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    Old 03-25-2009, 12:29 PM   #1
    Surgery042909
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    Question Cervical Anterior Fusion--thoughts

    Hi!

    I face this surgery on April 29th. I am a 45 year of female.

    Looking back my discs have probably been herniated for a long time. I have known for the last 4 years. The spinal cord was not affected and then for some reason between 09-08 and 02-09 my spinal cord became compressed more then flat, kind of crescent shape at C4-5 some slight compression at C5-6 and C6-7 but nothing major.

    My neurosurgeon thinks it probably dates back to a car accident 25 years ago that just compromised the area enough to let time do the rest. It seems unreal something so long ago could come back to get you.

    I am scheduled for surgery 04/29/09 to decompress the spinal cord and fuse from c4-c7 with the use of instrumentation and an anterior approach.

    I am thankful I have a GP who has been watching the discs yearly since they were discovered 4 years ago to be herniated and that when I told him of strange symptoms in my leg he did not hesitate to send me for a MRI immediately and 2 days later a neurosurgeon.

    My original symptoms all came and went and included pain across my left chest, all through the shoulder and occassional numbness in the left arm and occassional headaches. All from a pinched nerve I am told. I dealt and dealt pretty well.

    Now I have periodic leg cramps (for lack of a better word), hyperreflextivity (sorry don't know if I spelled that one right) pain at the base of my neck, and lose of some use of my left hand. It works but slower and not at fine things like clasps or grabbing little stuff. The most interesting symptom I didn't know was even a symptom until seeing the NS was the occassional urgent need to visit the bathroom. It is really quite amazing how things work. I have lower back stiffness leading into my left leg with the MRI showing the rest of my spine as being fine but the doctor says this one is not connected.

    I am interested in what I should expect in repards to range of movement after the fusion. (C4-7). I would also like an idea of what to expect following surgery recovery wise. Will I be able to take care of myself or will others need to come in? I am lucky and thankful that my symptoms are not extensive or constant but I understand the danger of doing nothing.

    My doctor has told me that I can go back to work (desk job) after 2-3 weeks but it seems most of you are saying longer.

    I am scared silly of having the surgery since I have never had any sort of surgery, ever!!

    Thanks for any insight and words to releive some of my surgery anxiety.

    Judi

     
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    Old 03-26-2009, 06:07 AM   #2
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    Re: Cervical Anterior Fusion--thoughts

    Hi Judy, I am happy to see your thread up. I have every symptom you have. Really mine started with the chest area.
    I am recovery from C5-6 fusion with 7 & 4 not in great shape.
    As are as mobiliy in my neck my surgeon said I may loose 10% which he stated is not much but thats only from C5-6.
    As far as work really you wont be able to say until you are into your recovery. Every recovery is different & not predictable. I do know with desk jobs you may return sooner. It is a long recovery & you will need to rest & follow every restriction. Your recovery will depend that.
    Do you know if you will have a collar? I cant see where you would be driving that soon. I did not drive till almost 3mnths post op. I am sure there are those who are able to drive sooner but not by much.
    I did not expect all of this & was surprised at how limited I was postop. Even though you may feel pretty well if you attempt to do to much you will really feel it. I think the recovery stage is hard for most.
    Try to be as prepared as you can be for surgery. Getting things together to keep you occupied. Alot of people like using a wedge pillow for comfort. Keeping things within reach for showering & so on...I made sure I got a good haircut right before. It sounds silly but I am really glad I did. You may need help for the first few days postop. Its always best to have someone around just in case. I could not manage to get out of bed on my own the first few days. alot of people use recliners more, its easier to get in & out of. clothes that are easy to get on & off, like button ups. Any house work that you feel needs to be done make sure its caught up on if you can. I declined so much before surgery all my plans went down the tubes so to speak. My headaches became to much to do anything & I tried to continue working & put off alot of preparing my house.
    I am sure others will join in here & you will find their advice more valuable then I can say. There is a great bunch of people here. good luck, Sammy

     
    Old 03-26-2009, 01:45 PM   #3
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    Re: Cervical Anterior Fusion--thoughts

    I am so confused.

    Did you have hardware?? Anterior or posterior? Mine is scheduled to be a anterior approach fusion with hardware.

    I guess I have a boatload of questions for the 16th when I see the surgeon again. I was told I could not drive for a week and afterwards would have to use a hard collar for driving for a few months. I was told that was to safe guard me in case of an accident. I was told I would need a soft collar for about 6 weeks when sleeping to help make sure I didn't move funny in my sleep. I was told the worse patients usually complain about is their throat for a day to 4.

    He told me he uses the titanian plate to speed recovery. He also said he does not harvest ones own bone to speed recovery.

    I know I can't lift things for awhile over 5 pounds.

    The surgeon told me that I would lose about 7% up and down movement because only one disc is currently functioning and moving anyway. (the other two are completely flat and dry)

    I am soooo confused, I don't know what to expect. I am a single mom living and working in a rural area, I have to be able to drive and get around.

    I don't mind working around some things but that one is really not something I can do without. I have to work. I have to eat. I have to do for the family.

    The doctor made it sound like I would be down totally for a week and house bound with the need to really take it easy for two weeks but that I should actually be feeling better in some regards. After that I could slowly resume my regular activities. Idon't expect to be doing jumpping jacks in a few weeks but I would like to able to take care of myself. What can I expect??

    Will I be able to shower alone? What can't be done that front opening clothes are needed? Can't we move our arms?? Are we able to walk to exercise? Is physical therapy usual or not usual after the procedure? Does the neck hurt afterwards? What hurts and can't be used??

    I am afraid this will be more then I can handle.

    Last edited by Surgery042909; 03-26-2009 at 01:47 PM.

     
    Old 03-26-2009, 03:15 PM   #4
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    Re: Cervical Anterior Fusion--thoughts

    I had acdf C5-6 c6-7 with hardware done on Feb 17th and I went back to work at 5 weeks. I could not drive for 4 weeks and had a soft collar for 4 weeks. It was not easy to sit in one position for too long but it has gotten better every day. I think I went back to work sooner than most and it has been tough the first few days but it is getting better everyday. I think it would be hard to go through this by yourself with no help especially if you have kids. I still have a restriction on lifting of 10lbs and no excessive bending, twisting. I am at 5+ weeks and still have restrictions with my physical exercise and will probably start physical therapy next week. I wish all of you the best of care with your surgeries and you just have to learn patience and do what the doctor says to do. Remember everyone heals at different paces so it is hard to know for sure how your body will recover. Take care,

     
    Old 03-26-2009, 04:44 PM   #5
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    Re: Cervical Anterior Fusion--thoughts

    Well, I too have had c4 thru c7 fused with the plate and donor bone. My experience is a little diff from cj's. I was house bound for 4 weeks which ment no driving. I had the hard Aspen Vista collar on (and the office indicated it was illegal to drive with it) and also had my in-laws here helping me. I was on a 5 lb restriction, no pushing, no pulling, no bending, no house work ect. for 4 weeks. I even needed help washing my hair everyday. I could raise my arms, but it hurt too much for about 2 weeks to do it. I then went to a soft collar and that has been on 2 weeks. I start PT tomorrow. The pain has been controlled primarily with muscle relaxers and I have vicoden when the burning starts. I think means I'm doing too much. I had the anterior approach and was in the hospital for 2 1/2 days. My pain pre op was almost constant and was gone after surgery. I love waking up in NO PAIN everyday since. It is almost like they wave a magic wand and it is gone and the price you pay is being inactive for a peroid of time. Good luck. Your outcome will depend on your surgeon and and how well you follow the restrictions. Good luck. It for me was worth it.
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    Old 04-02-2009, 11:14 AM   #6
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    Re: Cervical Anterior Fusion--thoughts

    Hi, I have recently had an ACDF for C6/7 and will try to relate my immediate post op experience.

    The first thing I recall is someone asking me was I in any pain. I said "yes, in my back". They asked me to rate it 1-10 and I said 8. I drifted off into sleep again and the next time someone asked me my pain level I said 3. I drifted off again and I woke again, semi conscious still in the recovery room to my surgeon telling me it had gone well but that the disc definitely needed to come out. I remember at some stage also wiggling my toes and fingers, just to check I still had use of them. There was a sense of relief that it was all over and I asked the theatre staff to phone my family.

    It is all a bit of a blur after that but I ended up back in my room with an oxygen tube up my nose, a drain coming through my wound from which blood would drip into a bottle and a drip in the back of my hand for painkillers and fluids. I was pain free and comfortable and welcomed visitors that night but I was tired to talk too much. Unfortunately, as soon as they walked out the door I felt a tremendous wave of nausea (from the anaesthetic) and started vomiting all over myself. Once the staff had cleaned me up I felt okay again.

    The staff would not let me up that night to use the toilet so I had to use the bed pan for a wee but I found it impossible to go. Whether it was stage fright (with the nurses there) or being numb from the anaesthetic and pain killers I don't know. I had to push and push like I was in labour just to do a pee and it took ages. The worst of it is I had to ask for it three times during the night.

    I was given a bed bath in the morning to clean me up and helped into pyjamas. I was then allowed to get up which I didn't find a problem. They took the drip out but left the drain in. I had to carry the drain with me everywhere that first day but they removed it that night. My first walk was to the toilet to go by myself - bliss! I put on a little makeup and brushed my hair. After that I got up and down all day and walked about the hospital carrying my drain.

    The only real pain I felt was only for a brief time in the recovery room. After the first day I didn't even need painkillers. There was, however, an uncomfortable lump in my throat but it didn't stop me eating the hospital food which was delicious.

    I was supposed to stay for 3-4 nights but my consultant was so pleased with my progress that he let me go home the next day.

    Hope this helps x
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    Old 04-02-2009, 05:14 PM   #7
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    Re: Cervical Anterior Fusion--thoughts

    i wouldn't count on only being away from work for 2-3 weeks. i had a single level fusion and was out for 9 weeks. i couldn't drive for 5 weeks because i couldn't turn my head far enough to back out of my garage. trust me, i tried. the bumps in the road were absolutely awful for the first few months, but i think i was particularly sensitive. i went right from the hard collar to no collar in 4 weeks. i had the aspen collar as well. i did wear my collar in the car with my husband driving for about 6 weeks. i do think it is illegal to drive with a hard collar on.

    after the first few days, i was able to take a shower by myself, but with quite a bit of pain and a lot of patience. it got better every week.

    please read the sticky on the top of this board about how to prepare for acdf. it is very informative and right on the money about what to expect.

     
    Old 04-02-2009, 11:16 PM   #8
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    Re: Cervical Anterior Fusion--thoughts

    Hello - it is good to hear a variety of people's experiences but it is difficult to compare a single level surgery with a multiple level surgery. Although the procedure is the same - it is multiple levels. That means more poking, prodding, drilling, shaving, handling of nerves, and longer time in surgery.

    You are going to have a 3 level ACDF if I read this correctly C4-7 - just confirming. I am fused C4-7 with anterior, donor bone and plating.

    The surgeons tend to under represent how you might feel after these multi-level ACDFs and I don't know why they don't just be more middle of the road. The sickness and accident insurance people cover this as a 6-9 week recovery. Some people will recover faster, some people longer - there is no way to predict!

    I am not a whimp and have a pretty strong consititution, I have had several surgeries before and know how to push myself so when I am telling you these things know that they are coming from a pretty hard headed person.

    I believe from my own experience and reading posts over the last 5 years that the average immediate recovery from a full ACDF surgery takes about 3-7 days. In that first week you most likely will feel pretty crappy and if you take too much medication and do too much for yourself then you will only prolong your recovery. So the goal is to really rest that first week. It would be good to have help for at least that time. Don't be fooled by your short stay in the hospital that this is a minor surgery. You will probably be a little weak, need help showering and preparing meals. You really won't be able to take care of kids in those first days. By the end of that first week you will probably be able to do alot for yourself and get little bursts of energy. So yes probably mostly housebound and mostly couch bound.

    The second week you will be doing a lot more, increasing your activity/walking, taking care of yourself. But will you feel like shopping, cleaning, cooking all in the same day - probably not too much!! You hopefully will be taking lots less pain medications by this week and starting to get your energy back and getting a little bored.

    The third week you start doing many of your activities but at a slower pace and with the restrictions your dr. puts on you. Each week thereafter you keep improving but also the nerves wake up and you start feeling the aches and pains and stuff as your body heals. some people experience little setbacks in these weeks by doing too much - you will have to gauge what you do based on how you feel. If you have a desk job the long sitting and stuff will probably set off muscle spasms but they can be managed.

    First after you can raise your arms unless they restrict you, it can be uncomfortable but there are ways around getting your clothing on - don't think you have to go buy a lot of new stuff. Just get something comfy for the first days you are home resting.

    You shouldn't drive if you are taking a lot of pain medications! There was a very interesting discussion on driving while medicated over on the pain board. Many people don't drive the first month.

    Most likely no physical therapy for a multiple level ACDF until 6 months, but every doctor has their own style so you will have to see what your's likes.

    You can get through this - it isn't the most horrible surgery one could have, but you do need to take care of yourself . Plan for worst and hope for best. That means plan it around a time you can get a little bit of help, be off for at least 3-4 weeks and hope that you could go back part time in week 4 but have a backup plan in case you aren't there. This is your shot to get back to a healthier life and you really want to go through the stages and heal properly!!!!


    You will have lots of moral support from all the great people here.

     
    Old 04-03-2009, 05:10 AM   #9
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    Re: Cervical Anterior Fusion--thoughts

    As you can see everyone is different. I was in the shower myself after the first couple days. I have shoulder & muscle issues & had this for years, I am sure that has alot to do with my recovery. My surgeon warned me he was really strict from the get go. I am sure he went by my preop problems, what he found during the surgery & how the recovery & fusion went as far as my restrictions.
    I did feel pretty good after the first few days but I know because I did feel so good I over did it. The worst pain as far as the surgery itself was right after waking up, but your in the hospital & its controlled pretty well. I stayed overnight & stayed on my pain meds so I felt decent by the time I was home. Had some throat pain & a hard time swallowing but it passed. No raising my arms. In my opinion I would just be very careful that first month at least. Give you neck time to fuse. Your surgeon will watch your progress & I am sure take it from there. That was good advice NP gave you, plan for the worst & hope for the best. That way no matter what your covered. There are alot of successful fusions & there is no reason to think you wont be one of them. good luck Sammy

     
    Old 04-03-2009, 01:40 PM   #10
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    Re: Cervical Anterior Fusion--thoughts

    I spent two nights in the hospital for my C5-C7 ACDF. I had thought I'd be able to return to work at 4 weeks but there was no way. I had the Aspen collar on for 6 weeks and though I type well, I never realized how much I may glance down at the keys, etc. I had a desk job (could require local travel but could avoid that if needed) and there was no way I could go back to work until 6 weeks.

    My biggest piece of advice - don't let yourself get deconditioned. When I did go back to work at 6 weeks it was awful. Not because of my neck but I had just puttered around my home for 6 weeks ... and the walk from my car to the door of our office was exhausting! I had additional surgery last May and with the doctor's blessing I started on my treadmill at day 5 post-op (started for 5 minutes at 1 mph - and added one minute every day and a half a mph every week or so).

    I was very concerned about loss of range of motion but all in all it wasn't bad. I had met someone who had more extensive surgery years ago and his ROM was very limited, but he told me most of today's procedures via ACDF are better than what he had. I did end up purchasing a new rear view mirror for my car that gives a wider scope of view. I got one that is removable as my husband drives my car occasionally and he hates the new mirror. I love it. Less need to look around. To be honest that's when I've noticed the slight loss of ROM - when backing out of tight parking spaces in busy parking lots.

    Let me know if there's anything else you want to know. I know it can be a scary proposition but all in all I'm so glad I did the surgery.
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    Old 04-03-2009, 03:43 PM   #11
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    Re: Cervical Anterior Fusion--thoughts

    Quote:
    Originally Posted by neckpatient View Post
    Hello - it is good to hear a variety of people's experiences but it is difficult to compare a single level surgery with a multiple level surgery. Although the procedure is the same - it is multiple levels. That means more poking, prodding, drilling, shaving, handling of nerves, and longer time in surgery.
    i realize that a multiple level fusion is more complicated surgery than a single level, and that is why i posted my experience. i thought the poster should know that if i had trouble driving after just a single level done, that she might expect at least that, but probably more.

     
    Old 04-08-2009, 10:53 AM   #12
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    Re: Cervical Anterior Fusion--thoughts

    Hello SpineAZ, I was reading some post, and came across yours. Aug. of 07 I had ACDF with a corpectomy and the removal of many disc. Had to wear the Aspen Collar, and even though it took awhile, I got better but my legs never did. They only got worse, weak, spasms and I can hardly walk. Long story short, after many more test, and MRI's doc feels the problem also is in the neck where they found a bone resting on the cord, which is bruised and small swelling. I will now face the Posterior Cervical Operation. He did not sugar coat it, and told me I would be in much more pain this time around, and would be back in my Aspen for at least 6 weeks. I'm 55 years young, and I want to have my life back, walking.. without my cane, or walker. Doc said if I let this go, I will end up in a wheelchair. I won't give up, and I do not want to be in a wheelchair if at all possible. SpineAZ, can you give me your account of the operation, and your recovery? I know we all heal different, and I have heard from others, but the more info I gather the better and faster I will heal. Right? I have faith in my Doctor, and I trust him so. He knows this, and has always been up front and to the point. No guessing with this doc. I really respect and admire him as a surgeon and a person. Any info you could pass my way will be much appreciated. Thank you and I hope you are doing well. Janatee Also I will have 2 small rods in the back with screws. I have plates, a cage, and screws in the front, so why not make me have a neck of steel....lol lol

     
    Old 04-08-2009, 08:27 PM   #13
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    Re: Cervical Anterior Fusion--thoughts

    I'll be honest with you in that the posterior approach is more painful than the anterior approach you had with the ACDF. I am a surgery veteran (back, knees, feet, etc) and I have to say that the ACDF was one of the least painful procedures I ever had in terms of "surgical pain". I woke up from the ACDF with a tremendous relief of my nerve pain down the arm and the incision wasn't bad at all.

    Fast forward to the posterior cervical surgery. The moment I woke up I was in a great deal of pain. The nurse said if I took the muscle relaxants regularly it would help and indeed it did help some. I made sure to ask for meds when I needed them (while in the hospital overnight) and took them at home religiously. This did help quite a bit. The posterior approach I had (foraminotomy C5, C6, C7) did end up relieving some severe stenosis that was causing severe nerve impingement. So I noticed within a few days (and not the first day) that the nerve pain had again subsided but the surgical pain was more than I had experienced before. Now in my posterior surgery he did some additional fusion work but not with any hardware. So I only had to wear the Aspen collar home. I did use it a few times in the first 6 weeks post op when I had muscle spasms and just had the feeling my neck was fatigued from pain. But I was lucky in that I didn't have to wear the collar full time.

    I don't want to scare you but be prepared for a bit more pain and don't be afraid to ask for relief. My doctor is really good - but I had to blatantly tell him that since he hasn't experienced it....the posterior surgery was more painful. I think he knew but I must have said it the right way as it really seemed to click.

    Keep in mind I am a orthopedic mess - and just had an MRI as I have some new symptoms toward the pinky side of my hand/fingers. It's possible I have a new area of nerve impingement (C8?). This is not the norm - I have a propensity toward very loose ligaments (hence the other orthopedic problems I've had) and that means I'm usually in for more problems than the average patient.

    The key here is removing the bone on the spinal cord will give you and intense amount of relief so the recovery and post-surgical pain will be worth it. You'd probably agree if I said "You'll have post-surgical pain but at the same time your other symptoms (spasms, etc) may slowly disappear after surgery.....and it will be worth it". I was scared of my initial ACDF but the relief I got was tremendous so I'm so glad I did it. I am the kind that says if surgery can fully or partially relieve something....let's do it!

    When is your surgery?
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    Old 04-09-2009, 08:06 AM   #14
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    Re: Cervical Anterior Fusion--thoughts

    Dear SpineAZ, Thank you for the quick reply. First, I do not know yet when the surgery will be. I have to give the doc the go ahead. He told me to go home and think about it, then let him know. He is a doc, who does not push anything...even though my husband and I know this is going to happen. I hate the thought of the pain, BUT, if this surgery will take away all the hurt, and the weakness, the spasms, and all the rest, then I say lets go for it. I do not want to end up in a wheelchair, by my choice. Doc told me he will have for me plenty of meds.. One thing I forgot to ask. During the ACDF operation, because of the moving of the windpipe, my poor throat was a mess for at least 9 months. It felt like it had a chicken bone in it, and felt swollen on the inside, but one day I woke up, and my throat was back to normal. That was the first thing I ask the doc, "will you need to move the windpipe in anyway, and he said no" So, how was your throat when you woke up??? I know it might be sore or scratchy from the breathing tube, but still, how was yours? When you feel like giving me a shout, please do. I should be getting some info on this surgery soon. I plan to tell the doc to go ahead today or tomorrow. Just have to get that courage to say the word. Thank you again for all the good info. The more I gather, the better I feel. Take care of yourself, and hang in there.... Janatee

     
    Old 04-12-2009, 02:07 PM   #15
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    Re: Cervical Anterior Fusion--thoughts

    I didn't have much problem with my windpipe - just for about 3 days I felt as if I had a sore throat. When they go in from the back (posterior cervical surgery) they don't get anywhere near the windpipe. But let the anesthesiologist know that with the ACDF you had some windpipe issues - just so they are aware for intubation during surgery (they will intubate you for general anesthesia). When ever I have been intubated I've never had any pain or scratchy throat sensation - but I have heard of other people who experience this with each surgery they have - so it may depend on each person's individual anatomy.
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