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ACDF pain returned

centerlineccenterline Posts: 23
edited 06/11/2012 - 8:26 AM in Back Surgery and Neck Surgery
I had ACDF surgery for C5-6 and C6-7 about 6 weeks ago. Pretty much the same story as so many people here. Prior to surgery, had terrible pain in my neck and right arm - and a little in the left arm. MRI showed significant spinal stenosis and foramenal narrowing. I do have the titanium plate installed.

Anyhow, right after surgery the arm pain was gone. It stayed gone for about 4 weeks. During this time, I was in a hard collar - but wasn't too religuous about wearing it tight. Also during this time, I had post-op tightness and discomfort in my neck and shoulders - which I am to understand is fairly normal following acdf surgery.

A short while after getting out of the collar, the pain started coming back in my arms (more in the right arm just like before - hence; same nerves). The pain is much less than before in terms of intensity though - more of an annoyance now instead of crippling. I also have increased tightness and discomfort in my neck and shoulders similar to the post-op pain from the first week home.

This recurrance does seem to center around my increased activity, including driving and a return to work (desk job).

I guess I fishing for any experience anyone might have with this.

It just seems odd that the surgery used solid bone and titatium plating to take the pressure off of the nerve roots and spinal cord - and the pain was gone for awhile. Those structures are in still in place (hopefully) and it seems wierd the pain would come back - even with increased activity as the spinal cord and nerve roots cannot again be pinched. I would think that too much activity would cause pain in my neck and shoulders only.

Thoughts? Experiences?


  • I had ACDF C5/6 in March and had continuing pain into July, I had a CT Myleogram, my Ortho doc was looking for a pinched nerve or anything that could be causing pain, but nothing was significant. My pain just went away about a month later and has not returned.
    I did not have to wear a collar at all, my Ortho does not recommend the collar, he told me that the titanium plate with the screws was very strong and would hold everything in place, so the collar was not necessary. Since I know that every Ortho is different.
    I hope this helps, but keep your doc updated. Hope you are feeling better soon.
  • and welcome to the forum....you will find so much support and understanding from our amazing members here.

    You are still so early in recovery and it does take time for the body to heal. Have you mentioned to your doctor your concerns? If not , then you may want to do that. We all heal differently so it becomes difficult to compare one case to another. I did well after surgery also then my pain came back and brought some new pain with it but I also have other spinal issues going on that add to my problems , I am NOT saying that is what is going on with you at all....make a list of your concerns and go over them with your doctor....make sure that you are following your doctor's orders and try not to over do it on those days when you are feeling good.

    Please keep us posted as to how you are doing and if there is ever anything that I can help you with then please just let me know and I will be more than happy to do for you whatever I can. I wish you all the best....take care....Miki
  • I have been lurking on this site for a long time and have found the best help here. Thanks for the quick responses. Wow.

    I do think that I overdid it. I was feeling much, much better and definately was inclinded to do more. It is easy to forget the limitations. It is also funny that when you overdo it, the neck (and related problems) don't immediately say "stop doing this!" Rather, the reaction is delayed. The pain kicks in a few minutes to several hours later.

    The slight recurrance of the arm pain does have me really nervous. I am taking easy this weekend and will let everyone know how everything goes. I have a follow-up appointment in about 2 weeks and will relay the outcome of that as well.

    thanks again
  • It seems that we all have been through that. Just when we think we're getting better we either do or don't do something and then get knocked out by the pain either returning pain or some new pain. So I think we can all relate. Definitely mention it to your doctor but don't feel bad about calling their office and just telling them what you are going through now. Maybe there might be a need that your doctor might want to see you sooner for. Or they might make a change in your medication if you are taking anything.
    In my case inactivity makes my shoulders hurt. So I make sure that even when I'm sitting I do shoulder rolls. You are a little too early to start doing any PT I would think but talk to your doctor. See what they say. But don't think you have to live like that for two weeks until your appointment. You don't.
    Again welcome and know that you are amongst some really great people.
  • That is worth a phone call to the doc. I'll give you my 2 cents worth anyway. Sometimes the healing of the nerve pathways can cause the pain to "return". You mentioned that the pain isn't the same intensity but rather an annoying pain. Perhaps it's your body healing those pesky nerves. One can only hope.

    I do agree that you should call however. It's better to be safe than sorry.

    Hope it's good news,
  • My dad actually had the same sugery as me (almost same - his was double level c4-6 I think, with hardware). Runs in the family except that I am 20 years ahead of him. His surgery was a couple of years ago. Anyhow, he felt great on day 2. No issues except complaints about the collar. Maybe he had a little discomfort here and there - but nothing great enough to even stick in his memory. He was back to work about the same time as me - and had no repeat discomfort or pain. I suppose my younger age might have me more active than him - and pushing things faster than him - and causing my own problems.

    Just thought I would share for anyone who read this.
  • Just got back from the doctors office. Xray shows that plate and screws are OK. Nothing looks broken, collapsed, etc. The Dr did tell me what I sort of knew was the answer...

    The nerves and spinal cord all take time to heal and the healing process is not exactly a perfect process. The nerves and spinal cord can flare up during the recovery process. It can take up to a year for the healing process to really complete. At 8 weeks post-op, I am still early in the game. Doing too much too quick can definately cause problems. In my case, the nerve and spinal cord compression was severe - so my issues did not seem to surprise the Dr.

    Overall, he did not seemed concerned at all. And I do trust my Doctor. He is good guy and has been honest with me from day one. I really think that if he saw something on this xray that was suspect or problematic, he would have let me know.

    I do believe that I am just pushing too hard and too quick back into normal activities. I am going to slow down and see if things get back on track better.

    On a sidebar, my bottom graft (c6-7) looked really good. The top graft (c5-6) seems to be further back (posteriorly) - more to the rear of the vertebra instead of the front. I did not ask about this as it slipped my mind at the time. However, if it was a problem, I think the Dr would have mentioned it.
  • am glad that you had a good doctor's visit and I am also glad that you are going to slow down a bit and take it a little more easier on yourself. Please continue to keep us posted as to how you are doing....take care....Miki
  • Did your Doctor approve your going back to work full time? I am at seven weeks and I am going to the dr. today. I am thinking that he will release me back to work tomorrow as that is what he stated in my disbility papers.

    Just curious. I only had a one level but I had severe compression also.
  • Centerline,
    This is my first post. I find it fitting since we underwent the exact same surgery, ACDF C-5/6 and C-6/7 with titanium plate. I'm only three days post-op and on the road to recovery. I'm taking it extra light. Still have numb right index finger and thumb. Hopefully, that will go away as the nerves heal. I had severe compression according to the MRI. Arm pain appears to have subsided, neck is really sore from the surgery. Dr. said this is primarily due to traction being used to do the disc removals. Makes sense since it feels like mostly muscle pain. Taking flexiril and percocet 7.5mg to manage. Walking with my daughter yesterday was great and helped me with my positive focus. Scar is a little larger than I would like, but I was told that Icing it will help? What did everyone get as far as advice on heat or cold for the post-op recovery period? Will a heating pad be bad to use on the back of the neck where the muscle pain is?
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