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bce420bbce420 Posts: 5
edited 04/15/2015 - 9:13 AM in Back Surgery and Neck Surgery
Thanks for any help in advance. I'd like to hear some opinions from other people if possible.

I injured myself in a fall when I was 25. My doctor at the time called it whiplash. I'm 35 now and since then, I've been mostly pain free, except for a month or so every year when I would have acute neck pain from sleeping wrong that would last for a few weeks and then get better on it's own. It's gradually gotten worse and the episodes have lasted longer. I've seen doctors, but they only did x-rays and nobody really found anything. 2 years ago, my right arm went number and it lasted for about a month. The doc, did an x-ray, said I looked fine, and it got better a month or two later. About 6 months ago, I came back from a long period traveling in planes, cars, etc. and woke up in agony. My of the pain has been in my upper back and my neck is constantly stiff. It seems to radiate out into my shoulders and everything around it. I started going to a physical therapist that is a little more osteopathic and my pain has been up and down since then. They do dry needling, MAT, etc. and I'd say they manage to help for a day or so at a time, but I've seen no real long-term improvement.

I finally went to a spinal surgeon because of a pain spike. He called for an MRI and told me that I have a badly herniated C5-C6 disc. He also pointed out that my C6-C7 is degenerating, though not in need of surgery yet.

Given that PT hasn't helped, he suggested a C5-C6 discectomy and fusion and was very patient answering my questions. he said it'd be a 1.5 hour surgery with 2-3 weeks of recovery. He was very confident and said he's done 1500+ of these surgeries, with an 85% chance of it getting better and a 15% chance of it staying the same. He did go over the 1% chance of really bad stuff happening. He said that if I do nothing, I'll "continue being miserable" and that "it's not going to get better on its own". He also said I could get the cervical epidural, but that it'd most likely be a temporary help at best. He also said that the stories of back surgery gone bad were "overblown" and that most people just needed surgery due to degeneration and age.

Random Googling seems to agree with the surgeon that it's a 95% success rate with this surgery, but those opinions are often from doctors that probably get paid from doing the surgery. My PT on the other hand seems to think that the statistics are much worse. He told me that "Over 35 years old, 25% get better and 50% get worse". Any anecdotes, statistics, or links about this particular surgery would be greatly appreciated.

I'm going to do the epidural and get a second opinion before I decide anything, but I'd appreciate any incite into your experiences with making this decision. I'm 35 and don't want to set myself up for months of recovery and 10 years of repeat surgeries and chronic pain, but my neck/upper back is tight and uncomfortable at best, spiking and painful at worst. I'm having trouble reconciling myself to constant pain and worried about what will happen if I don't get it fixed and end up getting in a sports or car accident. On the other hand, I'm worried about making it worse and trying to figure out how much I should just get over it and deal with the constant PT and discomfort/pain. I'm also little frightened of being in the 1% and ending up paralyzed. How did you decide that the chance for improvement was worth the risk?

Thanks for any opinions you might be able to offer.


  • LizLiz Posts: 7,832
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    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • No disrespect to the PT, but that sounds pretty lopsided. I wonder if it's because he sees all the ones that don't do well? My doc's PA said 90% chance I'll be normal (I don't believe that either). I think when I researched the heck out of this, 70% of people had at least a 50% improvement. I think a small number get worse.
    I think in the hands of someone experienced, it is a very, very small chance of paralysis. It wouldn't hurt to get another opinion as well.

    ACDF w/Corpectomy C3-6 12/8/14 ; Laminectomy C3-6  5/19/2016

  • I am 36 and had the ACDF done. My level included large bone spurs as well so the decision was easier. I just knew I wasn't getting better or younger.
  • You have certainly done your homework. I have c-4-6 issues as well and recent symptom of numbness in arms has caused me to consider surgery because I fear progression of symptoms with eventual paralysis. I also fear being in the dreaded 1%. I tend to agree with Ready because patients that do well most likely don't have to use PT as a resource as much. Same with sites like this one. I am finding a lot of support here but I also am aware that people who are dissatisfied tend to talk about it more than people who are satisfied ( if that makes sense.) I am new here and have my 1st appt w/ NS on the 22 so I will keep you posted about what my exact options /problems/ decisions/ experience will be. I am happy to be "surgery buddies" if it comes to that.
  • Surgery should not be performed as a pain fix; it is designed to stabilize and/or fix a problem. The biggest misconception is that surgery will take all your pain away. It couldn't be further from the truth in some cases. Anything better on a pain level is merely a bonus. And yes, sometimes there is more pain, but I disagree with all those percentages. It's all conjecture. That holds no water what so ever... And 2 weeks to recover? Your INCISION is barely healed at that stage!

    At the end of the day, it is your decision, despite what you will read and/or hear. If you look hard enough, you will find many answers on the same topic with many different spins. There's a lot of room for a lot of opinions, but at the end of the day, you situation is unique. Everyone is different.

    In any event, my advice is to get a 2nd opinion regardless. Make sure you see a BOARD CERTIFIED NS as well. You would certainly want the best of the best operating on you.

    Doug Hell
    Spine-Health Moderator

    Realize that FEAR is our worst enemy. Get up & get out in that stormy weather of the real world & kick fear in the teeth. Stare at it dead in the eyes & walk right through it into the storm; because once you're wet, you won’t fear the rain anymore
    edited 04/17/2015 - 7:45 AM
    TWynnB said:
    No disrespect to the PT, but that sounds pretty lopsided. I wonder if it's because he sees all the ones that don't do well? My doc's PA said 90% chance I'll be normal (I don't believe that either). I think when I researched the heck out of this, 70% of people had at least a 50% improvement. I think a small number get worse.
    I think in the hands of someone experienced, it is a very, very small chance of paralysis. It wouldn't hurt to get another opinion as well.
    Most success rates are measured with hard data, from insurance companies. As in any data analytics, numbers can be misleading. First, what do you define success as? I would argue that my ACDF was successful. Am I back 100% where I was when I was younger, no! Am I much better than I was and not in as much danger from by bowels or bladder shutting down, YES!.

    With numbers there are other variables as well, what is the skill level and experience of the doctor, same for the facility? If you had the data, how well behaved were the patients, did they restrict their activities as prescribed by the doctor. With enough insurance data, I could probably tell you what percentage of people listened to their doctors and did not smoke during recovery and how many did not follow the doctor's instructions. I could not tell for a specific person very well, but I could make statements about the overall population of patients.

    In general, the data that I have seen indicates that the ACDF procedure is reasonably safe when performed by competent physicians at good facilities. Success rates are also generally good. Since I have not personally done that type of analysis on these conditions, I will make no statement as to the accuracy of any of the numbers. But the studies that I have seen do indicate that this procedure is generally safe and effective. If I did not believe this, I might not have had the procedure myself.
  • way back in 2003. It was the most successful of my four spine surgeries. I have been very fortunate in that I have had no pain or weakness since. I have started experiencing some numbness in my hands and forearms, over the past year but not bad enough to look into it. If you choose surgery, know that it is possible to heal very well from.
    Best wishes and if you have any questions, feel free to ask!
    Fused L2-3 to S1 and at C5-6. I have a central herniation @ T11-12 and multiple bulging discs in my thoracic. I also have fibromyalgia and suspected arachnoiditis, awaiting my results of a recent MRI.
  • Thanks for all the replies. I never got a notification and didn't realize this post had made it up. I'm getting a ESI epidural this Friday and we'll see what happens. I'm hoping for some relief, but even if that happens I'll have to decide about surgery since I've had episodes every year or so and they seem to be getting worse over time.

    The original spinal surgeon is board-certified, a consultant for a pro football team, had a spinal fellowship, and said he'd done 1500+ surgeries so I'm assuming he's good enough. My PT called the surgeon a liar and maintains that the statistics are manipulated, but has also referred me to a second opinion from a "more conservative" neurosurgeon who is also board-certified. If that guy says surgery is required, I'll probably have to go for it.

    It sucks but as someone pointed out, there seems to be no real consensus except get a good surgeon you trust, get surgery if he says to, don't smoke, and hope for the best. I also understand that pain may not go away and that getting back to a stable neck is the goal. I'd like to be able to drive a car and play sports without worrying about breaking my neck. I'd also be lying if I said that the thought of living with this much discomfort/pain didn't distress me. I got married 6 months ago and this wasn't how I was hoping to spend the first year of our marriage.
  • I worry that any surgeon will want to do surgery (when you're a hammer, everything looks like a nail) and I also worry about being paralyzed if I don't have surgery. You have certainly done your homework and it sounds like you have a good NS. So sorry this is happening while you are still a newlywed.

    Doug thanks for the clarification "stable neck is the goal." I have not thought of it like that but of course you are right and will keep that in mind.
  • I am going through almost the same thing. I'm 21 with c5-c6 herniated disc. My doctor suggested doing an ACDF but then suggested doing an artificial disc replacement. This allows the moton to remain and takes away stress from the other levels instead of adding it. The recovery is also a lot shorter. I would suggest talking to your doctor about going this route.
  • I had a severely herniated C5/C6 with spinal cord compression. I had years of pain from the issue. We don't know how long it was this way since my PIP didn't do much to help. They would blow off the pain and wanted to treat other issues( My neurosurgeon thought that my blood pressure was high because I am in pain). I had surgery in September despite all that my doctor's partners tried to stop it for other issues. I don't regret my surgery in the least. DId it get rid of the pain? No but it cut some of it down including the weekly flare ups in my neck and shoulders . I believe that if this was addressed when I first went to them for the pain years ago, I may have been able to prevent surgery.
    All you can do is do the best for yourself. It sounds like you have done some research and that's great, Don't just take your doctor and your PT's word for their views on what to do. They currently both have stake in your choices that will ultimately put money in their wallets. I'm not saying that's all they care about but they may not totally have your best interests at heart.
    Tracie C
  • Saw NS yesterday. He suggested artificial discs for 45,56,67 as some have suggested. I also need a discectomy because 4 is pressing on cord. I also need a cage for stability. He says 6 weeks recovery which seems like a long time to me but according to what I have been reading, it seems pretty standard.
  • Ivy so now are you thinking artificial discs rather than fusion? Or is this another surgery down the road? Spmepne posted that the recovery from artificial disc replacement was easier faster. Can someone clarify this? Maybe the overall healing is faster but the external support ie neck brace either soft or hard collar driving restrictions are longer correct?
  • bce420bbce420 Posts: 5
    edited 04/30/2015 - 6:12 AM
    My NS can't get me in until early June. I deferred my epidural until after the second opinion at the recommendation of my PT. The pain has been worse so I'm just trying to manage that until the second opinion. I'm not sure what he'll say but the spinal surgeon told me that the artificial discs still end up fusing a lot of the time and that he did not recommend them because there is not 15-20 years of research behind them, unlike fusions. I'm interested to see what the neurosurgeon will say. I'm not sure about the recovery time.
  • But he also said fusion. I am having 3 levels done plus removal of c-4 w/ cage (always the overachiever- haha). Idk if that makes a difference. My surg is scheduled for June 9. Looking forward to being on the other side but at the same time dreading it like I'm sure everyone is.
  • I was on the fence with 1 level ACDF or the artificial disc and made the decision today that I am doing the ACDF. My insurance gave me the thumbs up , my doc has probably done over 1000 of them in his life. I feel very confident in his ability to do a successful ACDF. I just don't want to cancel the pre cert. and start from scratch to see if they will even cover the art. disc. My insurance considers it experimental and you have to jump through hoops to get them to approve it. I just want to get the surgery done and start living a normal life. Surgery date May 13th . I am feeling positive and ready!
  • Best of luck. I am looking forward to being on the other side now. I think I have finally reached the "acceptance stage." {{{HUGS}}}
  • Best of luck for both of you, I had my "acceptance stage" about 2 weeks before my 2 level ACDF, I was at peace with my decision and ready to move on, I was actually started looking at vacations and even motorcycles for later this year, adding places to my bucket list..etc. I am almost 4 weeks post op, doing great (other than the stupid neck brace).

    Stay positive and you will have a successful surgery.

  • Asil65AAsil65 Posts: 112
    edited 05/01/2015 - 1:51 AM
    Thanks Lam Man and Ivy

    Thanks for the kind words. I tend to be a worrier I am really working on staying positive doing relaxation exercises. My friend bought me this book . Prepare for Surgery Heal Faster . Been reading it and trying to listen to relaxation tapes . I Being in the health field I have seen how positivity can make a difference. I also did not want to postpone my surgery any longer because my brother is getting married Memorial Day weekend and my family and I have to be there. Will be a passenger of course.
  • Thanks Lam Man and Ivy

    Thanks for the kind words. I tend to be a worrier I am really working on staying positive doing relaxation exercises. My friend bought me this book on how to heal faster by preparing for surgery . Been reading it and trying to listen to relaxation tapes . I Being in the health field I have seen how positivity can make a difference. I also did not want to postpone my surgery any longer because my brother is getting married Memorial Day weekend and my family and I have to be there. Will be a passenger of course.
  • Thanks Lam Man and Ivy

    Thanks for the kind words. I tend to be a worrier I am really working on staying positive doing relaxation exercises. My friend bought me this book on how to heal faster by preparing for surgery . Been reading it and trying to listen to relaxation tapes . I Being in the health field I have seen how positivity can make a difference. I also did not want to postpone my surgery any longer because my brother is getting married Memorial Day weekend and my family and I have to be there. Will be a passenger of course.
  • Agreed. Good luck with surgery! I'm a bit of a worrier too (assessing risk is part of my job) so I'll have to work on staying positive.
  • Another quick update from me. I had a second opinion from a neural surgeon that was recommended by my PT as a "conservative" surgeon. Basically, they said "if he says surgery, do the surgery". I met with him and he basically said that lots of people have neck pain, that he didn't see neural symptoms/risk, and that he did not recommend surgery. He also said he disagreed with the previous spinal surgeon and did not see "gross instability" so I can resume activity. When I asked questions, he said surgery was probably only 50% likely to help and that an epidural for the neck didn't have a lot of success. He recommended PT and anti-inflammatory meds, which aren't really helping so far. After that, he pretty much said I needed to get a primary doctor (which I don't have) and work on pain management.

    Just thought I'd update in case anyone finds this and is finds the information helpful. Mostly good news I guess, except that I'm dealing with enough neck/shoulder/upper back pain that I had pretty much resigned myself to surgery. Now I have to figure out what else I can do instead to help manage the pain.
  • I went to a pain management doctor and he did a radiofrequency ablation on my neck. It worked great. I was pain free for almost a year. It lasts 6months to 1 1/2 year . I am doing surgery only because if I had a bad fall etc I would end up with spinal damage. If it wasn't for that I would do the ablation again. Can't your surgeon refer you to pain magament? That is what my first surgeon did.
  • bce420- I'd recommend you to try pain management first, even before CONSIDERING surgery. There are plenty of less invasive options you might want to try first: PT, ESI's, pain meds. Keep in mind that if you choose to have a fusion, there's a chance you'll need more surgeries in future. I'm 25 years old and 3 months post ACDF and I can tell you recovery is NOT 2-3 weeks. Not sure why your doctor would tell you such a lie. Full recovery for a fusion is up to 2 years, its a very lengthy recovery process.
    Every surgery has risks but you just need to trust your doctor :) get a second opinion and do your research!
  • Bce420........everyone's case is different so I can only speak from my own experience. In 2012 I had a severe episode of neck/shoulder/right arm pain that actually kept me out of work for 8 weeks. At the time I was told by an orthopedic surgeon that I had a near-complete collapse of disc C5/6 and 6/7 and that he felt my only option at that time was to schedule a cervical fusion surgery. I went for a second opinion to a neurosurgeon who encouraged additional more conservative measures. It was a routine of cervical traction twice a day every day using this very specific device called a Saunders Pneumatic Cervical Traction unit. I used it 20 minutes in the morning and 20 minutes in the evening and I never missed a day for two years. So I was able to postpone surgery during that time but was most remarkable is that I was COMPLETELY pain-free until my most recent episode when I did end up needing to have surgery, Jan 2015. The discs had completely collapsed and I was beginning to lose function in my right arm, the pain was much worse and the traction was no longer helping. But at least I had the benefit of buying myself some time. Technology and surgical procedures change and improve constantly. If you are curious if the traction device is for you then you should discuss it with your doctor.

    Hope this is helpful.
    C5/6, 6/7 acdf Jan 2015
  • Anne63AAnne63 Posts: 2
    edited 06/13/2015 - 11:06 PM
    Looks like most of you have had your operations, I am due on 17th June 15 and very apprehensive, I'm having 2 discs taken out and fused but I won't have a collar which I find abit scarey ? What if I jolt it ? I have read few post surgery people saying they have had collers on for weeks ? Is it just my surgeon, or just UK practice that we don't have them .
    A dawes
  • Anne63......I know it seems confusing about the collar. If you read enough of the forum threads you will see there are a bunch of folks who had to wear a hard collar in recovery and a bunch who didn't. It seems to very much depend on the procedure you're having, the hardware they are using and the stability of your neck and vertebrae. Bottom line is it's important to follow your doctors instructions and ask questions. I had no collar after C5-6, 6-7 and did fine. I followed the doctors limitations about no lifting, no driving until cleared and no raising arms over head initially. I slept in bed on my side with a very low pillow under my head and another pillow against me for my other arm to rest. I did a LOT of walking in my recovery and it really helps.
    Hope you have a very successful surgery and an easy recovery. Take plenty of time to take care of yourself and heal.
    C5/6, 6/7 acdf Jan 2015
  • Hoping all goes well with your surgery today. Will be praying for a good recovery. Your internal hardware is acting like a external collar. Just follow Doc orders. I had a c6-7 discectomy with fusion only 1 level. No collar ever. I did chose to wear a soft collar on my own when I had a long drive shortly after my surgery just for extra protection in the car. Hopefully your Doc will put on a waterproof dressing and you can get into the shower right away, That helped me so much. You will have a sore throat initially very sore and will likely only want liquids and very soft food. By day three I was eating normally again. PM me if you have any specific questions.
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