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Failed ACDF cervical fusion

So I am not fused 21 months post op for a two level ACDF 5/6-6/7.    I was told that I need a posterior approach revision surgery now.   I do not want to get this but my pain level has actually been increasing lately.  What are my options though?    I was actually thinking outside the box out of desperation lately.   Maybe stem cell shot into the surgical area or even HGH to help promote bone growth.    Anybody out there have similiar situation going on or have had the posterior surgery.    I could use some advice.  Thank you

Feel better all

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Comments

  • memerainboltmemerainbolt IndianaPosts: 6,357

    amarino
    I am so sorry you are going through this. My only advice would be do your research, make notes and questions for a discussion with your doctor.
    While you are waiting on other members to reply, go to the search box and key in "posterior revision surgery", scroll down past the ads and there you will find other discussions on this issue.
    Good luck and please keep us posted.

    Sandra
    Veritas-Health Forum Moderator
    ---------------------------------------------------------------
    Please read my  Medical History
  • amarinoaamarino New yorkPosts: 7

    Thank you for the advice.  

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  • Bruce EitmanBruce Eitman Akron, OH, USAPosts: 1,510

    Amarino

    Have you discussed this with more than one surgeon?  I would want a second opinion.

    Bruce

    Read my story at Bruce - My Story
    ACDF C4-C5-C6-C7, and getting better every day
    It has been a process of healing, learning, exercising, and resting - and figuring out when to do which.

  • MetalHeadMMetalHead Posts: 35
    edited 08/23/2018 - 4:34 PM

    Hi Amarino, 

    I am 20 months post-ACDF C4-C7 and mine has also failed between C5-C6 & C6-C7.  I am currently awaiting a poster revision and will have C4-T1 fused this October 

    So I will share with you everything I’ve gone through and tried. But I also think it’s important for you to find out where your pain is being generated, as I’ve been told that not all non-unions are problematic or symptomatic. Some people never know their ACDF failed.

    I have done the following procedures with no pain relief,

    Cervical epidural steroid injection, trigger point injections, cervical nerve blocks.  I have not done stem cell or plasma injections as neither of those were offered as an option for me.

    I did do a test procedure to pinpoint the origin of pain and it was determined that it was discogenic and was a direct result of the non-union. 

    So the options I was offered by 3 separate surgeons were - 1) repeat anterior fusion followed with a 3 month CT and if still not fusing, then posterior revision. 2) live with it until the screws & plate work lose then have posterior revision (BUT the bone graphs that are free floating in the disc space are wearing down my bone plates and eventually there will be no hard plate left to fuse, so all future corrective surgery will be more complicated and compromised) 3) posterior revision 

    I was also told by two of the surgeons that 18 months is generally the cut off for bone growth, after that not much will happen.

    I started with mild pain at around 6 months post op (up to that point I was in heaven! Totally off narcotics and back to my very active lifestyle... I was so glad I’d had the surgery and felt better than I had in 20 years!)  then the arm pain came, slow and steadily worsened I started seeing a pain management doctor, we started experimenting with different procedures., Then about 6 months ago started having severe neck pain with the arm aching and I stopped doing my usual activities.  About 3 months ago I became housebound and unable to drive from both pain and narcotic use.  So where I’m sitting now, there was no way I could avoid an additional surgery. I have had a 2nd and 3rd opinion.  I have been given very few options.  

    I finally settled with my 3rd opinion doctor because 1) he is a neurosurgeon and not just a spinal surgeon 2) he has been interested in everything not just my spine - nutrition, bone density, vitamins etc 3) he was honest about how hard the posterior revision is and he also showed me my own scans and explained the hard bone loss that would cause another anterior revision to fail 4) he is fusing down to T1, which sounds terrible but he said the C6-C7 is a major mover and having it fused will cause all the strain to be pushed onto C7-T1 and eventually that disc will degenerate. He said the Thorasic discs are much more stable and can take wear and tear better so moving the onus to the T1-T2 disc will hopefully help me avoid doing neck surgeries throughout my 40’s.  5) he is going to use my own bone for the posterior fusion.  So as you can see, I went with the surgeon that didn’t give me the easiest answer, but did give me the most thorough answer, and he also is concerned with my future and wants me to avoid more surgeries down the road... as he said the ACDF is a one and done, if it doesn’t work we’ve  got a challenge and he’s also said that one surgery usually begets another which is why he’s taking down to T1 this time. 

    Sorry, I’m rambling on and on... my point is go see several doctors. Try several different things to help with your pain relief. Get several opinions and decide what is best for you based on your current pain levels and how much it interferes with your life. And if you are like me, prepare for your pain to increase significantly... so get started on getting some surgical opinions and get your studies underway. I started this journey back in September and I am finally on the surgical schedule for October 1.  It’s been a rough year, all full of doctor appointments, scans, tests, and narcotics.  I’ve basically stopped living, so if i were you, I wouldn’t waste any time getting some appointments scheduled for 2nd & 3rd opinions. Find the doctor you trust now!. Start with getting a referral to a pain management clinic so you can try several things in the interim. 

    Good luck, I hope my rambling answer helps somewhat, sorry for the lengthy reply.  I’ll update with my surgical experience when I finally get there. It’s all quite terrifying and I’m still finding myself trying to convince my brain that I can handle this pain to avoid the surgery, but I know I can’t.  


  • Amirino, sounds very familiar as well. I had the same ACDF of C-5 through C-7 on Sept 2 2014 which also failed with lucency showing at all end plates. Latest MRI also shows narrowing of C-4 disk now as well. Yes I’m still in pain but I’ll wait until the hardware starts failing before I let them go posterior and add a disk on top of that. As you allready know, surgery isn’t a guarantee that the pain will resolve. Definitely get another opinion!

    DavidG

    Veritas-Health Forum Moderator

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  • He said the Thorasic discs are much more stable and can take wear and tear better so moving the onus to the T1-T2 disc will hopefully help me avoid doing neck surgeries throughout my 40’s.  5) he is going to use my own bone for the posterior fusion.  So as you can see, I went with the surgeon that didn’t give me the easiest answer, but did give me the most thorough answer, and he also is concerned with my future and wants me to avoid more surgeries down the road...

  • He said the Thorasic discs are much more stable and can take wear and tear better so moving the onus to the T1-T2 disc will hopefully help me avoid doing neck surgeries throughout my 40’s.  5) he is going to use my own bone for the posterior fusion.  So as you can see, I went with the surgeon that didn’t give me the easiest answer, but did give me the most thorough answer, and he also is concerned with my future and wants me to avoid more surgeries down the road...

    Any comment for this... ???

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