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Old 02-26-2010, 06:09 PM   #1
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ACDF Step by Step

I thought I would start a thread that will hopefully be a step by step listing of the events involved with this surgery. I have read alot of info on this surgery but it seems that the details, the little things, are missing. I have never had surgery so ANY little thing that I learn is new to me. So first a little background.

10 years ago I was in a head on collision. Both cars were totaled and I was knocked cold for 20 minutes. The resulting damage was a herniated disc at C6-7. The initial treatments included epidural injections and pain meds. All was well for 8 years. Slowly the old pain returned along with some muscle tightness. Occasional visits to the orthopedic with muscle relaxers and cortisone shots worked for months. In October I began to get a tingling sensation in the fingers of my left hand isolated to the first hour or so that I was awake. The tingling lasted for longer and longer periods of time until January. In mid January I went to the orthopedic group and was referred to a shoulder specialist who prescribed muscle relaxers, an x-ray, and physical therapy.
The day therapy was to begin I started getting a pain under my right shoulder blade that was traveling to my right arm. 2 weeks into therapy the pain had become intense. Therapy consisted of electrical stimulation, traction, and exercises. The therapist referred me back to the doctor who ordered an MRI. Meanwhile my right hand began tingling that would last 80% of the time I was awake. Sleeping was becoming difficult.
The MRI showed herniations of the disc at C4-5, C5-6, C6-7 with nerve impingement at C6-7 to the right and mild impingement on the left nerve at C5-6. C4-5 was pressing slightly on the spinal cord. The doctor referred me to a spinal specialist who delicately told me that he wanted to do this surgery. He encouraged me to get another opinion which I did from a neurosurgeon. He was in full agreement on the surgery. I asked him about the ortho vs. neuro debate and he was quick to say that if he was having the surgery he would go with the orthopedic. He had a lot of reasons but the jist of it was that the ortho did spinal surgery exclusively.
So the surgery was scheduled for March 4 at 1:30 PM. He wil do C5-6 and C6-7 for sure and get a better look at C4-5 while he in there and make the decision then. Today I did my pre-op registration. The majority i could do online so that reduced my wait time. Typical reception type info was gathered and a full blood panel was pulled. A note on that: I am a notoriously "hard stick". This resulted in 3 rather painful attempts to get the 3 vials needed. I am used to this but the other patients that were in chairs near mine were not. People can make strange faces when they see someone else in distress. A high school aged teen was beside me and her mother said quite loudly " She is not touching you". While i was uncomfortable I did not complain. Apparently my face told a different story. There was an EKG followed by a sit down with a preadmit RN. Questions were typical of patient history and any allergies. She was interested in any anesthesia issues. I told her that I was worried about nausea and she reassured me that they would be extra careful with meds especially considering the surgery. This was a HUGH deal to me.
So the surgery is set. ACDF with cadaver bone and plating. One night in the hospital. No brace except for when in the car. In my next post I will discuss my job and what the doctor said about returning. Exciting.......not so much but I hope it will help others. Sorry so long....

 
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Old 02-26-2010, 06:49 PM   #2
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Re: ACDF Step by Step

So sorry to hear about your upcoming surgery...I truly hope that you have good success and helps with your pain! As you will find on these boards...there are those with both good/bad results with this type of surgery...

As well as varying opinions on what type of surgeon..

I've had 3 cervical fusions...the last was both anterior and posterior fusion...

For me..(Just MY personal opinion for my own body)...I only have a Board Certified Neurosurgeon for my cervical issues/surgeries as they specialize in both the spine and the brain and the C-spine can have so many issues in that area...

But..it's totally up to each person..although most recommend that they be Board Certified whichever you choose...

Just so you are fully aware...which I hope that your Dr. has gone over all the statistics for with you...that fusion surgeries have about a 50% success rate when it comes to the pain issue...they are mainly done to alleviate the pressure on the nerves and hopefully take away the risk of paralysis and the numbness...

I truly hope that you are on the other side of the 50% to take away all of the pain..that would be wonderful! But as you can see on the chronic pain boards...there are those of us that have had our fusions fail and live with daily pain..

This is not to scare you or others..truly that is not my intent...it is to only inform those having surgery the POSSIBILITY that it may not take away all the pain permanently...

Again..I ALWAYS pray for the best for those having them...I just wish for myself...I had found this board 9 years ago to hear the good/bad/ugly to be informed more...

My first fusion did last for a good 2 years without hardly any pain before it failed...so that was wonderful! But I was devastated at this because I thought it would be a permanent fix and only ever have to have one surgery for life...my first surgeon did not go over that with me.

I wish he did as I would have been more prepared for my mindset..

I wish you great success and it's great that you are openly talking to the nurses/Dr.s about your concerns...like with the nausea...I have trouble with that too and they can easily give you the medicine to help with that...

The main thing is to do a search on the boards for the lists of things to do/have around the house to make your recovery easier...

And please take all the pain medication as directed to 'stay ahead' of the pain...especially the few weeks following the surgery...don't try to be brave..REST as much as possible as this will help your healing process..

I TRULY wish you the best!

Last edited by Ilovemycutedog; 02-26-2010 at 06:52 PM.

 
Old 03-03-2010, 12:44 AM   #3
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Re: ACDF Step by Step

Why the NS would tell you a OS is the best I'm not sure, and a OS does not just do the spine, they work with bones of all kinds that for sure.

A NS knows the nerve system and must have great skills to operation on it, both NS's I've had mapped my C5-6 and C6-7 myelopathy, out in their minds and know what was from it and what was not. My neurologist is my pain doctor, he gives me 2 to 3 injections into my spine.

Every 2 months and he don't need a machine to tell him, he got them right as he knows where to put them. He feels the spot then inject it, he has never missed nor has he made me have bad pain from missing.

My new NS is also a OS yes he is both, he does very risky operations that other will not touch, another thing I've noticed most OS's, want to pull all bad disc the first time. While both my NS will only pull C5-6 and C6-7, where the myelopathy is even though C4-5 is blown and the rest are on their way.

I under stand why now, as we age our spines gets more room for disc, and it may not cause myelopahy and if it does another operation can be done. Waiting to see is better then upping the risk factor, by doing more levels at the same time.

I do under stand some OS's may well do a great job, but the fact is all the problems we have, are from our nerves and NS's know that better. A OS really never has to know much about the nerves, to do a spinal operations, where NS has to to get to be a NS to start with.

 
Old 03-03-2010, 02:41 PM   #4
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Re: ACDF Step by Step

OK...not trying to add to the debate. Just posting the experience as it happens. Certainly not trying to imply that I am correct. The decision should be made after research and thought. I am comfortable with the way things are set up for me. My surgeon does only spinal surgery. There are other doctors in the group that are specialist in other fields. So please take no offense as none was intended. So on with the story...
I am a chemical technician at a large chemical plant. We work under the high performance work team concept. Essentially that means that we have only one boss and are self directed, and we rotate positions. One day I might be pulling wrenches for 12 hours and the next I might be sitting on the control board behind 24 monitors and running the plant. There are also several day jobs that we rotate thru, mostly admin type things. All jobs require a certain level of fitness due to the inherent risk of the job. We have our own nursing staff and all medical leaves require clearance before return to work. We produce hydrogen peroxide at my plant but the surrounding plants produce all kinds of things from cyanide to amino acids. My insurance is excellent and medical leave results in no loss in pay for 6 months.
So I am all set for tomorrow. The house is in order, and most of the items from the sticky about ACDF are on hand. Excellent post by the way. Many thanks to all that participated. So a lovely dinner tonight then the starvation routine begins. I am a bit nervous but only because there is so much unknown to a first time surgery patient. Wish me luck and I will return the first chance I get. I should be home Friday but it remains to be seen if i will feel well enough to post. Thanks for the well wishes and I hope you are all well. See ya soon

Last edited by Administrator; 05-31-2011 at 03:31 PM.

 
Old 03-03-2010, 02:53 PM   #5
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Re: ACDF Step by Step

Poohnut...please don't think that there is a debate about the surgeons...it really comes down to personal preference and as long as you are comfortable with him..that's what really counts...

So..I hope my post didn't come across as anything but my own experience and whom I chose...everyone is different and that's what makes the world go round! LOL...

That's what is great about this board..you can read all sorts of experiences/thoughts on everything...add your own research..and make a decision yourself as you have done..What a blessing that you have good insurance and sounds like a good plan for time off to recover...that is half the battle right there!

I will be praying for a great outcome with your surgery and an easy recovery....Please post down the road when you feel up to it as we always want to hear how people are doing...

Take care!

 
Old 03-03-2010, 03:59 PM   #6
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Re: ACDF Step by Step

I'm sorry if I miss took your post, I do agree it's up to the person, and everyone should research this stuff for them self's.

My case is not the norm it's a bit more troubled then most, my myelopathy has been mapped out by 2 NS and both agreed, when I say mapped out it means they know what nerves are pushed/cut 1/2 in my spinal cord.

And what it is and will do to me from it, the signs that it gone to far is if I lose control, and go to the bathroom in my pants. Or get bad weakness in my right side of my body, or if I get anything I can't live with as it may not ever go away.

 
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