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ACDF alternative

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:30 AM in Neck Pain: Cervical
My recent MRI reveals disk herniations at C4-5, C5-6, and C6-7. Symptoms are pain in neck, shoulder, left arm, with tingling down left arm. (naturally I am left handed).

My surgeon suggests ACDF, now scheduled for April 30th. I have found numerous stories of folks having this procedure who are experiencing significant complications.

My research shows a potential alternative: endoscopic laser surgery. Minimally invasive, home same day. I have not located anyone in the Chicago area performing this surgery.

The EDITED performs this procedure, but at $30,000 upfront (not covered by insurance) this could be risky.

The worst aspect of my situation is the insecurity of making the right decision.

Any comments or suggestions would be appreciated.


Doctors name and contact details removed by forum Moderator (paulgla). We do not permit publishing specific doctor's or institution names and contact details.


  • the pros and cons and some personal stories about folks that have tried your alternative approach. Your post almost reads as a spam. I hope you are not spamming cause that isn't allowed.

    Try the search tool on Laser Spine and you'll get more research for your decision.

    Good luck.
  • Welcome to Spine-Health.

    I've had a 3-lvl ACDF (same lvls as yours) and consider mine a success. It does seem to take a while to heal as I still have muscle spasms and an achy neck, but it was very worth it. Before surgery, I had tingling and numbness 24/7 in my right arm and was losing strength in my left along with tennis-elbow type symptoms. All of those symptoms were gone immediately after surgery. The main thing is that you need to have 100% confidence in your surgeon if you choose ACDF surgery.

    I just wanted to let you know that there are successes like mine out there. Many members here who've had that surgery have moved on and no longer post because they're back to their old life - they no longer need support. I stay to help others like yourself, when I can.

    Take care and feel free to PM me if you have questions or want to talk.
  • Hi Cath,

    Thanks for your comments. I do have confidence in my surgeon, but also know the complications that can happen post-op. My surgeon developed the side-approach ACDF and is highly respected. It is just that the procedure seems so invasive compared to an endoscopic laser diskectomy.

    By coincidence the EDITED radiologist called while I was writing my post. Their opinion is the only treatment needed is the disk at C6-C7 to remove a bone spur, remove the bulging disk material, and perform a foramintory (expand nerve tunnel). He says the pain and numbness plus weakness in the left arm are caused by nerve pressure at c6-c7. He also said the C4-c5 buldge is not problematic as I have no neck/jaw symptoms. C5-C6 would be pain in the upper shoulder, which I also do not have at present.

    So their suggestion is far less invasive than the ACDF. The LPI claims a success rate of 92%.

    Assuming both surgeons are highly regarded the question becomes "Which way to proceed?" It seems to me the endoscopic laser procedure would allow for more future options if there is no relief. The ACDF is rather permanent and not reversable.

    Were you aware of the EDITED and/or the endoscopic procedures?

    Thanks for your comments. They are very much appreciated!!

  • Thanks for your comments. I had no intention to create a "spam" post as I am not endorsing EDITED or any other procedure/instituion, just looking for suggestions or experiences.

    If you thought my last post was spam just wait until you read my reply to Cath! ;)

    I will check out the search tool on Laser Spine to see what I can learn. I do appreciate your suggestion, it is helpful when making a difficult decision.

  • Have you talked to your surgeon that you have the ACDF scheduled with about a discotomy or a mini-discotomy or any other less invasive surgery that he can do? Most surgeons will offer those if they think that will fix your problems. Some folks only need a disc trim and spur remove, if the disc material is healthy and there are no other degenerative problems in structure or vertebra.

    Just something else to think about before coughing up 30K up front. I always wonder why they won't file the insurance for you and deal with that when they are so world renowned and everything. One other thing is after care after you leave the place...you have to think about followups and meds and all of that in case things are perfect or don't heal up as well as one would hope.

    Good luck in your decision.
  • You make a good point regarding follow up care. They are in Florida and I am in Chicago. Even if their procedure is successful what are the odds of not requiring any follow up visits?

    I am waiting for a return phone call from my surgeon to discuss alternatives to ACDF. He might recommend something or at least reveal why he would be against the endoscopic approach.

    Using the search tool I did locate useful information on the Tampa company and their procedures, including their 20-page required document. They certainly are money focused, reminding me of the time-share approach.

    I would be really happy to find someone in the Chicago area performing this type of surgery, especially if they accept Blue Cross! ;)

    Reading through the many posts I did locate a few from folks who had the ACDF and are doing great now. At this point since the surgery is scheduled for April 30 the decision is to go ahead unless I am comfortable with an alternative solution.

    I will post on this site to share what I learn. This site has been very helpful during this difficult time.

  • Sorry to have named names in my first post, I was not aware the site did not allow specific institutions to be named when I wrote it. On the other hand it can be useful information to learn of specific experiences, pro or con, in order to make an informed decision.

    For example some Tampa area institutions have very negative reports with doctors certified in the Caribbean. Others have board certified doctors on staff. Knowing who is who can be helpful, although I am sure lawyers are monitoring posts to try to make a buck on 'disparaging comments".

    I assume it is OK to name names in a PM?

    In the future I will refer to them as "the Tampa Florida guys".... ;)

  • rdahm,
    Check your Inbox. I provoded a long response regarding ADR as a altwernative. Wanted to be sure you noticed it. SOmetimes its hard to see when you have a new mnessage on ths board, it doesnt exactly stand out. LOL.
  • Steve,

    Thanks for the tip. It is difficult to locate messages on this board, and sometimes tough to find the thread I started!

  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    You make me look and feel old school!


    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • Ralph,

    That seems like a pretty big nut to absorb without insurance to cover it. Are you guaranteed to be out of pain afterwards? I'm recovering from a two level done two weeks ago today. I know I'm not out of the woods yet, but so far so good. There are some really good neurological institutions in Chicago. I looked into those florida guys also, but it wasn't covered by my insurance either. I wanted to get better in the most minimally invasive way, but I didn't want to go in the poorhouse on just one procedure. You never know how many more you may need over the course of your lifetime.
  • Yes, Paul, I wonder that too. My surgery cost $120,000. That doesn't include MRI, xrays, follow-ups, etc. Just the 3.5 hour surgery and one night hospital stay.

    If the Laser therapy is only $30,000, why wouldn't the insurance companies jump at the chance?

    There's gotta be a reason...
  • After Googling the names of the doctors and institutions, I realized it was not for me. You will find court cases and news articles that might change your mind. I found blogs (not this one) where people talked about their experiences in Florida. Some good, some not good at all. It will take some research on your part but you will find it.
  • Dear Ralph,
    The most disturbing thing I found for myself was. I found more than one person talking about the battle they had with the Florida institutions refunding their money. They were not very happy..they paid $30,000 up front, insurance company paid the institute, and they were stuck fighting for a refund.
    Didn't sound like anything I wanted a part of.

  • Further research into the Tampa clinic reveals they have both State and Federal investigations on-going, plus multiple lawsuits. So, they are not an option.

    I am going forward with the 3-level ACDF on April 30th. I am confident in my surgeon and will simply hope for the best.

    Have a great Easter!
  • Thanks for your comments, Debzab. I also learned the Tampa guys have many lawsuits and Federal/State investigations. I would not go near them. My surgeon mentioned their procedure is not likely to resolve the problems. It sounds easy to the uninformed patient who is looking for a less invasive procedure, but they are selling false hope in my opinion.

    My ACDF is going forward on April 30th. I will just hope for the best and prepare for the worst.

    I will soon be a 'spiney'! :)

  • I'm glad that you've made an informed decision. I'm sure it will go well and I hope it relieves your symptoms.

    You're already a spiney - you'll just soon be a spiney with hardware. :-)

  • I had surgery Dec 08. Two level ACDF with hardware and bone spurs removed. Surgery was on Monday 11:00 a.m. Tuesday I was released at 9:00 a.m. and was at my son's basketball game by 7:00 p.m. that night. Wednesday I started walking a mile a day. Went back to work at our hardware store on Friday. I've learned after numerous surgeries, take the pain meds, get up and get moving. Doctor said if I felt like going to game...GO He was amazed with my progress. (Now if I could just find something for the nerve pain I would feel like a new woman.)Good luck with your surgery and Happy Easter!
  • I'm glad you made your decision. I am 11 days post op ACDF C5-6-7 & am doing well. I walked 4 miles toady & felt great. My biggest problem is showering & washing/drying my hair...it wipes me out. I'll never take the little things for granted again! I have never had any pain at the surgical site, just some muscle spasms. I do not regret having my surgery. Good luck!
  • I did a lot of research before having 3 level ACDF surgery. I would have LOVED to have a less invasive approach but after lots of research and seeing 3 surgeons to get opinions I believe I made the best decision for my specific condition.Florida is not the only state that does the micro procedures, most good neurosurgeons will do them if they think they are an option. In my case it was not an option and I believe this due to the other spine issues that I have. I also believe that when they tell you the micro procedure is 92% successful that this is true, what they may not tell you is that in the future some of these folks have to have more surgery (so do some of us who have traditional surgery). Again it depends on the condition of your spine. If it had been an option for me, my first choice would have been artificial disc replacement but again this was not an option for me. You are doing the right thing, checking into all the options and trying to make an informed decision. My suggestion would be keep researching, get a second or even third opinion, ask to talk to people who had the less invasive procedure (I asked for an received a list of about 100 people to call for a place in Florida). One thing I noticed was that all of the folks on the list had surgery within a year or so of the date I got the list. I would have liked to talk to folks who had surgery 5 years or even 10 years ago. Anyway good luck to you on whatever you decide. I also found that after I contacted places in Florida (I spoke to 3 places) they kept on calling me and emailing me. My NS is incredibly busy and does not have to chase business and that put me off more then anything else did.

    All the opinions expressed are my own and should not be considered medical advice.
  • Thanks for your comments. Your experience gives me hope that I will have a similar outcome! It is your sharing of your experience that is most helpful. Being a 'first timer' is where the uncertainty comes from, thinking about the potential complications when in fact there may not be any problems post-op.
  • Wow! What a quick recovery! Thanks for sharing your experience. It is a great relief to learn of your outcome, and I can hope for the same in my case.
  • Hi Cath,

    "Spiney Ralph" kind of has a nice ring to it! :)

    Thanks for your advice both on online an in the PM!

    You are great! O:)

    Have a wonderful Easter weekend.
  • LJ,

    Thanks for your insights. I too would have loved the less invasive procedure, but according to my surgeon it may be just a temporary solution with short term relief only. This is why the Tampa guys are willing to give you references from recent patients.

    I have mentioned in other posts that after two weeks of research into many alternatives I have decided to go with the ACDF w/hardware procedure. The folks on this board who went through the procedure and had a remarkable recovery is very encouraging and helps to remove some of the fear of the surgery.

    Have a great Easter!
  • I am trying to tell my story to anyone who will listen. I went into EDITED for neck surgery. eventually had a dural leak with a bad headache. since EDITED doesn't have anyone on staff at a hospital, they had an ambulance ship me to my hotel with my iv intact. the ambulance guy was asstounded by this. later that night, my arm went dead and I called the ambulance and had them take me to the hospital. I had a hemmorage which requied emergent suregry. The damage to my cord is permenent and my right arm barely works. After all this, no one would touch me and I still had the pain. I went to microspine which is a small operation and they did surgery on me and the pain is gone but the weakness is not. I am learning to use the left arm which is hard. Lost my job but I am of retirement age so at least I'll get soc. security. EDITED never called or even responded to my calls. I am currently in litagation with EDITED and there are a bunch of lawsuits pending according to my attorney. I read somewhere that a venture capital company owns the place and all I can say is don't go there.

    Doctors name and contact details removed by forum Moderator (paulgla). We do not permit publishing specific doctor's or institution names and contact details.
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