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Ironic surgical decision dilemna

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:29 AM in Back Surgery and Neck Surgery
For years my goal has been to "fix the root cause" of my neck pain and cervical issues. I've gone through all of the hoops of conservative treatment, and nothing has provided lasting relief.

After my latest MRI and ortho consult, he is suggesting ACDF at c5/6 as the next step...I didn't get the sense that this was an urgent necessity or that I'm at risk of imminent spinal cord damage, but his gist was that my condition will likely not improve without surgery, and could get worse.

So my dilemma is that after wanting for so long to have a partner in attacking the root cause, now that I've been presented that option I'm waffling a bit on what to do. Biggest concern is that I understand there are no guarantees with surgical outcomes, and I do not want to end up much worse than I am today from side effects, complications or future impacts from the initial surgery. Part of this is that I've "adjusted" to my issues and have learned to compensate and deal with the pain, reduced ROM, weakness, tingling, etc. It's my "new normal", so I don't really remember what it's like not to have all the problems, and part of my internal conversation is "hey, if you've dealt with it this long you can continue to deal"...However, I really want to try to solve my issues, feel better and prevent any further deterioration. This part of my internal conversation says "go for it".

Anyone else struggle like this?


  • I have not had an ACDF so I can't really comment on the recovery.

    My thoughts are that you have a lot of symptoms already. If things continue to degenerate will you do further damage?

    I try to base my decision on many things.
    Is it emergent?
    Will it get worse? quickly? or Slowly?
    Will my delaying treatment hurt my chances for recovery?
    How old am I? Does that matter? Will it matter when I NEED to get it done if I wait?

    When you add the answers and you have several opinions from doctors you can usually get an answer you are comfortable with. Be it good or bad in the end, its being comfortable that you made the correct choice for you at the time you made it. There are no guarantees in this stuff :(
  • Hi. I had cervical problems for over 4 years before my ACDF on c5-6 last November. By that time, I had significant nerve damage to my left arm & shoulder. My MRIs (taken one per year), showed that the herniation was growing and not going to go away. By the time my surgeon (VERY CONSERVATIVE)tried pt with traction for the 3rd time, and other meds with no relief, he ordered another MRI. He called the next day, & said the surgery is necessary to prevent any further damage. That scared me, plus being sick of not having relief, I opted for the surgery without a second opinion. In my case, it did NOT RELIEVE my symptoms. I have ongoing nerve damage, and still trying to recover. In my case, I wish I wouldn't have "jumped" into it so quick. But I guess there would be no other way for me or my Drs to find out that it wouldn't help me. I can see your dilemma. I would first suggest a second opinion, then go with your gut. Only you can really decide whats best for your body. Don't let me discourage you...there are many good outcomes from having that disc removed. I do have better ROM which helps. Good luck in your decision, and keep me posted!!
  • I understand exactly how you feel. I am a Lumbar Spiney, but we go through the same emotions. I was on the fence about it literally right up to going into the OR. I knew it needed to be done, but I think fear of the unknown will do that to you. Obviously there are no guarantees. Perhaps another opinion will help ease, your decision. Good-luck
  • I think of it like this: I'm now 41 and everyone in my family has lived into their late 80's or early 90's. My assumption is that I will live that long as well. Do I want to deal with non-stop chronic pain that long? Not a chance! On a weekly basis I'm afraid I'm that much closer to ending up with a surgical solution -- I've gone through what seems like a million conservative procedures and have an upcoming discogram to prep for L5/S1 repair -- but I'm at a point where I am willing to do it if that's what it takes.

    I think it's productive to re-evaluate your pain (and other factors) and question whether you are still at the threshold of "tolerable" symptoms or not.
  • ...for the input and responses.

    I've dealt with this stuff for so long that I have a natural skepticism that all of my symptoms and issues would resolve via surgery. I would be overjoyed to find relief, but I think I would go in with very reasonable and conservative expectations.

    If I do decide to have ACDF, I would approach my prep and recovery with gusto, to increase the odds of success. I think attitude and psychology is a big part of fixing any physical issue, so even though I'm a skeptic I do realize the need to focus on the positive and do what I can to help create a good outcome...
  • I definitely know what you are talking about. I am so "used to" the pain, like you say - its the new me. I have learned how to deal, re-learned how to put on my pants and shoes, learned how to sit with pillows propping me up and know that almost everytime I stand I need to brace myself til the pain subsides. It makes me question whether or not I should go thru with surgery. My Dr. told me the same thing the first time I saw him, "we will definitley try conservative treatments first, but I only see your condition getting worse and eventually having sciatica down your left leg in addition to your right" Since then I have tried PT and an epidural steroid injection, but neither has helped. I have gotten 2 more opinions and they both reccomended surgery. So I am leaning that way. I go back to my original Dr. this Friday to talk about surgery. The thought of a pain free life is very appealing, I am not on pain meds but still I know I can't live my life on ibuprofen. I am 29 and have yet to have kids and if just standing or walking for a half hour gives me horrible back and nerve pain I fear what a big pregnant belly would do. Sometimes I have to hold back tears - and not just from the pain: from the frustration of it, as the song goes "I'm so sick and tired of being sick and tired!"
  • Last thing I wanted was surgery, but when all conservative measures have been tried and pain was still there, I could not live with the quality of life that I had. And I have nerve damage and didn't want to cause more. I also thought about my financial responsibility in the marriage. I was taking a lot days off due to pain and knew that it wasn't good. I mean they (my boss) seem to be supportive but how long can they hold out for me to get well?
  • obx,
    I'm in exactly the same boat. Only I'm dealing with the lumbar spine. I have pain down my right leg. It's bad sometimes and better other times. When the pain's absent or hardly there for days, I think... Maybe I don't need surgery. When the pain's bad for days on end, I think... I hope the doctor says he wants to do surgery. Then I think, what if I don't fuse? What if the nerve pain is worse instead of better? What if I don't heal properly or get excess scar tissue? I've thought about waiting it out a year just to be sure, and then decide. I guess it's always a risk, no matter what you do. Also, I think the more questions we ask the doctors, the better informed we'll be so we can handle whatever decision we make.

    I totally understand what you're going through. I've learned to live with the "new normal" as well. If I still have good days, then I'm afraid to risk those. I have an appointment with my Ortho today, who will discuss the results of a nerve block I had. Then we will go from there. I will ask tons of questions so I can think on what he tells me over the next few months. If he wants more tests, all the better, because then I know he wants to be 100% sure of what he's dealing with. My pain's gradually been getting worse over the last week and a half, so I'm at the point where I hope he at least offers surgery. Then I can decide for myself.

    Hope this helps. Praying also helps, if you trust God. That's something I do regularly to help me make decisions.

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