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ACDF am I making the right choice. I'm suddenly afraid. Recovery??

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:40 AM in Neck Pain: Cervical
Hello, I am new to this and have never tried a forum like this. I have been researching ACDF over the last several weeks since have tests to check on symptoms which were mainly numbness in my hands, some wrist pain shoulder/neck pain.

I have met with the spine surgeon, an ortho specializing in just spinal surgery. After review my xrays and MRI as well as the exam, I have significant DDD, with osteophytes C4-5 and C5-6 with decrease lordosis causing kyphosis, stenosis at the foramens parathesis bilateral UE, along with cord compression confirmed also with physical exam; hyper reflexes, clonus... Surgery is schedule for 12/30/09. Happy New Year!

Basically I am overwhelmed. Am I making the "right" decision to proceed? I am comfortable with the surgeon, have asked many questions, yet...I am a physical therapist, 40 yo, very active, especially karate recently as well as gardening , kayaking ,bicycling, and skiing with a son and a new widow for just a year this month, so everything is overwhelming.

My symptoms aren't that severe, but from my work experiences and discussion with the MD, I know relieving the compression sooner than later can prevent nerve injury and further neurological and sensory complications as well as more musculoskeletal changes. I don't want to be kyphotic and in pain as well as not able to pursue my activities that get me through this time and in the future at my age

I love my karate; was to be testing for my black belt, that may need to be delayed. But I worry about getting through this alone. What will I really be able to do and when, other than what has been described to me by the MD and PA: pain, taking care of my son with some supports, getting him to school without driving, returning to prior activities without too many limitations, feeling alone, and just being suddenly afraid with a date scheduled to work within the confines of medical insurance too. Basically I am scared, nervous and ready to call it off, though there never will be a "good time" to do it.

The surgery itself doesn't bother me, though having someone so near my spinal cord and the hardware is a little unsettling. I quess I worry about waking up and not having my husband there and having a meltdown with the staff thinking I am crazy. I am more concerned about the getting around, at home not too mobile, pain,eating and sleeping,not driving for awhile, will the fusion cause major losses in ROM, and when I'll really be ready to go. Is 3 mos until I can do most things realistic as has been described, with obvious thing not to do like bunging jumping. Is the collar that uncomfortable?

I hope someone may have had similar concerns/ fears. I know anxiety is a factor as well as a history of depression, not improved by the winter.

I know many of the posts have information, but I am looking for some direct encouragement during this hectic holiday season, when I am not feeling particularly festive.

Thanks to anyone who may have some input, ides, further questions to ask, or comments.



  • Welcome to Spine Health. Well the good thing is that we really have a lot of control over how well and how quickly our recovery goes. As a PT I'm sure you've seen how attitude and conviction can make a huge difference in how a patient responds to treatment. Same goes for spine surgery. Every surgeon has their own set of time tables that they will tell their patient, based on their experience and the patient's condition and conditioning. There are many people here who will explain that they've had horrible times recovering and that 3 months is unrealistic. Please remember, that is THEIR recovery and not yours! Also keep in mind that the vast majority of members are those who continue to have pain or issues. So the statistics are very misleading if you try to base or judge your own status against theirs.

    Since you are in good shape going into this, that will help tremendously. There's a list of things to do to prepare for surgery and for recovery that may help you out tremendously. Having your home prepared for your restrictions and for not feeling too keen the first few weeks, will go a long way to making it doable. Having the cupboards stocked and meals pre-made and frozen is a huge help. Even hiring someone to come in every couple of weeks to help with the house work does wonders for the attitude. Establishing a routine that you follow every day that consists of things like eating a well balanced breakfast, showering, resting, walking, resting, well balanced lunch, walking, resting etc ... I also like to keep a log of how long I walk and how strong I felt during and after the walk. This is just a few of the things you can do to help make your recovery go well.

    Many people will tell you to exhaust all conservative measures before embarking on a fusion that cannot be undone. You have to keep in mind that only you and your doc understand the extent of your damage and risk of leaving it unrepaired. Anyone suffering from cervical myelopathy will tell you to catch it earlier than later. If you still feel uncomfortable about your decision, I find that writing down all the pros and cons and looking at it in black and white and going with my intuitive voice to be a good guide for me.

    So as you can see, there's no easy answer to your questions. Sorry for your loss and as far as my beliefs go, he will be there with you anyway. I doubt that the nurses would look at you strangely if you did get emotional. Anesthesia generally creates a bit of emotional upset in folks. Not all, but many. As long as you are aware of it up front, it has no power.

    Best wishes to you and once again Welcome to Spine Health.

  • So great to hear your story karateka! We have diligently been trying to hear it in chat, please feel free to talk to us in there. You sound as if you need a lot of support and we are more than willing to help you with that.

    So sorry you lost your husband, and at this time of year, so hard for you. How old is your son? Is he old enough to help out his mom? Search on this site for the things you should have in place at home when you get out of the hospital. I found a reacher/grabber and a shower chair to be very helpful. Prepare meals ahead of time so you can just heat them up. Lots of supportive pillows, especially a body pillow so that you can lean back on it and support your shoulders. Do you use a laptop? A tilting, over-the-lap table for that will make things easier. There is one on www.activeforever.com.

    As far as recovery, we all have different experiences with this. Three months is a reasonable time. My ROM is only decreased slightly. I notice it most when backing up my car. BUT, there are many days that I forget I had the fusion done. You just have to be careful not to overdo certain things with your neck.

    Merry Christmas! and again, please feel comfortable chatting with us.

  • I too have had a 2 level fusion also I had no pain or numbness problems before my surgery. I knew that I could do treatments other then surgery but after doing much research I came to the conclusion that this surgery would have been necessary 10 years down the line anyway.I also know the younger you are the better your body takes surgery as well as heals. I had no nerve damage but there would have been some in the future. I have a GOLD rated health insurance policy so cost wasent a problem but with this Obama care insurance passing I knew it would be a matter of time for my employer to drop my private insurance and use the Obama one instead as we all know employers dont care about employers they only care about the bottom line!. I am now 3 months post opp and still healing. I am lucky as my wife has a great job and our home and autos are paid in full we have 0 debt. I could imagine the lack of income during healing after this surgery could be a problem for some. I will say I am glad I had the surgery done and have no regrets. Good luck
  • The first surgery I had for C5/C6 was a laminectomy. That resolved part of the problem, but not all of it, so I ended up having ACDF. I was driving and back at work two weeks after my C5/C6 ACDF. Five months later my C6/C7 disc "collapsed" when I was lifting something. I knew about the phenomenon of adjacent disc disease, but I thought it would be several years before I would have to worry about it. My understanding is that adjacent disc disease is more likely in people who are physically active.

    I had a doctor tell me that with a one-level fusion I probably wouldn't notice much difference in my range of motion. I did notice it. I am not happy with my fusion experience, but I am sure there are people who are happy with theirs. Everyone is different.

    I'm not trying to discourage you. I'm just telling you my experience.

    If I hadn't had that laminectomy, I would have been a candidate for total disc replacement (TDR) for my first surgery, but having had the laminectomy meant I could not have ADR at C5/C6. As for my C6/C7 disc, I finally found a surgeon who will do a TDR even though I already have a fusion (most surgeons in the U.S. won't), but CIGNA denied my doctor's preapproval request, claiming the ProDisc-C is "experimental". So, now I am in the appeal process. If I had a lot of money, I could go to another country and have the TDR done there, but I don't have that kind of money.


    Post edited by moderator paulgla. Political statements are not allowed on the Spine-Health forum.
  • You haven't posted for a bit and I wondered if you are okay. I remember the first month being very tough. I wanted to check in and see if you need any help or ideas.
  • I am a little over three years since my 2 level c5/c7 ACDF surgery. I had bone grafts and instrumentation with this. I am completely pain free and so happy that I had the surgery.

    Like many others went the conservative route for about 6 months until one morning I woke up with the most excruciating pain; the pain was a level 10 in my neck radiating down to my shoulder and arm. The nerve pain was like a hot poker down into my fingers. I ended up being hospitalized overnight because they couldn't manage my pain. Then the doctor decided it would be time to do surgery, but I had to wait another three weeks before I could get scheduled in.

    That was the most horrible time of my life. I was living 24/7 on percocet and that only took the edge off. I couldn't work anymore. I was out of work for about two months after the surgery.

    I do have a little loss of ROM with my neck movement, but like someone else said this is usually when I'm backing the car or when I am switching lanes when driving. Otherwise I don't really notice anything different now. I still have numbness on the tip of my index finger. I think after three years that will be permanent nerve damage. Once in a while that finger aches and it's a little annoying, but that's it.

    I posted on this board a lot while I was recovering three years ago and kept in contact here frequently for the first year. I haven't been on in a long time, but I wanted to let people know that there are some of us who do get better and have no pain. Very few people stay on who get better.

    It was a little troubling for me when I was first on and recovering that there weren't many people who felt they completely relieved of their pain after their procedure. I had kind of thought in the back of my mind that I would never be completely pain free because of the posters on here. Now I know that they probably just go on with life and don't have a need to stay on. I know that if I ever go through this again I have a wonderful place to get support. Happy New Year! Sheila
  • I am so glad to hear that you are doing well. I had left the board after my PLIF when I felt well enough and I was "OUT HAVING FUN LIVING MY LIFE"....

    Now I have been here again alot lately waiting for my C5-6-7 acdf. My pain is high and my meds aren't working to well. I don't feel well enough to go any where :O( this is my social time. I can watch a movie with friend (on my lap top) ((how sad is that?))

    I love to see happy ending's.

  • Thank you so much for taking the time to post. It is tough reading so many folks struggling through their recovery and then not letting us know that the end of the story was good.

    When was your turning point? I'm 5 months post 3 level ACDF and am getting stronger all the time. I still have a toothache in my neck though. I have moments of being pain free but the toothache soon comes back. It doesn't stop me from doing most things. I can't sit at a movie theater if they have chairs with no neck support and things like that which I hope is not a permanent situation.

    Again thank you for sharing your success. Happy New Year to you!
  • Sorry to hear that you need another surgery. Good that you have an idea of what a ACDF is all about.

    Take care
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