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Upcoming Neck Surgery

Background: I am a 43 year old male, I do not smoke, drink, and I try to take care of myself. In October of 2014 I had a C5-7 ACDF using the PEEK bone substitute spaces, plates and screws. I wore my c-collar for 2 months and used my bone simulator for 6 months without fail.

About 6 months ago I started having a return of the symptoms, tight neck muscles, pain between the shoulders pain under the shoulders, burning in the right arm, and numbness in my hands - especially after I wake up in the morning. These symptoms were very similar to what sent me to see the doc in the first place about my neck. My original surgeon basically blew me off and said that there was nothing wrong with me. I self referred myself to a orthopedic spine specialist who had me do a 6 week round of PT, which did nothing to improve my symptoms, but was necessary for my insurance to approve the CT, meylogram and MRI. I just got the results back from these test which showed a non-union and some additional canal narrowing on the right side at C6 and C7.

My doc has recommended that I undergo a revision of the fusion, this time the surgery will be from the posterior approach. He is also planning on using allograph bone, a bone grow agent, and additional hardware. My recovery from the ACDF was pretty easy, what can I expect from the posterior surgery. He made the comment that recovery is a little rougher from this surgery. What can I expect?
Dave
2012 C5-C7 ACDF with fixation - failed to fuse
June 2014 - Planned revision surgery
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Comments

  • tjbrion18ttjbrion18 Posts: 1
    edited 05/05/2014 - 10:31 AM
    WOW, this sounds so familiar that I thought I wrote this myself. I have had a similar situation. I had my first surgery in May 2011. About 3 1/2 weeks later I feel coming down the stairs and screwed the whole thing up & fracturing my neck at C6 on both sides! It was ugly and complicated. So the same surgeon had to go back in and re do this mess as best he could. This time he went in both anterior and posterior! I am going to be honest, it was difficult on the posterior recovery. Well, here is where I start to sound like your story. Shortly after the 2nd surgery, in late 2011 I was having problems, pain, it felt like my hardware was protruding thru my neck, numbness, nerve pain & so on... It took me over a year and 1/2 before I could get a doctor to finally say "oh yes, there is a problem here!" They told me to go 2 the same surgeon, but like you he blew me off. So I found a different surgeon in the Seattle area. I know one thing, I will never ever do a CT scan with contrast! That was very painful as my nerve roots were cut off & when the contrast dye hit them it was pain I never ever want to know again! The surgeon then told me I would need 2 do a 3rd surgery, but it will be a 2 level neck fusion due to the failed fusion/non union. .... So he went in only posterior.......again, I felt as if I got ran over by a truck. However, it was short lived. I am now 11 months out and better than I was, but still in some pain, but am ok. So yes, recovery is a bit more pain at first due to the additional nerves and muscles they cut thru, but after about 5 to 7 days this is a lot better. For me it was the first 3 to 4 days that were the most difficult then it got a lot easier from there. Then the rest of the recovery is about the same as the other one. I had to use a bone growth stimulator 4 hours a day for 8 months after this surgery, so you may want to ask about this, it helps with healing and to avoid the non-union... Good Luck...
    Tracey
  • I did talk to the surgeon about a bone simulator and will be getting one this time around. My previous recovery was ok, I was up and around in about a week and back to work in about a month. I have a desk job and this time I am going to take 6-8 weeks off as that is the extent of my short term disability at full pay. I am hoping for the best this time. around.
    Dave
    2012 C5-C7 ACDF with fixation - failed to fuse
    June 2014 - Planned revision surgery
  • I am aware of the risks, most of the issues were in acdf surgeries, and related to the dose. He has recomended this as he cannot remove the existing peek cages, and I have had almost 0 bone growth in 2 years. He is also proposing a small dose to try to get me to fuse. I have a second opinion set up with a spine specialist that was recomended by a friend. I am a former paramedic, I used to work in the continuing medical education area, now just continuing education, so I have read my fair share of reaserch papers. I ask questions and attempt to drive the bus and advocate for my care. I appreciate the concern and the helpful information on this site as it is top notch. I wish I would have found it before my acdf.
    Dave
    2012 C5-C7 ACDF with fixation - failed to fuse
    June 2014 - Planned revision surgery
  • sandisandi Posts: 6,302
    edited 05/08/2014 - 5:20 PM
    I just came across this very recent study on the use of bmp in the cervical spine. I would strongly encourage you to do some more research into the risks of using bmp........
    http://www.healio.com/spine-surgery/cervical/news/online/{fea735f0-5099-42e1-aa83-4f005657e73a}/study-use-of-rhbmp-in-cervical-spine-associated-with-likelihood-of-complications
  • jlrfryejjlrfrye ohioPosts: 1,110
    I had BMP used in my cervical area after 4 failed fusions. There were no options left for me. BMP was not approved for cervical area so I became a experimental patient to get around it. Operation day scared the crap out of me, ive never seen so many people in the operating room in any of my previous surgeries. My surgeon warned me that with BMP it can cause severe swelling in the beginning and it would be possible that I would need to put on a vent until the swelling went down. I was lucky, the swelling was bad but not enough to prevent me from breathing. They video taped my surgery ( which to this day I still want to see but surgeon will not allow). For me the BMP was a lifesaver. I finally fused and have had no issues with over-growth yet. Its been years since that surgery. As for the posterior surgery it is a tougher recovery but not as bad as I was led on to believe. The hardest thing for me was getting up from a laying down position for about 2 weeks. If possible ask for a script for a hospital bed for a few weeks it will save you from alot of pain, It also is a slower recovery so be patient
    Good luck
    Susan
  • RangerRRanger on da rangePosts: 805
    edited 05/11/2014 - 3:03 AM
    Back in 2007 I had a anterior/posterior cervical fusion of C4 thru C7 along with a corpectomy, discectomy, strut and cage installed along with plates, rods, & screws. I had a bone growth stimulator post op and a hard collar for a few months. Unknowing to me until 3 years later when I obtained the surgical report I found out the neurosurgeon had used BMP also. At first I was really upset probably because it was not discussed with me pre-op. But to this day that fusion is rock solid.

    Due to the severity of my osteoarthritis I had to have more cervical spine fusion. Right now I am 6 weeks post-op of a posterior fusion of C2 all the way down to T3. My first few days in the hospital went really well as my pain was controlled by mostly Tylenol every 6 hours. However the 2nd and 3rd week at home was really tough and I had to rely on valium and oxycodone to take the edge off when my pain mostly just between the shoulder blades got intense.
    This surgery was done by a different surgeon then my first ACDF and we did discuss everything pre-op including the use of BMP. He told me he did not plan to use it and he did not but did educate me and put my mind at ease that in certain situations it can be used safely in cervical fusions even though it is not FDA approved.
    This last fusion took over 10.5 hours in the OR to complete as old hardware had to be removed, lots of arthritis also to be removed, new hardware top to bottom installed, it just took longer than the surgeon anticipated. It really was more painful recovery than my first ACDF and I have a long way to go yet. I had to learn patience all over again which never was my forte.
    Wishing you all the very best of health,
    Ranger
  • Well I got my surgery date - June 4th. I have one more appointment with the surgeon to go over everything before we start cutting. I trust this surgeon as he came highly recommended from several people including my college roommate who just happens to be an orthopedic surgeon as well. I asked him who he would go to and this particular surgeon was on his list.

    We have not made a final decision on BMP, we will make that decision when I see him next.

    I am just ready to get this fixed, I have things to do.
    Dave
    2012 C5-C7 ACDF with fixation - failed to fuse
    June 2014 - Planned revision surgery
  • RangerRRanger on da rangePosts: 805
    Hey Dave,
    Sounds like you have your plan, write down all of your questions before your appointment, and take someone with you. It's good to have another set of ears to take in all this information you will receive.
    June 4th is not far away, you've been thru this before so you know somewhat to expect. I am almost 6 weeks post-op and now I am just starting to really feel like I'm making improvements.
    Good luck to you!
    Ranger
  • RetroDave15RRetroDave15 Posts: 37
    edited 05/12/2014 - 11:50 AM
    Ranger - been down this road with both my wife and myself. My wife is about 4 months out of a revision of her L5-S1 with the same surgeon who is doing my neck. I know it is a different procedure, but her follow up and recovery is completely opposite of of her 1st surgery. We had our initial surgeries done by the same neurosurgeon, I went first that time. This time we are with an ortho spine specialist at a sports medicine practice that has a good track record with "young" patients.

    As for my recovery, getting my lair set up; netflix, roku, laptop, and lots of pillows. Just need to get a few things wrapped up a work now.
    Dave
    2012 C5-C7 ACDF with fixation - failed to fuse
    June 2014 - Planned revision surgery
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