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Discouraged after ACDF surgery

edited 06/11/2012 - 8:58 AM in Back Surgery and Neck Surgery
Had a bad fall from a bicycle July 2010. Four months later I was in agony with burning pain in left arm. Finally diagnosed by MRI with herniated discs at C5-C7. Tried extensive PT and epidurals with no relief. Never had any tingling and numbness, only pain. Tolerated the pain with 3800 mg. daily of Neurontin, the maximum allowed. Exactly one year after accident I had two level ACDF. Surgeon removed "two large herniations" during the surgery that "went very well," in his words.

Unlike many people I've read about, I awoke from surgery with NO pain relief whatsoever. In fact, the first four weeks were so painful I became convinced the surgery was a failure. By about the fifth week my pain lessened. It's now five months post-op and although my pain is less, I'm still taking Neurontin at 1800 mg. daily, and am very discouraged that I won't see any more pain reduction. I think my surgeon did the best he could, but he's only human. I worry I may have ruined my chances for optimum healing by waiting "so long" for surgery, though my surgeon doesn't think so. My pain seems to be all from my formerly compressed/damaged nerves. I seem to be past the point where my pain can be blamed on "inflammed/excited" nerves that just need time to "settle down." I do not have any muscle aches or spasms.

If anyone has gone through the same pains that eventually subsided and improved, I'd love to hear what you did, if anything.

Would also like to know why some people seem to get almost immediate pain relief after surgery, while other unlucky souls don't get immediate relief. Thanks!


  • Many have releif right after surgery only because the medication they put in the surgery area and the incision pain might help make there regular issues subside, Bu many times slowly pain can return and become acfualy worse then it was before surgery,

    So by having still pain right after surgery might not always be a bad thing as long as its slowly geting beter, At least that might be showing sighns of healing vs surgery totaly failed,

    I felt ok right after surgery but got way worse once everything healed,

    Just keep your fingers crossed, Best of luck,
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • MetalneckMetalneck Island of Misfit toysPosts: 1,368
    the herniations without replacing the disc space with a cage, ADR, allo or auto graph,(fusion), or some form of hardware (anterior) plate to stablize and account for the lack of disk???

    I have seen many times when a surgeon does a discectomy only .... only to have to repeat the discectomy again later, or advance to a more involved cervical repair and stabilization with the above mentioned modalites.

    Curiously yours,

    Spine-Health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!  (Click on Welcome to Spine-Health)

  • I had an ACDF with graft in April. They also placed a cage around the graft/fusion site. My arms felt better instantly, however as the surgeon told me, he could fix the pain in my arms, but my neck may always hurt. My nerves were compressed for over 12 months. The ortho has told me that the damage can be permanent and it could also take over 12 months for them to 'revive'. I am still on nerve blockers for the pain in my arms, but it is nowhere near as bad as it was. I was curled up in a ball for four months.

    My arms 'ping' now. I get the bright bolts of pain, some aching and burning but its much better. Before the surgery I had NO neck pain. Now I do. But life is still better than it was. I do hope you get to feeling some improvement soon :)

    Rohain - ACDF April 2011

  • Many have releif right after surgery only because the medication they put in the surgery area and the incision pain might help make there regular issues subside, Bu many times slowly pain can return and become acfualy worse then it was before surgery
    I think that's what happened with me, in part. I had my latest ACDF at the end of July, and throughout August and into September, I felt INCREDIBLE! I thought all was wonderful. Once I got back to work, and as time went by, I do not feel as well, and back to having pain and stiffness, and spasming.

  • Dave, I had ACDF surgery, and to my knowledge that surgery always includes replacing the disc material with something to hold the vertebra separate. In my case he used a titanium cage with allograft material in it. It is interesting you mention that only a discectomy is sometimes done, commonly known as an ACD procedure. I had two surgeons tell me that an ACDF is superior to an ACD, although I did find one research study that concluded a "simple" ACD surgery is not any worse than an ACDF. As a patient, I just want the best procedure that will relieve my symptoms, but it's hard not to want to "argue" and debate with my doctor when I come across info. that might contradict his recommendations. Have such a discussion isn't easy because I'm just the "naive patient"--how dare I question the knowledge my doctor spent years acquiring? Not every doctor is going to have the time and or be willing to have a "mini-debate" with you about what he knows vs. what you learned in a few hours of research.
  • Thanks for all the comment. Charlie and Rohain, you both said you had practically instant relief. I am very curious to understand why some people have fast relief, while others don't. Does it have something to do with the type of nerve compression you had, or the duration? Does decompression from DDD respond differently than if the cause was from a sudden trauma compression? Nothing that I've found in my "research" seems to address these variables, although I did find some references to studies that indicated that in general a worse outcome was related to length of compression time.
  • MetalneckMetalneck Island of Misfit toysPosts: 1,368
    I had a physical medicine doctor tell me about the same thing ... The amount of time for the nerves to "heal" is/would be equal to the amount of time that the nerve(s) was/were compressed.

    Many others have used quotes that state something along the lines of nerves regenerate at X mm per Y .... I never could really understand that one cause the nerves were never severed (lord willing).

    My first ACDF did give me immeadiate relief from the acute pain in my fingers and hand .... only to be replaced 4 - 6 weeks later with numbness that had lasted for years ... even after another ACDF anterior - posterior with posterior rods ... It was untill I got my surgical report a little over a year ago that I found out that my second surgery led to a paralyzed right arm ... that led to yet a 5th surgery and two levels of corpectomy and cage full of my hip bone .... still have the numb left 1/2 hand and severe neck should pain. Adjacent disc disease now also.

    Certainly understand the debate issue but we are the ones that are going to have to live with the results of whatever they do .... so I say debate away (with them)(not us)for we are now together in all kinds of weather!!

    Warmest regards and hope for continued improvement for you and us all,

    Spine-Health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!  (Click on Welcome to Spine-Health)

  • I have also read that the sooner that surgery is done once the symptoms show, the better the chance of a successful surgery.

    It worries me because I was referred for an MRI scan on my neck back in August 2010 because I was having symptoms in my arms.

    Things have got worse since then symptoms wise, but an MRI done a year after the first one, showed almost no change in the state of my neck. I do have cord compression at two levels. My neurosurgeon is doing 'careful watching and waiting'. I believe that he knows what he is doing (he is well respected by other medical people), but I wish someone would explain the reasoning behind it and what my prognosis is. Even my GP is concerned about my sytmptoms and has referred me for a second opinion.

    We have to put ourselves in their hands and trust them. I keep telling myself that, anyway!

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