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still having trouble after acdf

Daniel GDDaniel G Posts: 4
edited 06/11/2012 - 8:44 AM in Back Surgery and Neck Surgery
Hi, I had my acdf at level c5-6 about 5 months ago. I am still having a pinching type pain in my neck and shoulder, upper back pain, and some numbness and tingling in arm/hand. My doctor had an mri done and said all the hardware is in the right spot still and they saw nothing new. I know from looking around that there are plenty of people who still have problems well after the surgery but he is treating me as if this is extremely rare and he is surprised.

Whats the deal? Could anyone who has had an acdf and comes across this let me know how they are feeling and how long ago they had it. Thank you very much, Dan


  • Daniel,

    First off, Welcome to Spine-Health!!! On the top of web page is a "search" box, so if you have more questions or want to research more, ...excellent feature there! :-)

    In August of 09 I underwent ACDF at the C6/7 level. About 7 weeks out of surgery I started getting all (except the burning shoulder blade) of my pre-surgical symptoms back! MRI at 8 weeks didn't show anything out of the norm! By December my NS put me on Lyrica for the nerve pain - did wonders!!! At just short of the 6 month mark I underwent my x-ray series. A crack had developed about 3mm under the bottom screw from my previous ACDF (C5/6). My NS didn't seem too concerned and told me "It will fill in."

    Since then I've undergone NCV/EMG testing for my extremities and upper/lower spine. See: http://www.spine-health.com/forum/chronic-pain/peripheral-neuropathy-idiopathic-stage for those results. In a nutshell, while I am sure there is some validity to the EMG testing I underwent, I *still* feel the issues are more radicular to neck/fusion status. My body hasn't lied to me yet, and I think that there are times that our bodies know more than us, and more than the doctors! My surgeon admitted on this last exam that he was at a loss, and referred me to an NS who also practices heavily as a Neurologist for another opinion. So I am almost 10 months post op, and still having issues. I would say just not to give up, and see maybe if you can get a referral so a fresh set of eyes can maybe see what is going on. Please keep us posted. Again Welcome!!!


    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Thank you very much Brenda. It is nice to know I'm not crazy. My NS suggested maybe the pain was in my head because there was no reason I should still be having problems. I don't know if he is just cocky and doesn't want to admit that a surgery he performed didn't get optimal results or what, but I have kind of been made to feel like a head case and a junkie looking for a fix when I ask for something to keep me comfortable. My doc told me I would just have to figure out how to deal w/ pain w/o anything narcotic. i said fine, just tell me what my options are, and all he could think of was the shot in the neck which didn't work pre surgery and I just don't like the idea of it. Just for a little more info I am 28 and not as fused at 5months as the doc expected me to be. He didn't give me a %. Thanks again!
  • You're very welcome Daniel! :-)

    The "Grrrrr" is for the 'in your head' comment. I hate when I see that - sorry had to fuss! I guess in an abstract way it is right - I mean, the nerve information gets processed "in the head" right? Sorry trying to lighten your mood a bit to give you a smile for this day! :-) *HUG*

    Now in defense of your surgeon a little bit? Most surgeons will tell you wording similar to: "There is no guarantee of pain relief", "A lot can go wrong up to including death with any surgery", "The goal of the surgery is to stop or prevent further damage",... It might well be that he can't see what is causing your pain (wearing those shoes myself right now with my NS). I don't mind so much if a professional can't answer my questions Daniel, it does "mind me" if they can't at least come up with a way to maybe find those answers?

    28, ouch that is young. I crashed a helicopter when I was a month shy of my 22nd birthday (almost 48 now). No MRI's back then (yeah, hehe, I know, I am dating myself here!), and even if there were, I don't think much if anything would have shown then. When I saw my NS in December, just before he gave me Lyrica, he told (or better stated reminded me) that the nerves were compressed, trapped etc., and there is a bit of memory there for that. As such, sometimes it takes the brain a while to realize that the nerves are now free, and free to heal - so pain receptors continue sending "pain" that isn't supported by physical issues anymore. Well, the surgery alone can create a lot of trauma for our minds and bodies.

    I would keep with what your doctors describes in your healing process, but maybe start (on your own if your insurance allows) looking to get another opinion, or see if your doctor can suggest a referral? 5 months out is a good distance on the healing road, but not unheard of to still have issues. Most feel that it can take 1-2 years for the nerve(s) to fully recover? As to the shots, they don't work for everyone, I know for me they didn't. Talk frankly with your doctor to see what "Plan B" can or should be. Sending good thoughts your way Daniel!! :-)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • SpineAZSpineAZ WiscPosts: 1,084
    After my ACDF I had some symptoms re-occur soon after and my surgeon thought it might be due to a nerve that hadn't calmed down. So I had one ESI to that nerve and it helped tremendously. It was likely a nerve that was moved during surgery and just couldn't settle down.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Welcome to SH. My cervical fusion was a great success, but afterwards I had severe nerve pain. They put me on Lyrica and it did wonders for me. Maybe this would be of help to you.

    Best wishes,

  • Hi, Dan! Nope, you're not alone out there. I had a 3-level ACDF C4-C7 with 2-level hemicorpectomies (removal of the front half of two vertebrae) in Novemmber of 2006. I had my first inkling that something was wrong back in 1998 -- suddenly I couldn't pick up even a piece of paper with the thumb and first two fingers of both hands. It was rough at that time, because I taught a lot of aerobics classes and was a personal trainer, and I couldn't lift a thing, honestly. That went away after a couple of weeks, and I just forged on as before (I'd had middle and low back pain since about age 30 and knew I had spondylolisthesis at one level, but I'd had pain so long I just wored through it. I was actually seeing a neurosurgeon about my lower back when I mentioned the arm/hand symptoms from 8 years prior -- and BAM we were on the road to surgery within a couple of weeks.

    Was it successful? Well, here's the thing, and I know that many people don't like to hear this. Surgery is performed to correct an anatomical defect that can be SEEN. Stenosis can be SEEN. Nerve compression can be SEEN. Disc herniation can be SEEN. PAIN CANNOT. Surgery can't cure your pain, it can only remove the cause of the pain and hopefully allow the nerves to function normally. Nerve tissue is a miraculous thing with the ability to regenerate. The best chance for that is when the compression has been relatively mild or has not endured for an excessive amount of time.

    My surgery relieved compression on my cervical spinal cord that had reduced it to about the size of dental floss for at least 8 years that I knew of. My neurosurgeon was clear before surgery that the goal was to stop the progression of an already bad situation, any relief of symptoms was just a bonus. That goal was accomplished -- for that reason, my surgery was a success.

    Do I still have symptoms? Well, yes I do. I kept the tingling in my arms and thumb/first two fingers. In 2008 I started getting some "zaps" of nerve pain in my neck and arms. Last week I found out that my graft has not completely fused and that there are stress fractures in the graft itself. I also have foramenal stenosis that still exists at several cervical levels -- but you know, there's only so much bone in the spine to work with, and only so many things that can be done.

    At this point I'm still very happy I had my surgery. If I had not, it was likely that the smallest of things (bump on the head, fender bender, etc.) could have caused my cervical spine to decompress on its own and left me paralyzed. Despite any symptoms I may still have from those levels, my spinal canal is now fully open at the fusion levels.

    Just know that a hundred people with the same procedure have a hundred different stories to tell. There are many successes out there, even when there is residual pain. You have to come to grips with what your own definition of "success" is. :)

    The pain is definitely not in your head, my friend. But you are still so early in your journey, don't worry too much about things right now, just do everything your doctor has told you, concentrate on relaxing... get a seated massage, relaxing the back helps relieve stress on your neck!

    I wish you the best.
  • Hi Dan. I'm sorry to hear that your dr is making you feel that way but can totally understand as I am going through the same exact thing. I just had the surgery done on April 16 so I'm just a little bit over a month out and my pain came back almost right away. They now (NS) say I have a "frozen shoulder" and I was put on a steroid that had so many awful side affects I felt like I was dying but it did actually help. However now back at PT for a little over a week now (3x). I was feeling a teeny bit better until this past Friday when at PT he worked it too much and I suffered in agony all weekend and he did it less today but the pain is back to being just about as bad as it was BEFORE the surgery. Had both a MRI and CT scan a week or so ago and NS said everything was good but yet my pain is back to being unbearable. And I can't stand it. I wish I had something to say to help you and myself.......I don't understand why they can't help with something. I pushed back our first ever family vaca...from this Oct to now May of next yr and now after reading stuff here I'm terribly worried that I will still be suffering at a yr out????!! I can't handle just the idea of that.

    Sorry, doing terrible right now, didn't mean to go off on a tangent......it's not in your head. And I'm about ready to sue workers comp over this. Because they made me go thru this pain and do things that didn't work for 8 months before finally ok-ing surgery and so now I've been living in pain for 9 months and I can't live with this.

    I hope you get the relief you need and get another opinion....that's where I'm headed possibly, that or to an attny. I wish you the best.

    Tara in CT
  • I appreciate all the comments. It really helps to know that there are others going through the same thing.

    Dolphinlove, I also injured myself at work. It is such a nightmare and broken system. It gets taken advantage of and everyone suffers for it. I ended up having to get a lawyer even though I really wanted to avoid it. But my company was sending the "continue w/o prejudice" form and told me how good of me it would be to sign it...lol. It gives them all the rights and power. I wouldn't sign so they shut off my payments and benefits. I have a wife and son to take care of and didn't get a check for 3 months. And all it was a stalling/ arm twisting tactic. Their own doctor eventually said it was medically necessary for me to have surgery after months of stalling, the whole time they were saying they thought i could work. I could see them trying not to pay for surgery, but to say i could have been working when I was totally incapacitated and then all they had to do is back pay me. They get no repercussions for forcing me to move in w/ in laws and how much they damaged our quality of life for all that time. I dont know what people w/o family to turn to do. So frustrating and maybe its me being paranoid but I feel like when docs/pt or who ever hears its a workers comp case they start off w/ preconceived notions of suspicion. By far the toughest year of my life.
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