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New herniation after fusion

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:33 AM in Back Surgery and Neck Surgery
In October of last year I had a fusion of L4-L5. It has taken a long time to start healing but I think it did what it was supposed to do. But I have had continued pain in my lower back around SI joints and no apparent reason. Lately I have also been experiencing severe leg and foot cramps (like charley horses) I had a CT scan done in Jonesboro where I live and went to my surgeon in Little Rock yesterday. He said the scan showed a large herniation at L3-4 that was not there before the surgery on L4-5. I guess my questions is - has anyone had similar problems? Where is the most severe pain located with a L3-4 herniation - and am I probably going to have this one fused also. I am a paralegal who works 10 hour days and sits over a computer all day and it is beginning to get intolerable. The doc did an MRI yesterday but I will have to wait a day or two for him to call me with the results as to how bad the herniation at L3-4 is. What are my options - anyone similar problem. New to the forum and just need some help. and thanks.


  • pollibibs, the text below the line is from a post I wrote in February of this year - the same month I had ACDF for C5/C6. I was aware of the "adjacent disc disc disease" issue before I had my ACDF. I just did not think another disc would go out so soon. Just recently, after more x-rays, my doctor finally confirmed/admitted that the level below where I had my fusion has "collapsed". (I suspect often we can feel the problem before it is obvious enough to appear in an MRI or x-ray.) The surgeon thinks I just need to do PT. I have no confidence in PT for this type of problem. That is just my personal opinion. I know I need to correct my posture, but I think moving my neck around a lot is just going to make it worse. I don't know. I could be wrong. My symptoms have progressively gotten worse. Before, I just had pains and aches in my shoulder/upper back and hands. Now I am having aches and pains in my arms too. Furthermore, when I did go to PT the therapist had me do something that I think screwed up my back. I wrote a long post about that experience. If you do go to physical therapy, be careful. Think about what the therapist is asking you to do. Don't let him or her put you in an extreme position that might cause more damage. That is what happened to me.


    My question is this: Have any of you who've had an ACDF had another cervical disc go bad shortly after having the ACDF?

    This is why I am asking:
    I just had a single level (C5/C6) ACDF slightly over two weeks ago. The first week after surgery I felt great. Just about all the symptoms I had previously were gone. I still had a few "twinges" here and there and some soreness along my index fingers, but overall I was satisfied. An X-ray 8 days after surgery showed everything was good. Then all of a sudden I started getting new, different pains. They are intermittent, but seem to be occurring with greater frequency: burning feeling at base of neck, a feeling of pressure or cramping in middle of upper back, and pain and/or numbness in the small finger of right hand. Something is definitely not right. I called my doctor's office yesterday and they gave me a work-in appointment this morning. As luck would have it, I was not experiencing the pains while I was at the doctor's office. (The pain seems to be dependent on my body/arm/neck position.) They did another x-ray and everything from the surgery still looks perfect. I explained to my doctor that I thought this pain was caused by something different, not related to the surgery (at least not directly related). To my annoyance, the surgeon did not seem interested in this new problem. He said he thought I just needed to do PT, so he recommended a book that would show me how to do neck strengthening exercises. (I won't mention the name of the book because I'm not here to promote a book). I went ahead and ordered the book online, but based on my previous experience, I strongly suspect the problem is that I already have another herniated disc. If so, I don't think exercises are going to help. In fact, the will probably make it worse.
  • to anyone reading this, if your surgeon recommends fusion, ask him/her if artificial disc replacement is an option. (Of course, keep in mind that your surgeon might not recommend a procedure that he is not trained in.) After my experience with fusion - the so-called "gold standard" procedure for a bad disc - I wish I'd had ADR instead, except I was told that because I had already had a laminectomy at that level (it gave temporary relief for less than a year) I was not a candidate for ADR.

    Be aware that if you have a fusion and then later have a problem with another disc you will have a hard time finding a surgeon who will do ADR on you at that point. Since having my fusion I have been told that that anyone who has had a fusion is not a candidate for ADR. That seems to be the opinion/consensus/rule/standard/recommendation (I don't know what the right word is) among most surgeons. I do not know if it is a medical regulation or if it is based on theory or actual research. In any case, there is at least one surgeon in Germany who will do ADR on patients who have had a fusion. I also found a surgeon in CA who does it.

    I should also add that the office assistant of a surgeon who has performed many ADR surgeries told me the surgeon stopped doing ADR because insurance companies stopped approving the surgery. Apparently ADR costs significantly more than fusion.
  • When performing clinical trials, surgeons are very careful to select a specific population that absolutely meets all the criteria for the procedure. They want the outcome to be as good as they can possibly make it.

    The "list" for things that disqualify a person for ADR is very long. It seems to me you have to just about have a perfect spine before you are considered a candidate...somewhat humerous since you wouldn't need the ADR if your back were that pristine!

    Also the jury is still out on the long-term outcome for ADR surgeries...how long will they last, and when they fail, how is it handled.

    Researchers have been working for more than 40 years to find the solution that will make disc replacement as easy as knee replacement. Any day now they should get the kinks worked out!!
  • Gwennie, given a choice, I'd rather take chance with an ADR than have a fusion I know for a fact will lead to more failed discs. Surgeons in Europe have been doing ADRs for years. According to Wikipedia, "Artificial disc surgery is still relatively new in the United States, but has been used in Europe for more than 15 years."

    If I could afford it, I would go to Germany and have the surgery there, assuming the surgeon said I was a good candidate.
  • CM said:

    I should also add that the office assistant of a surgeon who has performed many ADR surgeries told me the surgeon stopped doing ADR because insurance companies stopped approving the surgery. Apparently ADR costs significantly more than fusion.
    Yea I hear thats how doctors do it.

    It should not work like that.

    Hope you get better..thanks for the info..
  • I need 2 ADRs in my neck...

    At 29 I cant risk the (fusion) so I just stay at home sad/mad/angry and wait it out..

    Whats crazy is these disc are made in the U.S.A...


    What makes me angry is that there made in Californa but you can only get them in Germany...

    SMH @ the FDA... they made it was for my Aunt to take Vioxx and have a Heart Attack but not for me to have an ADR at 29...
  • The Charley Horse cramps are usually from not enough calcium/magnesium. I had to take the supplements 3 times a day but the leg cramps stopped. I am not at home so I can't tell you what the ratio is supposed to be. It usually takes a week or so for them to disappear. I had also put my computer on top of a file cabinet so that I was standing to do my computer work. It is much better for your lower back if you are looking up. I cannot sit for more than 15 minutes, even now after the surgery and still stay pain free. I am trying very hard not to have another level herniate.
  • I had ACDF on C5/C6 in February of this year and the C6/C7 level has already collapsed. I am pretty sure I am going to need surgery in the not-to-distant future. I absolutely do not want another fusion. I have an appointment with a different surgeon at the end of this month to talk about the possibility of ADR. According to the surgeon's office assistant, the surgeon will consider doing the ADR if I meet certain criteria (I don't what they are).

    My immediate future seems so uncertain. I think my job is making my neck and back worse, but if I quit I won't have health insurance unless I pay for COBRA, which will probably cost at least $500/month. I could try to find a different job, but then I might still end up needing surgery. That wouldn't make my new employer very happy. What if... What if... What if... I'm stressing out so much it's driving me crazy. I'm having trouble concentrating, remembering things and making decisions.
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