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  • ACDF Fri but no longer in pain?

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    Old 10-29-2006, 11:43 AM   #1
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    ACDF Fri but no longer in pain?

    I am scheduled for ACDF C5-6. C6-7 with autologus (pelvic) bone graft and titanium plate (and Aspen cervical collar for 6 weeks) at the end of the week. However, I am not having the intense pain I was having for months and the numbness is nearly gone (was down my right arm). Still I am very weak in my arm, 3/5. I wanted to get opinions from people who have had this surgery. I am very scared of the pain and the postop recovery. I am also recovering from a thyroidectomy done 3 weeks ago--my surgeon will go through the same incision.
    My hospital is supposed to be very good--Hospital for special surgery (NYC)


    previous fusion and rods for scoliosis

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    Old 10-29-2006, 06:16 PM   #2
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    Re: ACDF Fri but no longer in pain?

    The pain for a cervical fusion done via the front of the neck (ACDF) is MUCH less than for back surgery. The reason is for back surgery they have to go through muscle and tissues, with the ACDF there is far less tissue to disrupt.

    I had a lumbar fusion in 1993 and vividly remember bad pain for an extended period. So, much like you, I was fearful of the recovery from the ACDF. I was happy to see how little real pain (comparitively) there was. You'll be pleasantly surprised.

    C5-C7 ACDF 5/06 @ age 39
    L4-S1 fusion with hardward 5/93
    Rt thumb fusion '13. R&L thumb arthroplasty '12 ; RT TKR & Bilat CTS' 11. Fusions: L5-S1('87), L4-S1('93), C5-C7('06), L3-S1('10), C4-C5('13). C5-C7 foraminotomy '08

    Old 10-29-2006, 07:38 PM   #3
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    Re: ACDF Fri but no longer in pain?

    Thank you for your reply. What I am really wondering is if I should have the surgery now (or ever). I have read posts where people say it is worse the longer you wait. I was very motivated to have the surgery when I was having pain and couldn't work or sleep, etc. Then I was having nerve pain and numbness. But since the thyroid surgery I have been having few symptoms (probably because I really stopped lifting anything and used pain meds more). So I am scheduled for this surgery (ACDF C5-6, 6-7) at the end of this week and feel like I won't be able to see improvement because I am not having the severe signs I once had (but my arm is weaker than the other one and the muscles are atrophied). Also, wearing the Aspen collar 24/7 for 6 weeks seems not very comfortable.

    Thanks again
    (I had my lumbar fusion and Harrington rods 20 years ago and don't recall much about the pain. I think that the cervical herniations may have started in 2003 because the arm pain started then.)

    Old 10-30-2006, 01:02 PM   #4
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    Re: ACDF Fri but no longer in pain?

    Only you know how much you have changed your activity vs. prior to your thyroid procedure and if you are taking more pain meds that could be deceiving - but I think that wouldn't affect numbness. So the question to ask doc is did removing the thyroid create more space in there and did things shift and did it change the mechanical situation?

    In my opinion surgery should always be avoided when it is possible and when there is no risk of damage and your symptoms are under control.

    Old 10-30-2006, 02:20 PM   #5
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    Re: ACDF Fri but no longer in pain?

    Your NS will advise if there is the slightest chance that things have changed. With numbing you must have cord compression? Do you have a buldged disc?

    I just had this done with my own bone as well. It was not that bad. I feel great now.

    Old 10-30-2006, 05:16 PM   #6
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    Re: ACDF Fri but no longer in pain?

    I don't have cord compression (per MRI), I have stenosis at the exit of the spinal nerves to my right arm which causes the numbness and nerve pain (and atrophy, along with disuse). I was never offered physical therapy or epidural shots for this problem. My internist (who I saw originally for this problem) put me on NSAIDS and Lidocaine patches, sent me for an MRI, and then recommended I see a neurosurgeon (while dealing with the thyroid tumor found on the MRI). The neurosurgeon gave me Ultracet which worked a little better than the Relafen.

    My MRI results (August and Sept) are similar--
    C5-C6 level, a broad disc bulge with associated small right paracentral disc herniation is noted which flattens the anterior aspect of the thecal sac with mild to moderate right central canal stenosis. There is no evidence for spinal cord compression or edema.

    C6-C7 level, a right paracentral disc herniation is present with associated high-grade right lateral recess and right neural foramen narrowing. Flattening of the right anterior aspect of the thecal sac is noted with mild to moderate right central canal stenosis. There is no spinal cord compression.

    I don't think that the thyroidectomy made considerable room so that the discs didn't bulge as much.

    My orthopedic surgeon is great at explaining things to me and seems competent. (I also appreciate how much he worked with my head and neck surgeon for scheduling the surgeries, etc.) He always tells me that the decision to do surgery or not is mine. It was a much easier decision in July, August, and September when I had a lot of pain and numbness! The fact that I am so weak in my right (dominant) arm makes me want to have the surgery (besides the fact that I have done all the preop testing already). It is just such a hard decision when it is "elective" surgery and sounds so painful and uncomfortable.

    Thanks for your advice

    Old 10-31-2006, 12:42 PM   #7
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    Re: ACDF Fri but no longer in pain?


    Make sure that you are OK with having an ACDF. I really think you need to talk to a Neurosurgeon to get his thoughts on this. Think of the OS as a house builder, and the Neurosurgeon the electricial. The house might be stable, but it's a bad thing if the wiring doesn't work.

    I had a 3 level ACDF, with some complications. It took about 4 months before I felt good enough to get off the pain meds. I'm hoping that your surgery will go better. Definitely get your house ready for you to recover, put things you'll need between waist and chest level. Go with small containers, a 12 ounce soda versus a 2 liter bottle. It will hurt to pick up heavy things, and a 2 liter soda is heavy after your surgery.

    Be prepared.


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