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  • ACDF - Long Term Results? Future Surgeries?

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    Old 08-20-2004, 09:37 AM   #1
    Hobbes
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    Question ACDF - Long Term Results? Future Surgeries?

    Hello everyone -

    In September, I am scheduled for ACDF to correct herniated disk at c5-c6 that's compressing my spinal cord. My neurosurgeon has recommended donor bone and titanium plate. Of course I am concerned that I am heading down a "slippery slope" of future surgeries. Given cord compression, I feel surgery is absolutely the right option for me at this point. But I am wondering if anyone can give some guidance on long term prospects? I'm 36 and in otherwise very good health. MRI showed no damage to other disks at this point. Does anyone know percentages of folks who end up undergoing future surgery?

    Many thanks for your help! This board ia a terrific resource!

    Hobbes

     
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    Old 08-20-2004, 12:04 PM   #2
    working
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    Re: ACDF - Long Term Results? Future Surgeries?

    Hobbes:

    I was scheduled for ACDF on 9-1 on C5-6 with harvest bone and titanium plate but have had some difficulties getting the surgeon to return my phone calls. The last straw was when he screamed at me regarding his busy schedule and I should not bother him with insignificant issues such as the neurontin and vicodin he prescribed were not helpful. Nevertheless the whole process has made me a bit uneasy and I am cancelling my 9-1-04 surgery and starting from the beginning - finding a new neurosurgeon. I would be interested in any information you findout re: future surgical problems and would appreciate your sharing should anyone contact you with a response.

    Hope all goes well for you.

    Working

     
    Old 08-21-2004, 08:37 PM   #3
    boxer_dog_luv
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    Re: ACDF - Long Term Results? Future Surgeries?

    I had the same concern also & wanted to avoid messing with the spine, discs unless it was unavoidable. I had ACDF with donor bone wo fixation C5-6, C6-7 on 6/30/04 & am almost 8 weeks postop. My NS who is very efficient and good about providing specific details about instructions said on my last appt. that there was a risk where the segments were fused that it could put stress on the level above and below. So I feel like that is a very distinct possibility - future disc problems & surgery. My principal who was my inspiration that I would be okay too after surgery (having had the same surgery in 2000 for DDD too - I too had no known inciting injury, am athletic and wonder how much of a DDD picture am I) in July started having problems with his lower (lumbar) back, started school with a pain patch of some kind, and is contemplating a second surgery as we speak. Needless to say, I am glad that I didn't know about his lower back problems as I was freaked enough making my own decision. For now: what I can do for myself - use proper body mechanics, not try to be superwoman moving 500 lb. antique furniture anymore, walk to build strong muscles supporting the spine & keep the weight down-less weight, less strain on bones & joints. I, myself, don't intend to push the ticket if I am predisposed to having DDD problems. I will try to look at what habits I have that might be detrimental to a healthy back & spine and hope for the best. I am 42 years old & my NS stated that he was reluctant to remove discs in someone that young. Last visit, he rattled off, that studies show if one lives to be 70 wo heart, lung or cancer history that stats show expectations are good that the person can live to be 90.

    Your post is excellent. I think we all are extremely interested in long term outcomes. Take care.

     
    Old 08-22-2004, 05:03 PM   #4
    Rolex
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    Re: ACDF - Long Term Results? Future Surgeries?

    Hobbbes and working,
    Why don't you guys try getting into the study for the artificial disk since you have only one level problem? I had surgery in March, got the Bryan artificial disk. I am doing well but still have some pain down my arm, especially if I am under a lot of stress.
    Check it out on google. Bryan artificial disk.

    Last edited by Rolex; 08-22-2004 at 05:05 PM.

     
    Old 08-22-2004, 05:38 PM   #5
    nero
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    Re: ACDF - Long Term Results? Future Surgeries?

    Hi,

    Your concerns are very valid and certainly along the same lines as my thinking prior to c5-6 acdf with own bone and plate Nov 03. I am post op and doing okay; had spinal cord compression and it was getting dangerous as it was sequestered into pieces as well...so no choice after awhile.

    However, I read many Canadian journals of medicine and confirmed unfortunate news that c5-6 level of all levels it seems is most likely to cause further stress on adjacent levels and thus another blow out. However, I, like the rest of you, had little choice and am glad to know that artificial disc is an option. Sometimes in patients, a return to surgery is required after 5 to 10 years after surgery. I have a bulging adjacent disc and asked my second and final surgeon to address this issue with me in relation to having to do this surgery again and again. He did consult with me and I went ahead and just did the one disc. My prior surgeon was cold and spent little time and intimidated me with his presentation of a knee plate instead only because he couldn't be bothered showing me what was going to be placed in my throat. Thus I would agree to find the right person... surgeon... etc as if things go in a direction you hadn't counted on you can at least solace yourself with the knowledge that you spent as much time trying to get the right dr. as you do checking out homes or cars to buy.

    Good luck... I am not perfect and get many pins and needles.. which has been discerned as being mostly from the spinal cord compression and which may go away.. but I am 50% less or more in pain and if this is the most I have to deal with I can still enjoy my time on earth... you have to remember its an injury to your body and very seldom can we go back and feel BRAND NEW.

    Good luck .. I had a lumbar discectomy as well in April 04 and have a high pain threshold but I can tell you I wouldn't have any quality of life if someone decent like my dr. had not intervened and given me some relief.

    sincerely,... trying to be ...nearly new again... nero

     
    Old 08-24-2004, 05:46 PM   #6
    Hobbes
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    Re: ACDF - Long Term Results? Future Surgeries?

    Hello -

    Thanks everyone for your input! I've been trying to research my question via various medical journals (did a search on PubMed and then went to the local medical school library) but haven't found a study that followed ACDF patients for more than 5 years or so. And no study looked at follow-on surgery as any kind of secondary endpoint. I inferred from one study about a 30% rate of second surgery -- but just one study and it was specifically looking for some other endpoints.

    All this being said, my neurosurgeon told me today that he expects a 10-15% probability of future surgery based on his 25 yrs experience. A lot depends on overall health of surrounding disks. Age at time of first surgery is also a factor because the more years you live the more things can fall apart!

    I agree that the artificial disks look extremely promising. Hopefully will be a potential help to all of us someday soon.

    Hobbes

     
    Old 08-25-2004, 06:16 AM   #7
    Ramsfan
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    Re: ACDF - Long Term Results? Future Surgeries?

    Hello Hobbes,

    I was 38 when I had my 1st surgery in 1995. I had my 2nd surgery 6 months later only because my surgeon at the time did not like using the titanium plates unless absolutely necessary so we opted for 2 separate surgeries. (c3, 4 and 5) I had my 3rd surgery last December on c5, 6 and 7. I used my own bone in all 3 surgeries. My 3rd surgery was done by another doctor only because I had moved from Delaware to Missouri. I was fortunate to have had 2 excellent surgeons and would recommend either one. I don't know the percentages of those requiring future surgeries, but I believe mine was due in part because I didn't alter my lifestyle as much as I should have. Although I experience aches and pains from time to time I still am satisfied with the results considering the alternatives.

    Frank

    Last edited by Ramsfan; 08-25-2004 at 06:20 AM.

     
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