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New pain after C4-C7 ACDF

Hello Everyone,

I’m know I’m not the first to post this, but I’m hoping I can get some new perspective on this. Some background, I had been in a few auto accidents 20 years ago, rear ended, hit on the side, none my fault and none caused any more than disc hernaitions that got better over time but always caused flares of chronic pain over the years. 7 months ago, I woke up in the worst pain ever, I could barely move and my left arm was completely numb, it slowly began to tingle horribly and twitch. I knew something was seriously wrong and had an MRI that showed disc herniations from C3 – C7. The doctors told me not to wait until the end of the summer to have surgery, I had it this last May, 8 weeks ago. Had I not have surgery the herniation’s would have made me paralyzed. I did a lot of research to see if I could get ADR surgery and I just couldn’t get it for 3 levels in my state. I had an ACDF from C4-C7, 4 months from when the extreme pain began. After the surgery, I woke up feeling the lump of pain in the back of my neck gone as well as the numbness and tingling in my shoulder and arm. The weakness has been slowly getting better over time.

I had stiffness pain and some headaches from the collar but thought it would resolve soon after weaning out of it 2 weeks ago. I now have NEW pain I did not have before the surgery, constant headaches, and some tingling around both ears. The small disc herniation C3/C4 was left alone and I’m starting to think it may have become bigger causing nerve pain. At my 6-week visit I was told I could start to wean off the collar and that my x-rays looked great and I have strong bones. The PA mentioned your neck may hurt as your changing to no collar but putting it back on doesn’t even help, or the pain meds!

They don’t want me to start PT until mid August. I don’t know what to do to help this head pain and tingling. Plus I feel a thoracic disc has become much worse. Recently the tingling has become so bad it feels like someone is forcefully running their nails over that part of my back. My arm would feel the same intensity of tingling and twitching right before my surgery.

I’m hoping to hear some people tell me they had the same experience and now they feel fine. I’m hoping that even if the discs got worse they can resolve themselves. I want to ask for an MRI at my next visit in two weeks but the situation is driving me a bit crazy. Anyone have some advice or hope of it getting better? Is it normal to have new pain and feel worse before you can feel better?


  • Faith,

    I would say that your expectations are too high. A three level surgery can easily take a year to heal. I only have low stamina and minor neck soreness left to deal with but I'm not at 8 weeks I'm at 8 months. I still had numbness, tingling and pain at your stage, enough to continue using both long and short acting narcotics. So yes things get better after surgery but be patient. If the pain meds are no longer helping talk to your doctor about changing or increasing them.

    And no, your disc at c3/c4 will never heal. It will continue degrading over time but your surgeon has judged that not to be a concern. My guess is that the hole is small and he thinks it is not likely to cause symptoms.

  • GdcGGdc Posts: 3
    edited 07/17/2015 - 4:00 PM
    I recently had ADCF C5/C7 middle of May. Main symptom prior to surgery was neck pain lack of sleep and intermittent numbness in the thumb and first finger and occasionally in my arms. Decision for surgery was that the compression on my cord had progressed to 5millimetres only. First 5 weeks post surgery I felt like I was recovering really well. Not sleeping laying down but pretty well in a recliner. Only residual numbness in the tip of my left forefinger. At 5 weeks however I started to get some burning in the back of my hands, numbness in my little and ring fingers some in the other fingers but less often. I also have numbness in my left foot and tingling in legs and a week ago have noticed to pain in my upper back includes numbness across the shoulder blades. I had a cat scan at 5 weeks and surgeon said the plate and screws were all in correct place, and had an X-ray this last week and he says it still looks good, still have all these new symptoms, which are worse at night and when laying down (so sleep even less) Surgeon wants to wait 5 weeks and do an mri. Still have soft collar on when moving around and no rehab allowed for another week which will make 10 week. Has anyone else had any similar experience and what was the outcome. Surgeon prescribe Lyrica to help with the burning sensation. physio things some of it might be the amount of tension in my neck and back muscles (doesn't explain the foot and legs, but could explain my shoulders. Or physio other thought was perhaps it is where the spinal cord has sprung back from its squashed state and is agitated as a result. surgeon said maybe there is still compression post the disc removal so might need additional surgery from rear to remove back of vertebra. I asked surgeon if he thought it might be c7 disc which had been good prior to the surgery, but he thinks unlikely because I am feeling it in so many different nerve regions. Any similar experiences would be appreciated .

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  • My burning fingers are finally stopping as of the last few days..So yea,it can all change,hang in there..I had a multilevel laminectomy myself and the coming back from numb is a real rough ride..Seems it hurts more when you can feel the damage that was once self managed..GL
  • Yea,they will/can stop burning..My fingers burned pretty bad..About a 6-7 but nightly..It started stopping that a couple days ago..I'm at 5 months post op and the coming back seems insane and painful seeing as how going in,I was numb..Coming back,I could feel every bit of damage with healing..Ouch!..Gl..And don't get too worrisome,alot of what I thought was prernanent for months,went away with healing..Wait 6 months before even considering anything is permanent...
  • Thanks for the feedback b0ssdad. Good to hear from someone. I suppose I just expected to continue to feel as I had for the start of my recovery rather than go backwards, but if others have experienced the same and improved it is good to hear. As mentioned my surgeon says maybe there is further compression, which is concerning if the surgery was specifically to remove the compression. Did you have hardware installed with your surgery and have you had an mri since. I don't understand why my surgeon wants to wait before doing an mri to see exactly what is going on. It is the not knowing that is worst for me, exacerbated by the lack of sleep. My surgeon prescribed Lyrica 25mg for me last week which is helping but I can still sense it is there some of the time, as you said more at night than any other time. Was you issues only in your hands, I am also getting some burning top of my feet.
  • Ok,lemme see if I can address your questions..Only in my case of course..

    " feel as I had for the start of my recovery rather than go backwards,"

    Heres my logic..Right after surgery,nerves bruised,hurt,freaking out..They continue to be numb..From shock,or compression..Esp c-5.Ns warned me c-5 can wig out when decompressed..Runns the arms,wrists,etc.As my nerves healed in my neck,the feeling started returning in my hands,fingers etc..And at night,the pain would go from a 2 to a 8,with groaning,lol..and I handle pain well,but this hurt..And as when a hand that falls asleep,and comes back,it hurts like hell,burns tingles,etc..So,while it seems to be getting worse,pain wise,burning etc..It already was hurting,the nerves with being injured couldnt tell your brain it hurt,Well,as you heal,the nerves heal,and the pain,while mild(numb) after surgery,for months even,will get far worse..Congrats..In my logic,the pain shows healing nerves..Up to a certain point..Then it levels out,and you get stuck with what you have..I was sure I was a goner,but at 6 months..Starting to get decent.

    "Did you have hardware installed with your surgery and have you had an mri since. "

    Yes ma'am,I did..Pedicle screws(8 of them) c-3 thru c-6 and rods..With fusion of course.

    "have you had an mri since. I don't understand why my surgeon wants to wait before doing an mri to see exactly what is going on

    No I haven't..Cat scans yes...They don't do them easily because insurance companies want a very serious reason..Like pulling teeth..Docs have a hard time getting them ok'd unless its emergency

    "It is the not knowing that is worst for me, exacerbated by the lack of sleep.""

    Yes ma'am,It was the worst part..Anxiety and terror cuts in on sleep pretty badly,lol..I agree.

    "as you said more at night than any other time''

    Sure was,8:00 P.M every night like clockwork..Even more if I used it that day..But always better in the morning.Degrading all day..

    "Was you issues only in your hands, I am also getting some burning top of my feet."

    Yea,I went myeopathic(sp,sorry),before surgery..Arms nd legs..But I was numb,so no sensations I noticed..But as healing went on,I became all too aware of the damage to my muscles and nerves it had done..I do NOW,lol...My hands were screwed,no dexterity,dropping,numb to the IV pokes even..Useless before surgery..And that was a long crawl back for my hands and wrists..The most pain I had was in my hands..Numbness was terrible..Joint,knucles skin burning like gasoline..Butr mainly in the left,and the first 3 fingers,as I read those 3 run off some of the same nerves at c-5..But again,dexterity returned fast..But numbness was 6 weeks before it moved an inch..Then,till now,VERYYYY slow improvement handwise,then the burning at night started..that was months,ouch..
    A lot of arm trouble..Feel strong,walk a bit,and it would be wacked the rest of the night..Just started improving this week,scary.

    My feet..Yea,weird stuff..Up and around,they feel fine..But if I lay down,they spasm,jerk,kick,lol..Its crazy..But that started at month 4,so im assuming its healing going on at the nerve root..I feel a vibration type tingling in my arch to middle toe..Little spasms all over them at rest..and so tinglin and mild pins and needles on the tops,again,at rest..

    But at six months..This week on many,after months of anxiety..Arm is strong again..Pain in arm from a 1 after surgery to a 6,to a 1..Hand from a 2 after surgery ,to a,7 to a 1..(at 6 months)

    Hand still feels a bit wonky..Feet still tingle some..pins etc..arm still gets a bit tired,but little pain now..

    Hope this helps....Gl..Sorry for the typos..
  • I was similar to B0ssDad. Immediately after surgery the pain and numbness were nearly gone except for the freshly cut neck of course. The next day it started creeping back "what is that" to "are you imagining this" and by the third day had returned. My Ulnar nerve lit fire by week two. Many times I wondered if I had made the right decision. In those moments I trusted the logical part of my brain and not my emotional side, the science that says "you had a tear and now that tear is fixed but it will still take time for the underlying nerves to heal."

    If I had my choice I would have rather been in pain from the get go and then gradually gotten better. The odd healing of day one followed by pain and numbness on the days and weeks that followed was strange. On the positive side it was really cool learning how powerful the body and the nervous system can be.

    I am now eight months out and the only two remaining symptoms that I have from the ACDF are a sore neck upon extended use and lower stamina than I was accustomed to. The neck pain is no longer at a level to need opiates. I still have moderate pain in my shoulder but that is a different story, I'm three months out from shoulder surgery.
  • Thanks guys your feedback has been helpful, what threw me most was I actually had pretty full relief except for the numbness in my left index finger for almost exactly five weeks before things flared up. I saw my surgeon again today and he did a neuro obs on me an I still have normal strength (considering) normal reflexes. And while I have the strong burning sensations and some numbness his sensitivity test with a needle and a one, two point test were fairly good except in the area expected in my hands for. C6 compression.

    He spent more time than usual with me today. Wondered how I had ended up on 25mg Lyrica rather than75mg , which he either wrong the wrongs script or the pharmacy got it wrong, so in a nutshell the Lyrica dosage he said was not adequate.

    He is going to do another ct scan next week and see how my fusion growth is proceeding, be 10 weeks postoperative. Also said in 14 weeks he might need to do. Myleograph, as mri would be affected by the frame in my graft, their is a small stainless steel rod in the centre of it. That is fine with me as I hate the MRI machine, not claustrophobic but I have sleep apnea so flat on my back, locked in that cage makes me anxious.

    Your comments and his feedback today give me a much more positive perspective. Surgeon said if the myleograph showed an issue he would do a laminectomy and fuse from the back also. Hope it isn't necessary but at least I know he is thinking ahead for me, and I feel much more he believes me now than I did when I explained my issues before. I realise a laminectomy on top of th ACDF might still not fix it as I know BoSSDAD had laminectomy, but decompression front and back at least would mean it can't get worse, the surgeon stills sees some stenosis on the right due to some Spurs.

    I am in Australia so if anything doesn't make sense in what I am saying let me know. Eg I know in the USA you need your insurance to approve different scans. Over here the doctor makes the call, and part of the cost is covered by medicare (government provided but they take 1% of everyone's salary) and part by my personal medical insurer, the gap I have to pay cash for. Can still get expensive.

    I really appreciate the responses. At only 2.5 months post op without a support group while you get told it takes a while to recover, I thought I was on the road at 5 weeks so the backward steps really threw me, so to hear stories with similarities give much better perspective on how long I might need to wait for the recovery to really set in. I know we have all had slight different issues and treatments and circumstances, I have hope I will improve as you have.

    How long did you guys take opiates? I don't like taking them and at 5 weeks had stopped, but have been taking up to 4per day since (max dosage allowed is 8 in 24 hours). I did forget to ask also, I have numbness across my upper back/ shoulders, never had before surgery, bit like my legs. Was this a symptom either of you experienced I never had c4 touched as you did so hope it is unrelated to anything new in that area. Again my surgeon really didn't comment on it even though I made mention. This area seems less improved with the lyrica.
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