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ACDF Folks, If you had it all to do over again?

LumpyLLumpy Posts: 103
edited 06/11/2012 - 8:36 AM in Back Surgery and Neck Surgery
I am vacillating about the possibility of a ACDF at C6C7. The herniated disk along with “associated posterior osteophytes” is “partially obliterating anterior subarachnoid space.” More than neck pain (which is getting better with PT), the nerve pain in my arms and possibility of progressive damage is my main concern. And yes, I am making another appointment with the NS to get some of my questions answered.

Here is one of my questions for the post-op ACDF recipients: If you had it all to do over, would you go through it again? Oh, and a follow up: Was it easier, more difficult or about what you expected?


  • I'm 11 weeks out from my ACDF c5-6, 6-7. I'd do it again, it's helped with the pain a LOT. And it was a lot easier than I expected. I was in surgery at 8:30, and home (after an hour and a half ride home) by 1:30. First couple days are rough painwise, but they kept me pretty well drugged up so I slept through most of it.

    Good luck in whatever you decide!
  • Hello Kat,

    I was wondering if there were any other Ulnar nerve compression people here. I had a subcutanious transposition about a year ago and the other arm needs one. With the C6C7 nerve pain and the ulnar pain, I pretty well have the hand covered :-)

    Was your pain primarily in the back or was it with the affected nerves?
  • HI,

    One thing that comes to mind is have you had a emg study and if so what were the results of it? A emg will help to isolate where the nerve pain is coming from rather the unler nerve or from the c5-c6.

    Although most surgeons will tell you doing a one level ACDF is a cake walk, it is your body and your assuming the risk of surgery. Be as informed as you can and all the risk involved. One important risk you should be made aware of is adjacent disc disease, following fusion surgery. A question you should take up with your surgeon. When you meet with your surgeon again be sure to have a list of your questions, so you can stay on track. Here is a list of questions that may help you plan all the questions when you meet with the surgeon.


    Having surgery on the spine is not like any other surgery. You will change the mechanics of it forever. With a one level fusion, you shouldn't loose that much range of motion. But another question to ask your surgeon.

    As far as happy about having surgery? Yes, I am happy I made the choice. I was risking paralysis and with myelopathy surgery is the only way to stop the progression. Even though I had a bad run of luck and have had 5 surgeries, I still am happy the surgery was done. I would hate to see the position or shape I would be in without it.

    Asking questions and getting informed it the most important part of it. Also be sure to research the surgeon and their track record. There is no such thing as being to prepared or having to much knowledge. Then the last most important realize the surgeon can only take you so far, the rest is up to you. Staying positive and following all the restrictions. Talk to your surgeon about a walking program to begin the day following surgery. He/she may have one they use(mine did), but you can always google one. Walking is the single most important thing you can do, keeping up your core strength. good luck with the appointment and let us know how it goes.
  • Hi Lumpy :) My surgeon didn't do the transposition, he took a piece of bone out, talk about OUCHIE!

    My neck pain was mostly in the neck, radiating down my right arm. I had gone to a chiropractor for sciatic pain that I get off & on, and she focused on my neck. By that evening I was in severe pain, and unlike my other back pain it didn't ever stop.

    When I had my EMG done for my elbows, they checked my neck also. There was no significant findings there at that time. But after the chiro yanked me about, they did an MRI and found that I had 2 bulging discs, and that if I were to fall or be in a car accident I was risking spinal cord injury, which is why I went ahead with the surgery. At this point in my recovery, I have nearly as much mobility in my neck as I did before the problem started, just can't turn my head as far.

    Keep us posted on how you're doing!
  • I had a 3-lvl ACDF and yes, I'd do it again if necessary.

    Like tamtam, my surgery was imperative to stop the myelopathy and regain use of my left arm, along with a few other things. I'm glad I had it done.

    For me, the surgery itself was easier than I thought it would be, but the chronic pain left in its wake was unexpected. However, the more levels fused the greater the chance of chronic pain afterwards.

  • tamtam, thanks for that link! I have a list I started a couple of days ago and that link will help me finish it. I hope to get an appointment this week to discuss it with the NS. TODAY, I want to have the fusion, because my fingers, my arms and my neck hurt. Tomorrow, I will say "no" if I feel better. Eventually, I will make a decision based on reason and not pain. That list will help me do that.

    Kat, I’m glad I didn’t have the bone thing, but my ulnar compression is coming back and I have it on the other arm, too. I had the EMG. Both arms are compressed at the elbow. It complicates the back thing, but I have become very familiar with what nerve causes what pain. The back is a unique problem, which means I will probably have to have the other arm fixed also. Another scar!
    :/ Yeah?:/
  • Cath111, what constitutes myelopathy? So far, I have the pain in my middle two fingers on both hands and other hand pains. I have arm pains. And there is no triceps reflex on one arm, but I'm not sure that would be considered myelopathy yet since the pain is managable most of the time.

    This is on my NS questions list BTW.

    Wayne (AKA Lumpy
  • And on a lighter note, I just noticed, when I sneeze, it makes my ring finger hurt :D
  • Although there was a gradual buildup of symptoms over the course of six months, by the time I had surgery I was having severe muscle spasms in my mid back and left shoulder, pins and needles 24/7 in my right arm, I had a very difficult time lifting a glass of iced water with my left arm, and I had tennis-elbow-like symptoms in my left arm (extreme muscle pain and could barely bend it).

    My pain became unmanageable. Between the time I saw my NS to schedule my surgery in September and the surgery in October (almost exactly one month) my left arm symptoms had increased tremendously. I was very lucky that I didn't wait.

    When I saw my surgeon for the first time, after he looked at my MRI, he told me that it wasn't a matter of "if" I had surgery, but "when". So there was no question in my mind whether to have surgery or not. The timing was also good because I wore my hard collar in the winter - that thing is so darned hot!

  • Hey Lumpy,

    Here is a good link that explains myelopathy best. Typically when someone has myelopathy, as the cath said is not a matter of surgery yes or no, just when. When one has myelopathy waiting is not on your side as the symptoms increase they are not reversible with surgery. Surgery is done to stop the progression, once they are there, they are always going to be there. Typically if someone has it the surgeon will tell you at the time of your appointment, however you may not of heard it as it is so much to take in. I might suggest that you take someone with you to your appointment. It is not that you can't do it by yourself, just so much to take in and learn. So two sets of ears are always better than one.

  • Everything I am reading from you guys rings a very familiar note with me. And yes, I probably do need a second set of ears. I don't think the NS said "myelopathy" but really that was what his whole discussion was about, now that I read and review more info. This site is a gold mine of info. Thanks again for a useful link.

    My personal criteria for my ulnar nerve surgery centered around a few questions: Will it get better? Will it cause permanent damage if I wait? The answers were "No" and "Yes" So I had the surgery before I had any atrophy. I need to have a similar conversation with the NS.

    BTW. I didn't really think of it being a part of the same issue, but my big toe has been tingling and semi-numb for a month or more :-? Guess I should mention that...
  • Yeah, after my ACDF I told my hubby we should have had the NS implant some bolts, I already look enough like Frankenstein LOL! If you have to have your arms re-done, will they do the bone thing to help prevent it coming back again? My surgeon said he does them this way as it's his preference, didn't give any medical advantages/disadvantages for either procedure. But I'd been having numbness for well over a year and was ready to feel again! When he closed the incisions, he put in a "wafer" that kept my elbows numb for a really long time, I'm just now getting the feeling back in them. Last couple of weeks I've thought of asking him to put another in there LOL

    And yeah, the numb tingling toe should be mentioned too. Best if the NS has all the info to make the best diagnosis.
  • Hi Kat, My ortho perfered the subcutaneous because of the quicker recovery time. That much I like, but the chance of reoccurance is still there and I'm pretty slim, so I can not only feel the nerve, I can see it. Not too well protected especially for the heavyduty work I do. I'm having my doubts about it lately, though. I know arm #2 needs done. I don't want to have to redo #1. I could get it all done at once, though. Less time away from work, but two immoble arms and a cervical collar :? If I made my wife mad I'd starve to death =))

    I'll start calling the NS again tomorrow and see if I can get an appointment to discuss this more. His assistant is going to love me
  • Lumpy said:
    I am vacillating about the possibility of a ACDF at C6C7. The herniated disk along with “associated posterior osteophytes” is “partially obliterating anterior subarachnoid space.” More than neck pain (which is getting better with PT), the nerve pain in my arms and possibility of progressive damage is my main concern. And yes, I am making another appointment with the NS to get some of my questions answered.

    Here is one of my questions for the post-op ACDF recipients: If you had it all to do over, would you go through it again? Oh, and a follow up: Was it easier, more difficult or about what you expected?
    Hi lumpy, I had a acdf in 2006 c4 to c6 with a corpectomy

    at c5 with hardware. Everything went well i recovered.

    Fast farward to January 2009 alot of my symptoms returned

    but it was different. Went to my surgeon and all the

    diagnostic testing was order. I was having a complication

    from the acdf surgery. What happens is the area above and

    below have bone spurs pressing into the spinal column and

    the exiting nerve at C4 and C7. So I had to have the

    Cervical Laminectomy June 9th 2009. It was either that or

    my arm continues to go numb and tingle and constant pain.

    So I agreed. The surgery was posterior and hurt more then

    the fusion and has taking longer for me to feel better. If

    I could avoid all surgeries I would. Having body parts go

    numb doesn't give you many options its either surgery or

    nerve damage. So I suppose I'll do it again.
    2005-ACDF with Corpectomy at C3-C-5.
    2006-L4-L5 diskectomy.
    2009-Cervical laminectomy at C3.
    Steroid injections series x 4.
  • Well, I went back to the NS with a page full of questions. Since my arm pain and tingling has eased some since the last time, he suggested waiting and doing 30 days more PT. I was good with that because I hadn't been hurting the last couple of days. Then today I spent a couple of hours doing computer work and I was ready to get the ACDF right then and there. Something about the computer desks and chairs at work kill me -- arm pain, neck pain to the point that I can't work. If I get up and walk around for an hour or so, it subsides. I'll give it the 30 days, but if nothing has changed I'm not sure what I will do then...
  • Lumpy,

    When I first started seeing my pcp for this I was having intermitten numbness and arm pain in my right arm and terrible muscle spasms in my upper back/shoulders. Some days I felt okay (I am thinking to myself I am fine) and then the next thing I know I am hurting bad. It would get worse with driving, typing and any kind of work really. When it is bad my hands curls into funny positions and I straighten them out and then they curl back a little bit later.

    Today I have constant arm/ hand and shoulder pain in both , non stop tingling in my both hands (like they are going to sleep). Constant muscle spasms in the upper back/shoulders. And as soon as I lay down my arms truely go to sleep. To make it even more joyous when I wake up I almost always have a nice haedache.....

    I hope PT works helps you. I never recieved any PT for this (NS said it would do any good at this point).
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