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2-3 Level Fusion (ACDF) - advice please

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Unread 02-11-2012, 08:15 AM   #21
ABBB
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Exclamation Pending cervical ACDF at 4/5, 5/6 and 6/7

Hi, I have just read your post about statistics from Amer. Society of Surgeons regarding advisability of surgery versus physical therapy. I have tried physical therapy three times and got no improvement. I am scheduled for ACDF at C4/5, 5/6 and 6/7 in two weeks, and I am terrified. My NS told me that there is a 90% chance of improvement....with the actual improvement in pain being 50%. IF that is true, I would think that the surgery would be worthwhile. I presently have no real quality of life. BUT I am terriefied after reading many posts from people who say they did not have good outcomes. How can I access the information you are quoting? Thanks

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Originally Posted by Leesa View Post
Hi ~ You have pinched nerves in your HANDS??? Or are the nerves in your neck affecting your hands?

I can tell you that I'm not a fan of surgery, only because most of the time your pain will NOT be relieved. The surgery only fixes mechanical problems - your pain will most likely still be there, and sometimes it's worse than before. There have been articles from the Amer. Society of Surgeons that stated that MOST of the surgery performed on spines in the U.S. had the SAME results as did physical therapy!! So in other words, the surgeries were useless. That went for the fusions too, as stated in the article. I've had 2 open spinal surgeries, and I'm worse now than I was before the surgeries - I have more pain than I had before.

Also, after spinal surgeries, you will undoubtedly have the "domino" effect, meaning that the levels either above/below the surgical site will fail - thus requiring further surgery. It's a never ending cycle unless you just opt for physical therapy. The only reason I would ever opt for further surgery is if my SPINAL CORD was being impinged.

I'm sorry you have to have surgery. You will need to talk to your doctor about post-op medications because they ALWAYS undermedicate the patient. Be firm about wanting adequate pain medication. The recovery is "longish." If you mean how long does it take to be fully fused -- that takes about a year - sometimes longer. As far as how you feel - it's different for everyone and it's hard to say. You will need some help for probably the first week. Sleeping - you will have to wear a collar for awhile - most docs have you wear a soft collar at night. They aren't too bad. It may take awhile before you feel relief because the nerves are very irritated - nerves heal at the rate of 1" per month. So it depends on your own case.

I hope I've answered a few questions. God bless and take care. hugs, Lee
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Unread 02-11-2012, 10:24 AM   #22
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Hi ABBB, Welcome.

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Originally Posted by ABBB View Post
My NS told me that there is a 90% chance of improvement....with the actual improvement in pain being 50%. IF that is true, I would think that the surgery would be worthwhile.
If there's only a 50% chance of actual improvement in pain, what's the 90% chance of improvement in - the surgeon's standard of living?

Most people who even consider spinal surgery do it in hopes of alleviating pain, paralysis, or something life-threatening; what other reason is there to chance going under the knife? And 50/50 is, IMO, pretty much a crapshoot. My surgeon advised against surgery for that very reason with similar odds.

http://en.wikipedia.org/wiki/Failed_back_syndrome

There are many options in pain management between PT and surgery, and many that don't necessarily involve daily narcotic medications (though those aren't necessarily the evil they're made out to be either - they provide a quality of life for many that's otherwise impossible).

You read about more bad outcomes than good outcomes because it's the people with bad outcomes who have reason to find support groups and write about them. People with good outcomes are continuing with their lives, and have (no offense to anyone here, but it's natural and true) better things to do.

Were your 3 courses of PT with the same therapist? IME their knowledge, skill, and experience can vary as much as any doctor's, and finding the right therapist can make as much difference as finding the right doctor.

I DO hope you've gotten at least 2 opinions, and asked about alternatives like ED, MED, pain management, and any others. Doctors base their recommendations on what THEY are knowledagable and experienced in doing - not what another surgeon may be able to do more easily/safely. (It's not like Miracle on 34th Street with Macy sending customers to Gimbels.)

Google: questions to ask neck surgery

Doc
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All opinions expressed are my own. For medical advice/opinion, consult your doctor.

Last edited by Dr. Smith; 02-11-2012 at 09:55 PM. Reason: wording
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Unread 02-11-2012, 11:26 PM   #23
cath1
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Default my original post, now 11 months post op

Quote:
Originally Posted by ABBB View Post
Hi, I have just read your post about statistics from Amer. Society of Surgeons regarding advisability of surgery versus physical therapy. I have tried physical therapy three times and got no improvement. I am scheduled for ACDF at C4/5, 5/6 and 6/7 in two weeks, and I am terrified. My NS told me that there is a 90% chance of improvement....with the actual improvement in pain being 50%. IF that is true, I would think that the surgery would be worthwhile. I presently have no real quality of life. BUT I am terriefied after reading many posts from people who say they did not have good outcomes. How can I access the information you are quoting? Thanks
Hi, welcome, and so sorry you have to be on this forum (nobody comes here for good reasons)

This was my original thread, and I am now 11 months post op from my fusion. My neck has healed quite nicely, I have 90% range of motion, with levels C5, C6, C7 fused with titanium plate and screws. I still do have pain, unfortunately, but it is by no means as severe and life debilitating as it was before the surgery. Given the circumstances and outcome I still would have the surgery again. But it was definately not a fun year!!

I still have a lot of issues with my hand, and am very seriously considering a second surgery on my ulnar nerve to release the pressure on the nerve in my hand. In fact I'm set to sign the paperwork and book the date for surgery on March 8th to proceed with it.

I am still on pain meds, not nearly as much as pre-op, but I am on a low dose pain patch and percocets to help with the residual break thru pain. I continue with physiotherapy 3 times a week, and will probably continue to go for a long, long time.

I can't tell you whether you should or shouldn't have the surgery, but the odds you gave are the same as what I have been given for the second surgery on my ulnar nerve. As a graphic designer who can't use her hand anymore I would take those odds as a chance to release the pinched nerve rather than have it continue to get worse throughout my life. The longer the nerves are pinched the more likely the nerve damage is permanent.

Do your homework on all the information about your surgery, learn as much as you can about your surgeon. Making an informed decision is half the battle.

I wish you luck in your decision. I do not regret having my surgery, I'm now able to drive again and do a little bit more activities that I used to be able to, and I get a bit stronger each week. And I'm thrilled to be able to move my neck and not be laying in bed all day.

BTW.... Dr. Smith is correct, those who have great outcomes do not post on forums because they have moved past their surgeries and gotten on with their lives. It's only those who are still having problems that seek out more information.

Take care,
Cathie

Last edited by cath1; 02-11-2012 at 11:27 PM. Reason: spelling error
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Unread 02-16-2012, 03:25 PM   #24
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Quote:
Originally Posted by Leesa View Post
Hi ~ You have pinched nerves in your HANDS??? Or are the nerves in your neck affecting your hands?

I can tell you that I'm not a fan of surgery, only because most of the time your pain will NOT be relieved. The surgery only fixes mechanical problems - your pain will most likely still be there, and sometimes it's worse than before. There have been articles from the Amer. Society of Surgeons that stated that MOST of the surgery performed on spines in the U.S. had the SAME results as did physical therapy!! So in other words, the surgeries were useless. That went for the fusions too, as stated in the article. I've had 2 open spinal surgeries, and I'm worse now than I was before the surgeries - I have more pain than I had before.

Also, after spinal surgeries, you will undoubtedly have the "domino" effect, meaning that the levels either above/below the surgical site will fail - thus requiring further surgery. It's a never ending cycle unless you just opt for physical therapy. The only reason I would ever opt for further surgery is if my SPINAL CORD was being impinged.

I'm sorry you have to have surgery. You will need to talk to your doctor about post-op medications because they ALWAYS undermedicate the patient. Be firm about wanting adequate pain medication. The recovery is "longish." If you mean how long does it take to be fully fused -- that takes about a year - sometimes longer. As far as how you feel - it's different for everyone and it's hard to say. You will need some help for probably the first week. Sleeping - you will have to wear a collar for awhile - most docs have you wear a soft collar at night. They aren't too bad. It may take awhile before you feel relief because the nerves are very irritated - nerves heal at the rate of 1" per month. So it depends on your own case.

I hope I've answered a few questions. God bless and take care. hugs, Lee
hi lee
dear cat
i couldn't have said it any better
myself
cat exhaust ALL
confirm ALL results
as many opinions as possible
as for yourself lee
God be with you
i live your pain
AND SOME SO ON THE MONEY
WISHING YOU BOTH RELIEF
YET TO FIND OUT IF I FUSED AFTER SURGERY #2
POWERFUL MEDS SOMETHING I HATE POWERFUL
WORD I KNOW I SHOULD BE OFF THEM AFTER SURGERY
NO SUCH LUCK AFTER 2ND SURGERY NEW ADDITIONAL
PROBLEMS AND OLD ONES ARE BACK
NOW PLATE CAGE SCREWS ? FUSION AS PER LAST
CT STILL HAVEN'T FUSED THAT WAS OCTOBER
THEN THE CANCER THING
anyhow take good care
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eva
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Unread 02-28-2012, 09:36 PM   #25
MalindaK
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Quote:
Originally Posted by bunz50 View Post
Hi Cath1, posted already but wanted to say I am from Ontario, had my surgery in Windsor, where in Canada are you, if you don't mind me asking. Bunz
**************
Hi, I had C-3 to T-1. I had slept on ice for about 11 years. (ok !! years. Pain meds mess up my bowels.) I went to a specialist who recommend a Doctor at a teaching hospital. I also have Fibromyalgia so he was well versed on that as well.

The surgery (done anterior and posterior) went well and I knew I had surgical pain when I woke up but I knew the neck pain was gone. No more ice for me.

I go to a pain specialist and she is a anesthesiologist and I get infusions that take care of the pain. I don't take many pain pills. She does "denervations. I would be in a wheel chair if she didn't work her magic on me.

Just go to sleep in a good mood and dream it's going to work. Have faith.

M
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Unread 03-01-2012, 01:06 PM   #26
joojee22
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Question question

For those of you that had ACDf, did anyone experience your vocal cords not working after the surgery?

The more I read, the scared-er I get.. LOL..

thanks.
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Unread 03-01-2012, 09:07 PM   #27
cath1
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Quote:
Originally Posted by joojee22 View Post
For those of you that had ACDf, did anyone experience your vocal cords not working after the surgery?

The more I read, the scared-er I get.. LOL..

thanks.
It's scary no matter what, I think that's natural to be scared!

I did have a sore throat and hoarseness for about 2 weeks, but my voice was totally fine. I had some swallowing issues for quite a long time, like a lump in my throat, but it went away. Once in a while I still struggle to swallow large vitamin pills, but that's about it.

Although my teenagers would have loved me to loose my voice, they didn't luck out!

Cathie
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Unread 03-01-2012, 11:24 PM   #28
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Quote:
Originally Posted by cath1 View Post
It's scary no matter what, I think that's natural to be scared!

I did have a sore throat and hoarseness for about 2 weeks, but my voice was totally fine. I had some swallowing issues for quite a long time, like a lump in my throat, but it went away. Once in a while I still struggle to swallow large vitamin pills, but that's about it.

Although my teenagers would have loved me to loose my voice, they didn't luck out!

Cathie
Yeah, I would second that motion. No vocal cord issues but swallowing vitamins or vicodins for that matter was a bear for quite awhile. I still instinctively turn my head to the side to swallow a vitamin at 4 years post (but they all go down the hatch now!).
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Unread 03-04-2012, 04:44 PM   #29
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Quote:
Originally Posted by joojee22 View Post
For those of you that had ACDf, did anyone experience your vocal cords not working after the surgery?

The more I read, the scared-er I get.. LOL..

thanks.
don't be scared yes it does happen
it changed mine
slightly more when coughing
a very noticeable
and know of a small # of people
good question
take good care
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Unread 03-09-2012, 05:11 PM   #30
ghostrider1
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Quote:
Originally Posted by cath1 View Post
I'm scheduled for surgery in 4 weeks to have a 2-3 level fusion in my cervical spine. My neurosurgeon will decide whether it will be 2 or 3 after my updated MRI which is tomorrow. But for now we know he will be fusing C5/C6 & C6/C7.

Is there anyone that has had this surgery that can offer advice on pain management, recovery, sleeping after surgery, anything that you wish you knew before your surgery? It's always helpful to hear from someone who has already "been there & done that". Would appreciate hearing how long it took for recovery and did you feel relief from the pinched nerves right away? (I have pinched nerves in my hands and neck which is excrutiating).

Is there anything you wish you knew before surgery that you know now?

Thank you!
Hi - I just had four level C3-7 completed on 6MAR and here I am. Key thing prior to surgery, gt as healthy as you can - walk - drink water - dont smoke and dont drink, I am not saying never again but get your mind and body ready for what it is going to go through. Practice being positive - you are strong and you will get better! I had more than enough at home when I got here, plenty of gatorade, water (most important), books and a good place to sit (pillows!). It is hared to relax and I am learning the true meaning of being bored!
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