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  • to ACDF or not to ACDF - plz help

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    Old 09-18-2003, 12:23 PM   #1
    go*big*red
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    Question to ACDF or not to ACDF - plz help

    Hi, everyone

    I'm usually over on the back board as I am post op single level PLIF on L5/S1 (March 5) However, now my cervical issues have me posting here for a while, now.

    I think my signature line shows briefly my history.

    My dr. also told me that if I were to have an auto accident that it would be devistating for me. I have bulging C5/6 & 6/7 with minor cord encroachment at one of those plus "boney bar?" at one and "boney spur" at other (what's the difference?)

    However, my pain most of the time is only on the left side of my neck to my shoulder. Daily I have a nagging headache starting at the base of my skull on the left and travels upward. No longer have full range of motion of my neck. I do have some (VERY MINIMAL) tingling in my first finger on left but when I get massages, electricity shoots from my neck down to my middle finger.

    I am really considering a 2 level ACDF before the end of the year. This cervical pain is so different than my lumbar pain which was EXCRUCIATING with spasms 24/7. However, my surgeon has stated on several occasions not to get in a car accident and wants me to wear a soft collar when on the motorcycle or riding the horse (neither of which I have done much of since my PLIF)

    Also, my neck/shoulder pain would rise to a 10 after turning my head slightly and then returning to neutral. Not on the turning but the returning to neutral.

    (geeze this is getting long!) I have tried the medx machine for necks, have a pump up cervical collar, have had one injection which was a joke and still do stretch as I can.

    What do you all think? About 85% of the time I'm pretty miserable with this. Those of you that have had an ACDF, any of you just have neck pain with intermittent nerve pain/tingling/numbing down extremities?

    My surgeon assured me that this surgery is sooooooooo much easier than my lumbar fusion (which was pretty easy for me as I think I was so miserable prior) and that it should be a breeze for me as I have such an extremely high pain tolerance.

    Input would be GREATLY appreciated. Thanks for taking the time to read this.


    ------------------
    gbr

    JDD
    2 Discograms
    4 Level failed IDET
    4 Confirmed torn lumbar discs, 2 full thickness
    Issues now with c-spine & thoracic
    Fusion of L5/S1 scheduled 3/5/03
    Fusion successful - feeling better all the time
    Major pain on L side of neck to shoulder - MRI revealed 2 shot discs (C5/6 & 6/7)
    3 upper thoracic discs bulging as well
    __________________
    PLIF 3/03
    2 level ACDF 10/03
    Redo 10/04 & hdwr remove L5/S1
    10/10/06 PLIF L4/5, Dynesys L3/4

     
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    Old 09-18-2003, 04:49 PM   #2
    NYFUSED
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    Hi,
    I also have had back surgery, Laminectomy L4-5 in 2001. It was a total success. Within 7 months I was completely pain free. I had an ACDF c5-6-7 in October 2002. From what you posted I see that you are in an "up against the wall situation". I am not a Dr nor a Nurse but can tell you from my experience that my lumbar surgery was a breeze compared to my cervical surgery. If I were given he chance to do it all over, I would NOT have it and deal with the pain. But, I was told like you that if I were in any type of accident it could be devasting. My tolerance to pain is very high and I am by no means a baby. I can't tell you not to have your surgery but get a second opinion and check out your surgeon. I did not and regret it every day. After my ACDF, I ended up having a posterior-foraminotomy at c6-7 and then got a staph infection and was in the hosp for another week. I am still in pain 24/7 and refuse to have any more surgery unless I was told that I would have permanent nerve damage or anything similiar. I wish you luck and hope you are pain free soon.

    Lori

    Laminectomy L4-5 2001
    ACDF C5-6-7 10/2002
    POST. LAMINECTOMY-FORAMINOTOMY 6/2003
    staph infec. 7/4-03- 7/9/2003
    __________________
    lami L4-5, ACDF C5-6-7, post. lami-foraminotomy c6-7, staph infect. revision acdf c4-5-6-7 new c4-5 2004. STILL IN PAIN 24/7

     
    Old 09-18-2003, 07:44 PM   #3
    go*big*red
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    Hi, Lori

    Thanks for responding. I'm sorry you had such a horrid outcome from your ACDF. Why did you have it - from trauma or DDD or what? And, what was your pain like prior to your surgery? Also, what is a foraminotomy? (sorry for all the questions!) I understand the posterior part of it.

    I had a staff infection in my foot after a surgery and OMG what pain! I cannot even imagine that kind of pain in my neck (no pun intended)

    No, I'm not up against a wall but for instance tonight I went to football practice to watch my 8 year old g-son. I was just a little off kilter from where they were playing so had to look to my right ever so slightly. Coming back to "neutral" or looking to the left then (which I did often as after a while looking to the right was extremely uncomfortable) the pain was a 10 easy. I, like you, am not a wimp when it comes to pain.

    And............. driving is becoming dangerous as well as I can't turn my head the range necessary to see on coming traffic!

    I'm not sure, either, if I want my neck to get as painful as my lumbar before I have the fusion. Which, by the way is inevitable at some point. So, I either wait and do it later or do it now. I'm glad I waited as long as I did for the lumbar, I'm just not sure I can stand that kind of pain again.

    I HATE THESE DECISIONS!

    And...............please don't shake your head at me , but because of my PLIF surgery and all the tests, etc., I have already met my deductible and out of pocket for this year. So..........if I have the surgery now, it costs me nothing. If I wait, it could cost me on the upwards of $5,000. So, there is also a practicle side which I know should not be the basis for a decision for surgery now or later, but if it's inevitable - ...... well, you get the picture.

    However, your story and situation surely gives me pause about the whole d**n thing. I just wish life wasn't like this at all - you know?

    I sure hope you get to feeling better. What is your prognosis? And....... thanks again.

    ------------------
    gbr

    JDD
    2 Discograms
    4 Level failed IDET
    4 Confirmed torn lumbar discs, 2 full thickness
    Issues now with c-spine & thoracic
    Fusion of L5/S1 scheduled 3/5/03
    Fusion successful - feeling better all the time
    Major pain on L side of neck to shoulder - MRI revealed 2 shot discs (C5/6 & 6/7)
    3 upper thoracic discs bulging as well
    __________________
    PLIF 3/03
    2 level ACDF 10/03
    Redo 10/04 & hdwr remove L5/S1
    10/10/06 PLIF L4/5, Dynesys L3/4

     
    Old 09-18-2003, 08:23 PM   #4
    winged phantom
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    gbr,
    please check here for my article on adjusting your car's mirrors... just search for mirrors, and that should bring it up. That should help give you some helpful suggestions about adjusting them.
    wr
    __________________
    • 12/29/89 C5-6 Microdiskectomy (no fusion)
    • 4/9/03 ACDF C4-7 with plating and donor bone

     
    Old 09-19-2003, 07:52 AM   #5
    luvwindnhair
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    Hiya GBR~

    I am 5 weeks post op ACDF plates/screws/my own bone/collar (which is now off!) I do not regret it at all. I have lumbar and Thorasic issues like you too. My neck only bothered me a few times since it began in feb this yr. But when it did, I thought I would rather die than have the pain, numbness tingleing it produced. I didnt think the recovery was too bad, but everyone is different. I think from what you say about the kind of extreem pain you are experiencing, I would go for it. But, I am also no MD, its just my opinion. I would have done mine sooner had I known the wonderful outcome. Good luck!

    Cindy

    ------------------
    L5/S1 herniation 7mm 01/18/00
    Microdiscectomy/Laminectomy 10/12/00
    Thoratic pain began Dx buldge @ T-8 08/02
    Had MRI on Lumbar because pain was returning, also scaned T spine 8/02, Dx recurrent L5/S1 herniation and new herniation @ level L4/5
    Cervical pain began 2/03
    Had MRI~Dx herination @ level C 6/7
    Had anterior decompresion with hardware and use of my own hip bone graft to C 6/7 8/14/03
    Now waiting for neck to heal to get my lumbar fusion...whoo~hoo
    Saving all my pennies for trip to Austrailia to get the ADR!!
    __________________
    L5/S1 herniation 7mm 01/18/00
    Microdiscectomy/Laminectomy 10/12/00
    Thoratic pain began Dx buldge @ T-8 08/02
    Had MRI on Lumbar because pain was returning, also scaned T spine 8/02, Dx recurrent L5/S1 herniation and new herniation @ level L4/5
    Cervical pain began 2/03
    Had MRI~Dx herination @ level C 6/7
    Had anterior decompresion with hardware and use of my own hip bone graft to C 6/7 8/14/03
    Accepted in Clinical trials/getting my 2 level Prodisc ADR in Feb!

     
    Old 09-19-2003, 12:24 PM   #6
    go*big*red
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    Hi Wing
    Thanks for the mirror tips. I responded to your mirror thread.


    Cindy
    Thank you for taking the time to respond (and read my novelette!) It shines a whole different light. The thing that really concerns me is the accident thing. Just in the last 2 days, I've had friends that have been in serious car accidents. Is this a sign? I certainly don't want to be stupid and not do anything to make my spine more stable! I've done all the pt and muscle strengthening I think I can do.

    So, which level are you going to have fused in your lumbar and which is going to be an ADR?

    Thanks again for giving me a whole different spin on everything. It shows there is hope!



    ------------------
    gbr

    JDD
    2 Discograms
    4 Level failed IDET
    4 Confirmed torn lumbar discs, 2 full thickness
    Issues now with c-spine & thoracic
    Fusion of L5/S1 scheduled 3/5/03
    Fusion successful - feeling better all the time
    Major pain on L side of neck to shoulder - MRI revealed 2 shot discs (C5/6 & 6/7)
    3 upper thoracic discs bulging as well
    __________________
    PLIF 3/03
    2 level ACDF 10/03
    Redo 10/04 & hdwr remove L5/S1
    10/10/06 PLIF L4/5, Dynesys L3/4

     
    Old 09-19-2003, 01:04 PM   #7
    winged phantom
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    Location: Central Florida
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    gbr, in case you missed it, I also responded back to you... you don't have to respond again, but I just wanted to make sure you saw it. I think you car ought to be repaired by the manu. at all costs... and by them!
    wr

    PS.. I just re-read this, and it doesn't make much sense... but I think you know what I mean. What can I say? It's Friday! :whew:


    [This message has been edited by winged phantom (edited 09-19-2003).]
    __________________
    • 12/29/89 C5-6 Microdiskectomy (no fusion)
    • 4/9/03 ACDF C4-7 with plating and donor bone

     
    Old 09-19-2003, 02:15 PM   #8
    go*big*red
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    Hi, Wing!

    I didn't see it so I'll go over there right now - thanks. It is Friday, isn't it? http://www.healthboards.com/ubb/dance.gif http://www.healthboards.com/ubb/dance.gif http://www.healthboards.com/ubb/dance.gif

    Can't dance in real life but I love the smilies! At least I can dance vicariously through them.


    ------------------
    gbr

    1st lumbar MRI showed 4 bulging lumbar discs and 3 bulging thoracic discs
    Diagnosed with JDD
    lumbar discograms
    4 Level failed IDET
    another lumbar disco
    4 Confirmed torn lumbar discs, 2 full thickness
    Issues now with c-spine & upper thoracic
    Fusion of L5/S1 scheduled 3/5/03 (PLIF)
    Fusion successful - feeling better all the time
    Major pain on L side of neck to shoulder - MRI revealed 2 shot discs (C5/6 & 6/7)
    3 upper thoracic discs bulging as well
    __________________
    PLIF 3/03
    2 level ACDF 10/03
    Redo 10/04 & hdwr remove L5/S1
    10/10/06 PLIF L4/5, Dynesys L3/4

     
    Old 09-22-2003, 12:25 PM   #9
    go*big*red
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    Join Date: Jan 2003
    Posts: 274
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    Good afternoon.

    Well, I wanted to bump this up in case anyone else might see it and add their wisdom. However, I am pretty sure I have made up my mind.

    Realizing that I don't have much tingling in my hands/fingers, I simply cannot take this pain in the neck any longer. I was up most of the night with it as anytime I would move - OUCH!!!!!!!! And am in a flare with my low back anyway and couldn't get comfortable so tossed and turned alot. Needless to say, I didn't get much sleep and am extrememly sore all up and down my spine and am sporting a wicked headache.

    I have a call into my Dr.'s assistant. I imagine the next step is the dreaded discogram which was hell for my lumbar - 5 level disco with 4 being intensily painful. I'm a little (okay alot) scared about this one.

    If anyone has anything to add or share, please do. I'm looking for all the experience anyone has had and is willing to share.

    Thank you



    ------------------
    gbr

    1st lumbar MRI showed 4 bulging lumbar discs and 3 bulging thoracic discs
    Diagnosed with JDD
    lumbar discograms
    4 Level failed IDET
    another lumbar disco
    4 Confirmed torn lumbar discs, 2 full thickness
    Issues now with c-spine & upper thoracic
    Fusion of L5/S1 scheduled 3/5/03 (PLIF)
    Fusion successful - feeling better all the time
    Major pain on L side of neck to shoulder - MRI revealed 2 shot discs (C5/6 & 6/7)
    3 upper thoracic discs bulging as well
    __________________
    PLIF 3/03
    2 level ACDF 10/03
    Redo 10/04 & hdwr remove L5/S1
    10/10/06 PLIF L4/5, Dynesys L3/4

     
    Old 09-22-2003, 01:23 PM   #10
    loverLife
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    I would do it. I too did not have significant problems when I had my ACDF. I had numbness and no pain whatsoever. My NS told me that I had absolutely no fluid around my disc and if I did not do it, I would become permanently numb in my hands and walk with a shuffle.

    If you already have tingling, your ahead of where I was. It really isn't that bad of a surgery. At least not for me. I am almost 5 months post op, and feel GREAT. I had level 1 ACDF on C-5-6 with donor bone and titanium plate 2 screws. I was back to work in 2 weeks and felt back to normal in about 6 weeks. (ebergy level wise). I now have full range of motion back and no pain, no numbness. I'd say he changed my life!
    __________________
    Christine

     
    Old 09-22-2003, 01:24 PM   #11
    loverLife
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    P.S. I noticed your user name. You must live in Indiana or be from Indiana. I am too. Indiana Spine Group is where I went. They're very good there.
    __________________
    Christine

     
    Old 09-22-2003, 05:47 PM   #12
    luvwindnhair
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    Location: Northern California
    Posts: 83
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    Hi GBR

    Sorry it has taken so long for me to answer your question!! I want to have L5-S1 ADR, but I shall see. I am glad my post has helped, I just hope all your treatments help more!! Good luck, I think you will be so happy in the end.

    Cindy

    ------------------
    L5/S1 herniation 7mm 01/18/00
    Microdiscectomy/Laminectomy 10/12/00
    Thoratic pain began Dx buldge @ T-8 08/02
    Had MRI on Lumbar because pain was returning, also scaned T spine 8/02, Dx recurrent L5/S1 herniation and new herniation @ level L4/5
    Cervical pain began 2/03
    Had MRI~Dx herination @ level C 6/7
    Had anterior decompresion with hardware and use of my own hip bone graft to C 6/7 8/14/03
    Now waiting for neck to heal to get my lumbar fusion...whoo~hoo
    Saving all my pennies for trip to Austrailia to get the ADR!!
    __________________
    L5/S1 herniation 7mm 01/18/00
    Microdiscectomy/Laminectomy 10/12/00
    Thoratic pain began Dx buldge @ T-8 08/02
    Had MRI on Lumbar because pain was returning, also scaned T spine 8/02, Dx recurrent L5/S1 herniation and new herniation @ level L4/5
    Cervical pain began 2/03
    Had MRI~Dx herination @ level C 6/7
    Had anterior decompresion with hardware and use of my own hip bone graft to C 6/7 8/14/03
    Accepted in Clinical trials/getting my 2 level Prodisc ADR in Feb!

     
    Old 09-22-2003, 07:23 PM   #13
    NYFUSED
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    GBR,
    Hi. My ACDF was due to a car accident. I was stopped at a red light and hit from behind. This was the 3rd time in 12 years. A foraminotomy is a procedure where the drill off the foramin to enlarge the space where the spinal roots exit. And yes that staph infection was a true killer. My prognosis at this time I am really not sure. I am going for a MRI with and w/o contrast on Thursday c-spine and with the lower back acting up my NS ordered another lumbar MRI. At this current time I have the following:
    C4-5 BULGE WITH SPINAL STENOSIS
    L4-5 HERNIATED
    S1 HERNIATED
    L3-4 BULGING
    LUMBAR RADICULOPATHY AT L3-4, L4-5, S1
    CARPAL TUNNEL IN BOTH HANDS
    I THINK I HAVE HAD ENOUGH...............

    Let me know what you deciede and good luck.
    Lori

    laminectomy l4-5 2001
    acdf c5-6-7 2002
    post. foraminotomy-laminectomy c6-7
    __________________
    lami L4-5, ACDF C5-6-7, post. lami-foraminotomy c6-7, staph infect. revision acdf c4-5-6-7 new c4-5 2004. STILL IN PAIN 24/7

     
    Old 09-25-2003, 03:32 PM   #14
    go*big*red
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    Well, hi, ladies

    Sorry it took so long for me to post - my bad!

    Cindy - if you're interested, my surgeon is doing trials right now on his own "maverick" artificial disc and he's taking subjects right now. There's no guarantee that you would get the ADR vs a fusion and you would have to pay your own way here.

    However, if your insurance wouldn't cover it, they have funding. If you're interested, let me know and I'll check with the mods and see if I can post info. He's doing the study until the end of the year.

    I'm so glad you're doing so well.

    Lori - that just sucks that you're dealing with your neck issues because someone just wasn't paying attention! Do you think all your spine issues are coming from that accident? And, yes, I think that's enough, too! What are they proposing on your lumbar? And, you should have had your MRI already - let us know what the outcome is with that, okay?

    For me and my lousy neck, it is doing nothing but getting worse as the days go by. I even have a pump up cervical collar that acts like traction and it's not even helping.

    I have an appt. on Monday with my surgeon and will discuss options. I am going to ask him about some alternatives ie. rhyzotomy (sp) or radio frequency injections but my understanding with those as I had also asked about them on my lumbar prior to the surgery and was told then that they are only for facet joint problems which I have none. So, we'll seel. I'm not going to go on like this, though. If necessary, I'll go ahead and schedule the surgery - I've had it! First is the disco and we all know how those feel! Bleh.

    I'll let you know what's up when I do. And, Lori - be sure and let us know about that MRI, okay?


    ------------------
    gbr

    1st lumbar MRI showed 4 bulging lumbar discs and 3 bulging thoracic discs
    Diagnosed with JDD
    lumbar discograms
    4 Level failed IDET
    another lumbar disco
    4 Confirmed torn lumbar discs, 2 full thickness
    Issues now with c-spine & upper thoracic
    Fusion of L5/S1 scheduled 3/5/03 (PLIF)
    Fusion successful - feeling better all the time
    Major pain on L side of neck to shoulder - MRI revealed 2 shot discs (C5/6 & 6/7)
    3 upper thoracic discs bulging as well
    __________________
    PLIF 3/03
    2 level ACDF 10/03
    Redo 10/04 & hdwr remove L5/S1
    10/10/06 PLIF L4/5, Dynesys L3/4

     
    Old 09-25-2003, 03:37 PM   #15
    go*big*red
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    Posts: 274
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    LoverLife

    Dowpe! I thought I had already answered your post to me. And, no, I'm not from nor have never lived in Indiana. It's the Nebraska Husker's fight yell and I am a huge Husker fan.

    As you can see from my previous reply, I'm ready to do something. Thanks so much for replying. I'm thinking if I do the ACDF that I'll use my own bone. It kind of wierds me out having a donor bone in there. I understand that the harvest site many times is more painful than the actual fusion site, but I think it's worth it to have my own bone and I'm a fast healer.

    Thanks again - that's great you're doing so well.

    ------------------
    gbr

    1st lumbar MRI showed 4 bulging lumbar discs and 3 bulging thoracic discs
    Diagnosed with JDD
    lumbar discograms
    4 Level failed IDET
    another lumbar disco
    4 Confirmed torn lumbar discs, 2 full thickness
    Issues now with c-spine & upper thoracic
    Fusion of L5/S1 scheduled 3/5/03 (PLIF)
    Fusion successful - feeling better all the time
    Major pain on L side of neck to shoulder - MRI revealed 2 shot discs (C5/6 & 6/7)
    3 upper thoracic discs bulging as well
    __________________
    PLIF 3/03
    2 level ACDF 10/03
    Redo 10/04 & hdwr remove L5/S1
    10/10/06 PLIF L4/5, Dynesys L3/4

     
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