bone growth problem. I would avoid that.

There are risks, but I wouldn't be afraid of the surgery. It sounds like you're have a pretty tough time now.

[Craig T]

Originally Posted by greglepore

Get a second opinion on whether a laminoplasty is an option. I'd try to avoid fusion.

Cervical laminoplasty also requires bone modification and fusion...and often fixation. It's not an easy surgery either, but it does preserve the mobility of the neck. I would have gone this route too if it were more than two vertebrae being fused. I don't notice any lack of mobility with just the C6-7, but you certainly will with multiple fusions.

If you're bone-on-on bone, the laminoplasty might not be an option.

https://www.youtube.com/watch?v=tsByp1msd9w

[Tobra]

Multiple levels like that increases the likelihood of trouble above and below the fusions

[Craig T]

Originally Posted by Tobra

Multiple levels like that increases the likelihood of trouble above and below the fusions

Even one fusion increases the odds of having trouble above and below. I keeping waiting for my 5-6 to go

[NY65912]

Originally Posted by Tobra

Multiple levels like that increases the likelihood of trouble above and below the fusions

That's what I was told by my pain management doc.

I probably will hold of on the surgery but will get another opinion. I need a doc that accepts No-Fault and I struck out with 2 docs recommended at the Hospital for Special Surgery in NYC

More epidurals!

Thanks

[Arizona_928]

Thing to consider is how long before you start fusing the other levels...

For my lumbar fusion I was told 10-15 years before they start doing the other level.

Hang in there!

[NY65912]

I saw a neurologist at HSS who confirmed that there is cord impingement ans myelopathy. He also said that I has hyperactive reflexes which also confirmed the MRI results.

I am now giving a lot of thought as to going ahead with the surgery. I'm still not very keen on doing it but I can't take the pain in my upper middle back between the shoulder blades, it's like a constant knife in there.

[MRM]

Are you on a rigorous PT program in addition to your pain management treatment? I'm not a doctor, but when I was younger I cut my teeth handling car accident cases, which were mostly neck injuries. From that experience I learned a few things. First, the surgery they are suggesting is very invasive and very serious. You have to be pretty bad before they start recommending fusions like that. Second, the quality of the surgeon makes a difference. Before you try anything approaching what they suggest you want the best ortho in the world, regardless of the insurance he accepts. Pay the difference out of pocket if you need to in order to get the best. You have to rely on personal referrals to find out who is the best.

Finally, PT often works when surgery seems like it's the only option. Neck and back surgery are so complicated and don't tend to have great results because of the shape of our spines. A brutal PT regimen with obsessive level follow up exercises can often get a better long term outcome than surgery. But you have to be willing to keep up the exercises forever. Do talk to your docs about a PT program and at least try to work out with a PT before going through therapy.

Final final thought, for what my advice is worth, your might find relief with ice. Ice actually reduces inflammation as well as having an analgesic effect. Inflammation is one thing that causes you pain, so reducing inflammation will improve your symptoms. So try ice and exercise and see if you can hold off on surgery for now.

[NY65912]

Wow, I never updated this thread. I had the surgery on 6/4/2019. It was very successful. They removed 3 cervical discs and install cadaver bone spacers in the empty space which knitts to the vertebrae.

I have no more finger, arm or neck pain. Everything went very well. I now have a 4" long titanium plate with 8 screws into the cervical vertebrae.

I spent 2˝ days in the hospital. The first few days were very tough but the healing was amazingly fast and I was back at my desk in 2˝ weeks. I should not have waited so long to have the surgery..

I was able to get by after being released with 1 or 2 oxy and Tylenol after the first day home. The neck brace was a pain but you get used to it.

Just updating in case anyone is thinking about the surgery.

Cheers, Mike

[GH85Carrera]

Originally Posted by NY65912

Wow, I never updated this thread. I had the surgery on 6/4/2019. It was very successful. They removed 3 cervical discs and install cadaver bone spacers in the empty space which knitts to the vertebrae.

I have no more finger, arm or neck pain. Everything went very well. I now have a 4" long titanium plate with 8 screws into the cervical vertebrae.

I spent 2˝ days in the hospital. The first few days were very tough but the healing was amazingly fast and I was back at my desk in 2˝ weeks. I should not have waited so long to have the surgery..

I was able to get by after being released with 1 or 2 oxy and Tylenol after the first day home. The neck brace was a pain but you get used to it.

Just updating in case anyone is thinking about the surgery.

Cheers, Mike

That is great news.

I waited way too long for my hip replacement surgery. That was one of the dumbest things I ever did. Getting the surgery sure fixed me. It is a lot less dangerous than neck surgery, but all surgery has risks.