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ACDF or not? Help please

pritdayppritday Posts: 6
edited 06/11/2012 - 9:02 AM in Neck Pain: Cervical
I'm debating on whether or not to have this surgery. I've already consulted with two neurosurgeons. The first one highly recommends it and thinks PT might do more damage. The second one thinks it would be fine to wait a month to see how I feel. I'm in my early 30's and currently have intermittent pins and needles in my left arm and soreness around my shoulder blade and shoulder. Here are the findings from my MRI...

1. There is straightening and significant reversal of the normal cervical lordosis consistent with torticollis.
2. There is a broad-based bulging annulus at C5-C6 with compression on the thecal sac and partial disc desiccation.
3. At the C6-C7 level there is a moderately large 3-4 mm left paracentral/posterolateral disc herniatiom with compression on the thecal sac and partial extension into the medial aspect of the left neural foramen with associates left neuroforaminak stenosis. The annular tear is clearly visualized. There is flattening of the anterior surface of the spinal cord itself, without evidence of significant direct cord compression. There is mild circumferential canal stenosis and disc desiccation.

I wish I had a more definitive answer as to if I should have this surgery or not. I'm not really in that much pain but I'm concerned about an increased risk of paralysis in the off chance that I was In a car accident or something.
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1

Comments

  • Excuse the typos....if I knew how to edit my post I would fix it. Damn autocorrect.
  • As I understand, if you have herniation, it will never heal. I'm looking at C4/C5 C5/C6 ACDF myself in May. One other consideration is that the longer your nerve is impinged, the greater the risk of permanent damage. How long have you had symptoms?
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  • t84a said:
    How long have you had symptoms?
    Approximately 1 month.
  • Can anyone else offer any advice? Please and thank-you! :-)
  • Once the disc is torn and herniated there is no repairing it. Surgery must be done. If you can handle the pain and feel you can wait then do it. But if the pain gets severe, you should have the surgery.

    Also the longer your nerve is compressed/damaged the longer it takes to heal. You can even get permanent nerve damage.

    I had intermittent pain for 4 years and severe pain for 2 years before my surgery. I am glad I had my acdf and I do have less pain than pre op, however I do still have chronic pain, but at least it is manageable now.
    ACDF C4-5 June 23rd, 2011

    Another surgery in the near future. I am 26 years old.

    Current Meds- Norco 7.5/325, Cymbalta 60mg, Gabapentin, Adderall 20mg
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  • On Wednesday I had an ACDF on levels C5 to C6 and C6 to C7. My pain began as a feeling of fire ants stinging my upper back. Within a week I had lost feeling in both hands. I didn't feel like I had an option. Immediately after surgery the burning in my back was gone, but my hands were still numb. I was afraid that I had permanent nerve damage, but within another 24 hrs. the numbness was gone. I share the concerns of the posters before me. The damaged disc will not heal itself and the longer you wait the better the chance that you will do permanent damage. Believe me, it scared me to death. I would correct the problem as soon as possible. It will only get worse on its own.
  • Do you guys really think it won't repair itself if I just give it enough time? I think I'm doing a little better every day. Honestly, it doesn't hurt as much as it used to. I'm scared of having surgery.
  • Actually....
    Most herniated discs heal on their own over time (one to six months). The goals of treatment are to:
    Relieve pain, weakness or numbness in the leg and lower back or cervical region.

    Prevent further injury by teaching the patient techniques and exercises for care of the back or neck.

    More than 90% of patients who have a herniated disc will improve within six months after nonsurgical treatment. For this reason, nonsurgical treatment is usually tried before surgery is considered.

    Nonsurgical treatment usually includes:
    Rest, followed by a gradual increase in activity
    Medication to control pain and inflammation
    Exercises recommended by the doctor or physical therapist to help reduce pain and strengthen the muscles that support the back or neck.

    In some cases, herniated discs heal on their own by a process called resorption. During resorption, the body absorbs parts (fragments or tissue) from a herniated disc that has ruptured.

    Surgery may become necessary in only a small number (less than 10 percent) of people who have herniated discs. Surgery may be considered for people who have progressive nerve damage or severe weakness or numbness or for those whose pain has not been relieved by other methods.


    There are 10's of thousands of people who have disc issues every day. Some have severe pain...some have absolutely no symptoms at all.

    If you were to do MRI's on a random 100 people on the street over 30....a large percentage would have disc issues and show even bulges or herniations...

    There really isn't a right/wrong answer for your own body..

    I, personally, only had surgery when the risk of being paralyzed was imminent....

  • I don't believe a disc that has shredded apart and pieces have extruded into your nerve root and spinal canal can or will heal its self?
    ACDF C4-5 June 23rd, 2011

    Another surgery in the near future. I am 26 years old.

    Current Meds- Norco 7.5/325, Cymbalta 60mg, Gabapentin, Adderall 20mg
  • When a disc has herniated and torn(annular tear)and it's contents are seen in the canal and foramina(openings in the bone that allow the nerve roots to pass through), it will not "heal" itself.

    What it will do, is scar over or continue to leak disc contents. If the disc scars over, the contents that have already leaked out may be reabsorbed, or,as your MRI states, they are drying out which may shrink them a bit, causing less pressure, or they will continue to produce your currrent symptoms.

    Time will tell. I had a traumatic injury with multiple vertebral fractures and herniations, with central cord syndrome, from the direct pressure on the spinal cord from one of the fractured vertabrae(C4). I had a fusion before I left the hospital, and most of my symptoms went away before discharge.

    I still have some chronic pain, although much less, and limited motion, some of that is from the other injuries.

    Everyone's experiences are different, I'm just grateful to have an intact spinal cord and be walking etc.

    Your body will tell you what to do, by increasing or decreasing pain or mobility, has been my experience.

    Hope this helps some,
    Dee
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