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paradiddle 12-01-2006 07:11 PM

Do I need ACDF???
I don't know if I have serious enough symptoms for ACDF?

I have been to Neurosurgeon/MRI. He recommended ACDF. Diagnosis was compressed spinal cord in C-5 and C-6. I seen the MRI with the squished spinal cord in those areas. Scheduled for surgery Dec 18. I also have Kyphosis. Doc said I may need work in C-7 at some point later. He wants to use allograft (donor bone) and also uses titanium hardware. I will be fitted with a neck brace after.

History of neck muscle spasms from 2 motorcycle accidents in 98 and 05. I had been the chriopractor (3) route after both incidents with not much success. I have also been to (4) PT depts and another doctor who gave me trigger point shots to reduce spasm. After the last accident I have had problems with numb fingers and thumbs. I don't drop things or have a great loss of strength but it does concern me. I walk ok and don't have any headaches. I do have problems working on computers and stressful situations. I believe I have hypermobile ligaments and can only find relief by stretching head to shoulder and manipulating neck until I get a pop.

I am hoping that surgery will eliminate my spasms as well as eliminate numbness. What made me go to neurosurgeon was a statement that my last chiropractor made and said I had no curve in my neck. I did some internet research and learned about kyphosis and found out about neurosurgeons.

BobM 12-01-2006 07:19 PM

Re: Do I need ACDF???
I think only you and a surgeon you trust can answer your question. You will probably get responses from those who would, and would not.

For the, there were two issues - pain, and nerve damage that was causing atrophy and loss of use of my left arm and hand. I had had problems for over 10 years, and then quickly got worse (like less than 2 months) - couldn't even hold on to a steering wheel on that side. The surgeon advised me I was risking permanent nerve damage if I waited longer. It took a couple of operations, but I have my arm back, and still some pain but much less. If I had just had the pain, terrible as it was, I don't know what I would have decided. But permanent loss of the use of an arm made it a straightforward decision for me.

Best luck!

SpineAZ 12-01-2006 11:00 PM

Re: Do I need ACDF???
Each person is different - for me it came down to a quality of life issue. Too often the pain and spasms were getting in the way of me living my life the way I wanted too - I found myself limiting my physical activity and even getting a bit grumpy when the pain lasted too long. In addition I had a hard time doing my desk job on occasion which was of course something I had to remedy.

I have always been of the mindset for myself that if I am 'suffering' and there is a way to fix it then I should go ahead and seek the fix. So for me the ACDF was the beginning of a better way of living (less pain, etc).

paradiddle 12-02-2006 05:19 AM

Re: Do I need ACDF???
[QUOTE=kross426]Each person is different - for me it came down to a quality of life issue. Too often the pain and spasms were getting in the way of me living my life the way I wanted too - I found myself limiting my physical activity and even getting a bit grumpy when the pain lasted too long. In addition I had a hard time doing my desk job on occasion which was of course something I had to remedy.

I have always been of the mindset for myself that if I am 'suffering' and there is a way to fix it then I should go ahead and seek the fix. So for me the ACDF was the beginning of a better way of living (less pain, etc).[/QUOTE]

Thanks... I would get a bit grumpy too. I would sometimes get very agitated with people that did not understand. I told them to imagine someone with a pair of pliers squeezing on my right side of neck. Same problems as you with work. I got promoted to do computer drafting and programming all day long. I found it very hard to complete the day.

After reading everyone elses stories of "severe" pain and total numbness I didn't think I qualified. On my first visit to NS he was not sure I needed anything after physical examination. He scheduled MRI because I had exhausted other avenues. After MRI he changed his tune and said I was a surgical candidate.

I would like to hear from others... thanks

SKZ 12-02-2006 07:38 AM

Re: Do I need ACDF???
Well I dont have any herniated disks. I have bulging disks and alot of arthritis. I am ALWAYS in a ton of pain for close to 5 yrs. I also have some arm pain and numbness in both hands. I tried EVERYTHING. My physiatrist said we were at the end of the line and he is sending me to a surgeon on Dec. 19th. I am likely to have the surgery (ACDF) at C5-6. and C6-7, before Xmas. I am not sure about C4-5 until I see the surgeon. I already had a discogram which recreated the pain at C5-C7. I am just to the point where I cant take the pain anymore and its bound to decrease with the surgery. I have limited so much of my activites...mostly because I cannot sit for any real length of time. Its really changed my lifestyle. I am 50 going on 70 at this rate. I also substitute teach in elem. school and the standing all day is really rough, too. I could never sit at a computer all day. I would have to be carted off to a mental hospital at the end of the day, if I did. :dizzy: ;)

SKZ 12-02-2006 02:52 PM

Re: Do I need ACDF???
I can really identify with you on the information thing. I am obsessed with knowing everything. I always have been. I can imagine with all your knowledge it would give you more to dwell on. I am a research fiend, which I guess makes me on the neurotic side. I have had ALOT of different types of surgeries and every single time I do this. I feel like I need to know everything so I know the right questions to ask and what a proper expectation would be, as far as the outcome. Your perspective will really be helpful to all of us. I feel like I must know every PT in Denver at this point. LOL. They all vary so much. I feel fortunate that I finally found a really good one. I have a great home program (that I am in the middle of doing right now, but am taking a break cos its killing me!)

SKZ 12-02-2006 04:36 PM

Re: Do I need ACDF???
You are definitely going to be a great one to keep in touch with, since we are the same age. I am willing to bet its somewhat harder when you get up there in far as recuperation. When do you start PT after your ACDF? I really dont know the protocol for this. I read somewhere 6 weeks or something like that.
Have a relaxing night!!

paradiddle 12-02-2006 05:56 PM

Re: Do I need ACDF???
Thanks for all the responses...keep em coming!!!

Sometimes the more people I talk to the less I know, but it is good to talk to people who have been there. If I listened to my boss, I would think that all surgeons just want to cut to keep in business.

One of my oldest friends, who is a pharamcist, had ACDF recomended for him. He went for 2nd op and ended up having a steroid injection done with a CT scan that worked for him. He said the HUGE needle was excruciating for 1 1/2 hours while they found the spot but he has been pain free for 4 years. He would do it again. Like I said the more I hear, the less I know.

It's good to hear that spinal cord compression should not be taken lightly even though I have been functioning ok with for I don't know how long. It was also good to hear from my NS nurse that she thought he was very, very good, for what that was worth.

PNo 12-02-2006 10:13 PM

Re: Do I need ACDF???
Hello - I have been around this particular board since early 2004. There are many people who come and go. Those that stick around tend to be the people with complications or the ongoing cases.

I consider myself a successful case even though I am not what I was prior to this disease taking over my body. My pre surgical pain levels are greatly reduced than prior to surgery #1 and #2 and although I am still needing more surgery, I am by far in a better situation. I started this journey in the off the charts pain category and less on the neurological problems category. I still have some minor arm cramping and finger numbness, and misc nuisance stuff left over in the neruo side, and still have pain issues. I had congenital stenosis, with herniated/ruptured discs, major osteophytes and minor cord compression, spondylosis with continuing DDD.

The one thing is that if you have DDD, the arthritic changes keep marching on and can bring renewed symptoms. But the nerve pain is much more tolerable if kept in check after the surgery. What I mean by kept in check is that if your case if more complicated don't expect to be able to do very physicial activities and not feel it, or computer etc. Everything in moderation.

I have had hysterectomy and abdominal surgery, I remember those being more difficult than the ACDF's. I had a 2 levl acdf with significant work on osteophytes the first time, and a 1 level acdf the second time which included some difficult work. I sailed through, minor swallowing problems, minimal throat pain, post surgical pain was well controlled. Biggest problem was fatigue and wearing that (*(&(*&*^ collar! The incision site etc don't hurt at all, its more in the bone while it heals. Muscle spasms for a while, but all those things were easily controlled by reasonable amounts of pain medicine compared to prior to surgeries.

THe one thing that seems to be common from the people that have been here is the longer that you wait to address neuro compromise problems the more you can expect that it may not get fixed 100%. Better to try to fix than have total loss of use :-) in my opinion.

Talk later.

bw67 12-03-2006 06:38 PM

Re: Do I need ACDF???
maybe someone has already said this, I'll admit I just skimmed through most of the replies...

if your surgery isn't until dec 18th, and you're uneasy as to whether or not you truly need an acdf, maybe you should consider a second opinion? if your insurance plan is like most, you shouldn't have to pay more than a specialist co-pay to reaffirm what the 1st doctor told you...

I'm actually one of the few on this board that posts from time to time that chose to have surgery, but instead of the conventional ACD with fusion I chose a less invasive procedure WITHOUT FUSION...

I saw 5 different drs who all recommended fusion, before coming across a dr who felt he could give me pain relief without removing the discs- I had C5-6 C6-7 herniations causing major pain down my right arm.

3 months later, so far so good.

I hesitate to post more often than I do because to me 3 months isn't enough time to jump up and down and rule the procedure a complete success.

But I definitely have felt better in the last 3 months than I have in the last 2 years, and I still have my discs.

Anyhow, as so many others have rightly said, every patient and every condition is different. For some fusion was the best thing they ever did, for others it only led to more problems.

If you've got a couple weeks, I suggest getting a 2nd opinion and continuing to do all the research you can towards making the most informative decision that you can for your specific condition.

best of luck


paradiddle 12-04-2006 05:26 PM

Re: Do I need ACDF???
I'm going in for 2nd op tommorrow. I have my MRI with me. I also talked to neighbor across the street who had 3 level ACDF done about 9 months ago. He was happy with results and told me what to expect. Told me to practice turning around without using my neck.

bw67 12-04-2006 05:48 PM

Re: Do I need ACDF???
glad to hear you were able to get a 2nd opinion, I hope it helps your decision of luck


paradiddle 12-05-2006 05:28 PM

Re: Do I need ACDF???
Got 2nd opinion. 2nd Doctor wasn't impressed with MRI and did not feel that I needed surgery. Did not believe that I was in any danger.

He is sending me for tests to rule out carpal tunnel for numbness in hands. Also is sending me to 3x a week for 4 wks PT with cervical traction. I'll give it a try and postpone surgery at this point.

bw67 12-05-2006 08:09 PM

Re: Do I need ACDF???
well, hopefully the 2nd opinion helped, and didn't muddy the water for you...

as long as the doctor feels you're not risking futher damage, and as long as your pain is tolerable, if you haven't tried traction to me it is worth a shot.

it provided me relief for well over a year...

in the meantime, you may even consider a THIRD opinion! and you can continue to research your condition and further consider your options...

I would make surgery your absolute last resort. that is just my layman's opinion, curious to see what some of the previous "posters" thoughts are given the new information...

again, best of luck


paradiddle 12-06-2006 04:20 AM

Re: Do I need ACDF???
I have never had traction suggested by anyone before, and this is going back to 1998. I think I will do a third opinion. I don't want to end up looking for an opinion that I like the best but being so far apart I would like to see an opinion that close to either one.

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