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NS: both ant. & post fusions on 6/30

allicat623aallicat623 Posts: 45
edited 06/11/2012 - 8:32 AM in Neck Pain: Cervical
Hello everyone.....

I saw the NS today. He said my neck is "grossly misaligned" and wants to do an ACDF at C5-6 with a metal plate AND a posterior fusion at C5-6 and C6-7 with side screws.

He said because of the severity of the compression on the spinal cord it should be done ASAP and he moved some other patients around on his schedule to do me next Tuesday, 6/30.

When I was lying back on the examining table, I had a major shock go through both arms and he heard me say "OOH".... and asked what happened. When I told him, he said we definitely need to do this sooner rather than later!

He explained to me that doing both front and back will give my neck stability and relieve pressure on other vertebrae. He also said the posterior fusion will give the spinal cord room to move. When I asked if the posterior fusion is the same thing as a laminectomy, he said, "you've been doing your homework!"

I have an appointment with another NS, but not until July 6th. These recommendations are exactly what my cousin who is a PT said they would probably do in my situation.

I will probably go forth with this surgery and cancel the second opion appointment, but I do have a few questions:

--Has anyone had both surgeries done at the same time????? If so what was it like?

--Anyone had a 2-level cervical posterior fusion? This is what I'm most concerned about. I've had the ACDF at C4-5 and so I know what to expect from that. I realize that going in from the back will mean a lot more complicated surgery and recovery!!!

I know you guys aren't medical professionals, but I'd appreciate any info/experiences you can share!!

Many thanks for all your support.


  • Alli,
    I have had both done at the same time, just remember we are all different. I had a 2 level ACDF done, then they turned me over and did a 3 level laminectomy, the surgery was about 12 hours. I had many problems, hence the length of surgery. The posterior does take longer to heal, you will probably start to feel better in 2-4 weeks, and a whole lot better by the 8th week. The muscles take time to heal. The ACDf is the easy part, I am sure that you will do well. Good luck and kep us posted.

  • Alli,

    It is true that the posterior surgery is harder to heal from. I have had both done and ended loosing the posterior neck muscle on the surgery. Mind you I have had posterior twice the other three from anterior position. The risk to the posterior neck muscle is very high and I hope they explained that to you. I unfortunately didn't understand that risk. Well also at the time I was so naive. Also I am sure you are aware that everytime they open you are at more risk for more scar tissue. But it is clear that you need surgery. So the risk has to be taken. When the surgeon discussed doing the anterior did they say wether or not they would be using your old incision. I would assume that your old incision is right sided anterior. Most surgeons prefer that side as your vocal cord nerves pass once on that side and twice on the left. Also if they are adding new hardware what about your existing hardware from the prior surgery. That is old hardware and if they are planning on removing it, I would assume by now it is covered in bone. My fourth surgery we tried bridging some hardware, well the surgeon did. Anyway that didn't go so well as It was to much for my esphoguas and I never got past the choking on food. So the hardware had to come out as I was getting dangerously close to aspirating on something. There just isn't room in the cervical spine for many things. I don't tell you all this to scare you. You are under taking a major surgery, well all spine surgery is major, but this is larger than straight up ACDF. So I want you to have as much information as you possible can going in.

    Next question I have is I didn't notice what type of bone they will be using? Lots of time on a lami they will use that as the bone. Is that what they plan on doing.

    I really wish you could reconsider calling and seeing about moving your second opinion up. Trying telling them the severity of your case and see if that doesn't help. After all I am sure this second opinion is for your knowledge to insure you are doing the right thing. Surgery is a huge choice and sometimes more is not always better. Neck of steel is a good example of what can happen by doing to much and not understanding the full effects of the surgery. Albeit she is very informed now, can't undo what has been done. I also say I was in the same position going into the posterior not very informed and not knowing the consequences of doing it.

    It is certainly true that everyone is different and heals at a different rate. Hopefully, this surgery which ever way you choose will be the last and take care of all your issues, so you can go back to a normal busy life. If I can be of any further help don't hesitate to Pm me. Good luck and look forward to hearing how you are doing.
  • RangerRRanger on da rangePosts: 805
    I've had a 3 level ACDF posterior & anterior, discectomy, corpectomy, with a
    strut, cage, plates, rods, & screws installed. The rods in the back were for added stability. Like you my surgery was fast forwarded to lessen the risk of
    paralysis or incontinence. I did not get a second opinion, I guess I was more scared of what might happen if I were to trip and take an innocent fall.
    It is a major surgery and healing takes lots of time but I firmly believe I am
    better off today. I am 20+months post-op at this time. Do what you feel is best for you, be confident in your decision and never look back. I wish you the best and take care.
  • Thanks Mark and Tamtam...The neurologist didn't explain a lot of details to me like the length of the surgery or the details of the recuperation. But he did say I could email him with any questions!

    My original appointment was for next Mon, 6/29. I emailed him a question about what should I be doing in the meantime with a brief summary of my MRI, he said I should come in today! So he is very responsive!!

    Mark: Thanks for sharing your story. I know it's not going to be easy; but thanks to folks like you, I know i can do it.

    Tamtam: He did say that he'd be using the same incision on the front. For that fusion, I didn't have a metal plate, so a new plate will be fine. The bone in the front fusion will be donor again; I didn't understand that there would be bone on the back fusion. I understood him to say that he would remove the spinous process and use screws and rods on the sides.

    Yes, I have to have the surgery...in addition to the burning pain, I feel more and more of the "electric shocks". I'm scared about permanent damage!!!

    I'll call the other doctor's office tomorrow and see what they say. They originally said nothing was available until August; then they said July 6th when I explained my situation. And I was fine with that, thinking I would see this doctor next monday, 6/29.

    So when he replied in the email to come today, well, I liked the fact that he was responsive. And my referring neurologist -- who recommended him from among several covered by my insurance -- said this NS isn't "quick" to recommend surgery....that 75% of the time he does NOT recommend surgery. And when he does, his patients have been very satisfied with the outcome.

    I need to go read neck of steel's story....
  • Hello, I too have had both anterior and posterior c3 thru t1 4 weeks ago. I was scared also but really did not have a choice. My experience so far with this surgery is that, my arm pain is gone for the most part. i do have aches in my arm once in awhile. the surgery itself was 5 1/2 hours long and they went in an old scar in the front and added another above it. a 4 inch incision in the back. This is where most of my pain comes from at this point. I do have trouble swallowing food so therfore i'm on a soft food diet as we speak. I spent 6 days in the hospital. my experience was a good experience. I was treated very well. when I went in for surgery, it was so fast for me but I felt bad for my family having to wait. I can literally tell you they were singing good nite sweetheart in one ear and telling me to wake up in the other. I hope this eases your mind a bit. It was a good decision for me (didn't have much choice either) I'm glad it's over too. Good luck. You'll be ok!!!
  • I have had both done but at different times. I think it would of been better to do them together. My arm pain and numbness is fixed and I am 3 weeks post op as of last Tuesday. It takes awhile to recover from because they go through your trap muscles in the back and those are the strongest muscles in your body, they hold up your head. I am still not moving my head much. I am suppose to get in my pool several times a day and exercise my neck muscles. I am glad its over and was quite nervous about this operation. Now I just have to help the muscles heal. The doctors will give you plenty of pain pills and I also got some pain patches. After I got home I just frozen bags of peas for the back of my neck to add some comfort.
    2005-ACDF with Corpectomy at C3-C-5.
    2006-L4-L5 diskectomy.
    2009-Cervical laminectomy at C3.
    Steroid injections series x 4.
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