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Old 06-25-2008, 05:36 AM   #1
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Question Questions for Neuro about 2 level ACDF C 4-5 C 5-6. Need some suggestions.

Hello everyone,

I usually post in the Pain forum, but I thought the questions might be better suited to this one.

My Neuro told me in September of last year that I needed to try some conservative methods to treat my damaged and bulging disks at C 3-4 C 4-5 C 5-6. When those treatments all failed to give releif he suggested I consider a Posterior Cervical foramanotomy to help realease the i compressed nerves at C 3-4 C 4-5. He told me then that the Foraminotomy would not treat all my neck problems. He said I will need fusion later, but that he wanted to wait as long as possible for that if I could handle it. I agreed and said if it becomes to much I will revisit later.

So In Jan. of 2008 I had the foraminotomy. I got better a little while and then started to decline. The Neuro sent me back to PM to try some more conservative methods and when those all failed he ordered the discogram. I had a four level discogram and it was excruciatingly painful, but yeilded ta good test.
It was found the discs that were bulging were also badly torn and also some had fissuring. Thus the Neuro said I needed to revisit the Fusion option. I said lets do it and move forward.
One more hoop to jump through ...he sent me to a Pain Psychologist to have a surgical assemsment. The Pain. Psych. approved me as a good surgical candidate with realistic ideas and expectations of surgery.

SO at the last visit to the neuro Iwas so upset about having to jump through the last hoop I missed alot of info he gave.
I thought that the Neuro said I would have a carbon fiber something. I had asked him if he used cadaver bone or my personal bone for the fusion and that is when he mentioned the carbon fiber thing. Later I askked the office and they said palte and screws.
Anyhow, I have made a few questions for the appt. on Friday. My Mom will be there with me to be a second set of ears since she will come to stay with me post op.

Here are my questions:
1.) How long is the surgery?
2.) How long is the Hospital stay?
3.) What about the pain contral Post op? It was good the last surgery you did, will it be the same??
4.) How long is the collar worn, and discuss this issue.
5.) Explain the type of hardware to be used and ask additional questions about it as needed.
6.) If and when would I have PT if any and for how long?
7.) What about going up and down stairs when I get home from the hospital? (14 stairs to the master bedroom)
8.) What about driving? I am assuming since the hard collar I was told would be on for 4-6 weeks, it would be when that is off...is this correct?
9.) How often do you do this surgery and what percentages are the outcomes? (optional)
10.) Will you yourself be performing the surgery or will a student be doing it? Why? Because I rather would like you yourself to perform the surgery?


If anyone has any suggestions or additions for the questions, please post tem for me.

If you have had this surgery or a simialar one on your neck please share your experience with me.

One thing I am planning on buying is something called a Wedge Pillow. I want mine to be at a good angle so I can sleep, read, watch tv, and even drik somethig with a strw if I can find one that fits the description.
I am nervous a little about the surgery. I had the other neck surgery and they went in posteriorly and I know this is an anterior approach. I have heard the anterior is a much less painful approach.

I do live alone and I am not in a relationship and have no kids. My Mom lives 2 1/2 hours away wand will be here for as long as she can. SHe may need to stay a week go home for 3 days or so and then return for another week.
If you had this surgery how long was it before you did not need help to say...shower, cook a small meal, or wash a load of clothes??

I plan on keeping the dirty laundry downstairs in a closet so as not to need to carry the clothes basket down to the machines.

Well I think thats it. Please share you experiences and outcomes.

Thanks for reading and hopefully after this Friday I will psot with the date of surgery.

Chrissy

 
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Old 06-27-2008, 06:36 AM   #2
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Re: Questions for Neuro about 2 level ACDF C 4-5 C 5-6. Need some suggestions.

WOW,

Not one reply on this thread.
Its fine I guess. My appt. Is this morning so I am going in with the current list.
C

 
Old 06-27-2008, 06:53 AM   #3
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Wink Re: Questions for Neuro about 2 level ACDF C 4-5 C 5-6. Need some suggestions.

I had 2 level ACDF 2 and half years ago and it was not bad surgery the worst part is doing nothing which you will do alot of!!! When I woke from surgey I felt relief already. I was off work for full 12 weeks, the last 3 more for me to enjoy myself after doing NOTHING for so long. I do not regret that surgery one bit. The other bad part is weaning yourself off the collar, you depend on it for so long and then when yo0u take it off those muscles really scream. It is just really really sore. I recently had posterior foraminotomy to relieve pressure off my nerves and that surgery was a doosey!! It really hurts bad so if you got through that ok then I would say this one will be a breeze. You do need help though. My brother in law was living with us at the time so he did all the running around for my kids and more. I believe I did not drive for 6 weeks. Like I said doing nothing is the worst. My recliner had a permanent butt imprint. Oh and I slept in the recliner for about 2 weeks until I graduated to the soft collar.Sorry I did not respond to this sooner. Let me know how Dr appt went. I had my ACDF in Feb and it got really hot wearing that collar so be prepared doing this in the summer....

 
Old 06-29-2008, 07:14 AM   #4
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Re: Questions for Neuro about 2 level ACDF C 4-5 C 5-6. Need some suggestions.

Hello Christy,

I just had a 2 level revision surgery done on my neck less than 3 weeks ago. The original 2 level fusion performed at c4-c5 & c5-c6 was done in 2006 and was done using a plate and donor bone. On my last surgery, they went in, removed all the old plate and screws and old bone fragments and redid it using a "cage" (I think that is what he called it) and my own bone harvested from the hip. The pain in my hip was bad for the first few weeks but it seems to be getting better now. When I had my last surgery, I was in the hospital for 3 days. I was relived for that as I did not feel comfortable going home right away like I did after my last surgery. As far as the collar goes, all the docs seem to be different on this but my doctor has me in an actual neck brace called a SOMI for 12 weeks. Driving, forget about it while you are in the collar or brace as your visibility is limited and it is in fact illegal in several states. Sleeping and lots of pillows, a recliner is also a good idea.

Good luck, I hope you got all the answers from your Doctor and keep us posted.

Stephanie

 
Old 06-29-2008, 11:09 AM   #5
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Re: Questions for Neuro about 2 level ACDF C 4-5 C 5-6. Need some suggestions.

Chrissy:

As you know I've done both. I can tell you I found the ACDF to be much less painful as it goes through the front of the neck (not through muscle like with the foraminotomy). At 6 weeks post foraminotomy I still need muscle relaxers but needed them rarely after ACDF.

In addition, often with an ACDF you end up with a sore throat for a few days - when they do the surgery they move your windpipe to the side so you can have some soreness, swallowing problems, etc. I had a sore throat (was given lozenges for this) but no real problems swallowing. If I had problems they would have given me liquid nutrition but I ate chicken the night of the surgery.

Please let me know if you have any more quesitons.


Not sure what the doctor will say but here's what I personally experienced:

1.) How long is the surgery? Mine was about 3 hours.

2.) How long is the Hospital stay? Usually 1-2 nights. I stayed 2

3.) What about the pain contral Post op? After my ADCF (and my recent foraminotomy) I had a morophine pump in the hospital and percocet for use at home. I was also given oxycontin but that makes me itch too much.

4.) How long is the collar worn, and discuss this issue. I wore my Aspen collar for 6 weeks and am so glad I did. Not only do I think it aids in healing - it "reminds" you not to move in certain ways. After the first week I could remove it briefly to shower. Some surgeons don't use a collar but I'm an advocate of the collar.

5.) Explain the type of hardware to be used I have two plates and 6 screws for C5-C7 fusion. I did not have any bone used besides small chips from existing bone (I think in the area of the surgery). In addition, some surgeons are usnig what I think is a biological product that mimics bone with the hardware.

6.) If and when would I have PT if any and for how long? No, no PT for me. Once I had the collar off I just had to take time to carefully move my neck around. I have seen some people who have PT but I would think that would be used more after the initial recovery period who were having problems that could be addressed by PT. Since you do loose a little range of motion PT wouldn't help much since you don't want to extend to far (up/down and left/right).

7.) What about going up and down stairs when I get home from the hospital? (14 stairs to the master bedroom). I live in a ranch but had no stair problems whatsoever. Just have much of what you need (snacks, drinks, meds) upstairs with you.

8.) What about driving? I am assuming since the hard collar I was told would be on for 4-6 weeks, it would be when that is off...is this correct? I did not drive for 6 weeks. Yes I had the collar on but even if I had not I would not have driven until about the 6 week point.
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Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
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Old 07-11-2008, 03:01 AM   #6
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Question Re: Questions for Neuro about 2 level ACDF C 4-5 C 5-6. Need some suggestions.

THANK YOU! I logged in to post the following question.."I am schedualed to have a 2 level ACDF fusion C4-5 C5-6 on Sept 12 in San Fancisco (I live in the Philippines) , what is the WORST i can expect and what is the BEST I can expect?"
My doctor wanted to do the surgery last April as I have lost some neuro functions , but I had to travel to the East coast to attend my Fathers funeral. Then he wanted to do when I returned to SF from the funeral. I pleaded no as I had a new granddaughter arriving in the Philippines on June 2 (and she is a real cutie!). So with a big sigh he aggreed to September.
I had an emergency exploritory abdominal surgery on Dec 24, 2007 for twisted, herniated intestines, adhissions, appenicitis. Then kidney and heart shut down when they realized I was allergic to morphine. After insisting I NOT be given a spinal block, I was given one which tore my L5 disc and had me flat for 2 1/2 months with spinal headaches. I needed more time to physicaly and phsychlogically recover from that.
My stress levels are off the charts...sudden high blood pressure for the first time in my life and a bunch of other stuff I will not bore any of you with.
So any other info, advice, anything what so ever will be GREATLY APPRECIATED!!!
Thank you...again!!!

 
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