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Greetings & my cervical situation

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:29 AM in Neck Pain: Cervical
Hi folks...first post here after lurking and reading up a bunch...I've found the site to be very helpful so far.

My situation with my cervical spine:

- 5+ years of "issues" that I can directly connect to my neck, and a shoulder injury over 15 years ago that may be contributing.

- DDD at all levels of my cervical spine

- Results from recent MRI: 3 herniated discs (C3/4, C5/6, C6/7) and one bulge at C4/5; plenty of bone spurs

- 2006 MRI showed DDD and one herniated disc, so looks like I've progressed (not in a good way)

- Primary symptoms: chronic and unrelenting neck pain, right shoulder and arm weakness (extreme), pain (constant but tolerable, although I have a high pain threshold), numbness and tingling in my right hand and fingers

Here are my questions for those of you in the know and with experience:

- My ortho is suggesting ACDF at C5-6. Does this make sense based on the high level summary of my symptoms?

- I asked my ortho about ARD as an option...I know he does this procedure (he highlights it on his website), but he seemed unenthusiastic about discussing this as an option. We didn't talk in much detail about it, but he mentioned issues with insurance coverage, hospital approval of the procedure, and lack of long term studies. I'm obviously concerned about what I've read about adjacent level issues after ACDF, especially since I have established problems at several other levels. Any thoughts on this?

- I've read various articles and studies on outcomes, but are folks finding relief from the neck pain after ACDF? I'd also hope that the arm weakness would improve.

- I realize everyone heals differently, but on average could I return to my knowledge worker job (from home, at minimum) within a week or two of surgery?

- Would I be able to handle a 10+ hour flight and week long vacation 3 months after surgery, as long as I used common sense and took it easy?

Thanks in advance for the insights...I'll be posting more in the coming weeks...



  • Welcome to spine health cervical forum.

    Listen to Kattoo13, I believe she has a lot of sense. I really like the advice she gives me.

    I would give you advice, but I am not at surgery level according to the doctors. I do beg to differ though. I want relief just like the rest of us.

    I hope everything works out well for you! :)

    Hope to talk soon!
  • thanks for the info and advice so far...

    at a broader level what I'm trying to reconcile (in addition to the questions from my first post):

    - looks like from the literature that ACDF is "successful" at about an 80%+ rate...i filter success as resolution of the limb pain and neurological symptoms. neck pain relief seems to be running at a somewhat lower success rate. so do I go through all of this with decent odds of success, but some chance of limited or no improvement, or....

    - do nothing, and risk either "as is" or a worse state of affairs...I'd think that I would continue to slide downward, given my experience over the past few years. I can tolerate a lot, but one of the reasons I'm actively looking at options now is that I'm finding it more difficult to deal and function with the symptoms...I also wouldn't want to end up in an even more serious condition if spinal cord compression becomes even worse...

    Seems like a relatively clear choice, but not really, if that makes any sense....
  • Welcome to spine-health, I am probably more an exception than the norm. I had and have many issues with my c-spine. I have had 2 ACDF's and a 3 level Laminectomy. They all have done what they were suposed to do. I have myelopathy which is going to keep some of my symptoms with me for ever. I have numbness in my left arm/hand, more bothersome than painful. Sometimes things drop right out of it. I also have trouble with my balance, walking down anything is a chore, have to think where my feet are all the time. To do nothing would be taking a chance that more damage may be done. You may want to get another opinion if you are not comfortable with your current doctor, it may help to have a second set of eyes looking at your MRI's and such. The initial surgery got rid of the severe pain that I had, the next surgery stopped my balance issue from getting worse, and my next surgery will hopefully stop a bowl issue and help with my spastic legs. I have been lucky in that I do not have much pain, more muscle spasms than anything else, but my c-spine will leave me know if I over do things. Only you and your surgeon can determine what path to take. If you have any questions, feel free to PM me.

  • My ACDF relieved almost all of my symptoms. I also had left arm extreme weakness and terrible muscle pain below the elbow and tingling 24/7 in right arm. Those symptoms were gone immediately after the surgery. The muscle spasms have continued, however, and now have aches in the back of my neck. I attribute both of these things to the recovery process and, because they've lessened, am fairly sure they too will go away.

    I seriously doubt that you'll be able to go back to work a week or two after surgery, maybe for an hour at a time with a long break inbetween. I don't think the trip after three months is out of the question.

    Of course, everything depends on how you heal. Are you 100% confident in your surgeon? Will you have to wear a collar?

  • My ortho is as good as anyone I've seen over the past 5 years for my issues, and is offering the most aggressive options to get to the root cause...other docs have primarily focused on conservative treatments (which I suppose is the right first course of action).

    Only issue I have is wanting more detail on "why not ADR" versus just looking at ACDF...I guess I simply need to ask those questions.

    I guess my biggest concern with fusion is that I set off a chain of events that leaves me in worse shape than now, but that is probably less likely of an outcome.

    Also, my weakness in my right arm is to the point where is just feels like dead weight, that it could "fall off"...most of this is centered in the deltoid and my shoulder...I've always wondered if there is also something wrong with my shoulder, but can cervical HD and DDD cause this level of weakness and pain in the shoulder area?

    Continued "thanks" and gratitude for the help here...
  • Yes, cervical issues can cause this degree of shoulder pain & weakness. I had C5-6 fusion (see signature below) and went back to work in one month, driving 8 hours a day. Was it hard? Yep, but I did it. Still have a lot of other issues causing daily pain, but the fusion took away the fear of permanent nerve damage from the herniation at that level. The longer you wait for surgery, the more chance of sx's being permanent. Flying at 3 months shouldn't be an issue, if everything goes as normal. Fusion is still considered the "Gold standard" for cervical issues. With your adjacent levels already showing signs of degeneration and other issues, I see where your surgeon would be leery of ADR. Good luck with whatever you decide to do.

  • Curious, I thought existing level issues would raise red flags for ACDF, but you mentioned ADR?

    Right on in that I absolutely do want to go down the path of permanent nerve issues (although in reality, my issues feel "permanent" since I've dealt with them for so long, and they won't get better unless I do something....guess that's another way for me to think about this...)

    Regarding work, if I go through with this I'm going to push to return at day 5 post-op, at least for a few hours per day...I don't do physical work, so I'd think engaging my brain again would help with overall recovery.

    You mentioned melatonin in your sig...I take that for some of my other issues....were you able to continue this right after ACDF?

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