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Question for ACDF surgery

Hi,

I am new to this forum and really feel lucky to read so much useful information here.

I do have couple questions for my wife, who was recently diagnosed as herniated C5-C6 disc. We were told by the doctor that she will need the ACDF surgery, sooner than later. This is really shock news. My wife is still young and she did not have much bad feelings for her neck until she was not able to move neck for two days in later October. The MRI result is very bad and we are recommended by the doctors to consider the surgery.

Before we make the final decision, we really have some questions.

How to find a good doctor? We already visited a doctor with 11 years experience and he seems to be a good doctor. However, should we try to see more doctors to find a better one? How do we tell if a doctor is good or not?

What is the typical side effect after the surgery? I read some posts and I can see that quite some people feel uncomfortable about the throat. Will that be a temporally condition?

My wife is a chemist and she used to do a lot of bench work. Is anyone on this forum doing the similar work? Will she be able to continue her work after the surgery? Is there any restriction about what type of work that the patient should avoid after the recovery?

I know this is quite a lot of questions. Really appreciate if someone can help on them. Thanks and wish you all a wonderful new year.
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Comments

  • i encourage you to read the sites faq near top of this page. it has the following info and much more;

    how to find a good surgeon.
    https://www.spine-health.com/blog/finding-a-good-spine-surgeon
    https://www.spine-health.com/blog/top-ten-reasons-you-should-run-your-surgeon

    there are also 4 links about questions for patients to discuss with their surgeons and hints on consultation preparation.

    something else for you to read
    https://www.spine-health.com/treatment/back-surgery/how-prepare-psychologically-back-surgery

    and have you seen these excellent tips for your for pre and post op preparation? ( from the faq's at the top of the page)
    https://www.spine-health.com/forum/treatment/back-surgery-and-neck-surgery/pre-and-post-op-must-haves

    others here will comment from their experience with acdf.

    good luck.
  • Hi there, Oldcat:

    While you wife's ACDF is a little different than mine, I just had one done at the end of October. So far, so good!

    I would say that getting two opinions is always better than just one. Experience is critical, of course, but so it the way the surgeon answers questions and the way his office/nurses respond to your wife and her needs. Are they too busy for her questions? Is the doctor dismissive or arrogant? All of those things are important, too -especially as your wife heals.

    Did the surgeon you saw talk about how long she will be off of work, etc? Have you asked your surgeon about her returning to that type of work - and more importantly, is there a way to adjust the positioning of her body/neck so that it doesn't damage more disks along the way, because if one area is fused, the other disks will bear the burden of the other being fused. So, perhaps you/she can start looking at how to prevent damage in the future. It may not be possible.

    I would say that reading so many posts - each person has their own set of challenges and reactions.

    For me - I had zero pain - but I did lose my voice for 35 days. Even my surgeon said that was a record. Some never lose their voice - it all depends on many factors. Most I have encountered are in some sort of pain and have taken pain meds, but I escaped that, thankfully.

    I am in a Miami J Collar - many are not.
    I have a bone growth stimulator - many do not.
    Many have sore throats - I never had a sore throat or pain.

    Swallowing was definitely a challenge in the beginning - even sipping water. Ice chips, applesauce, mashed potatoes, cream of wheat, smoothies and yogurt were about it for a few weeks. Then, gradually, things eased and got better.

    Initially, sleeping in bed was not possible for me. I slept in a recliner the first week, then the sofa the second week and then my bed - but using the cushion of my sofa propped up in bed so that I was pretty much sleeping almost sitting up for a few weeks. (Again, I have this collar on, so it made some of this a little trickier). Now, I am sleeping normally, even with the collar. Nerves are healing, so it helps.

    The theme I keep seeing for those of us who are healing is boredom and impatience - some doing too much too soon.
    I would encourage her to not rush. So, she should plan to read and rent movies, crochet, knit - whatever and catch up on those things she has wanted to do from a chair or bed but has never had the time to do.

    Oh yeah - if on pain meds - plan on constipation - and make sure you have what you need to deal with that. That's no fun!

    I posted my experience on here chronicling my experience.

    I am doing great. I just have to wait until the end of January to see how much fusion has taken place. That will determine whether I get the collar off or not. But, I am pretty functional - and I can now even drive. I just don't lift heavy things.

    The biggest thing I can suggest is to prepare, which will help to alleviate some of the stress. Keeping the stress down as much as possible will help.

    One thing I was told by someone working at the hospital where I had my surgery done before I had it was:

    1) Hydrate, hydrate, hydrate - drink as much water as possible up until the time you are allowed the evening before surgery. (Not coffee, not tea - which dehydrate - but water.)

    2) Rest as much before surgery as possible. If you are at a deficit with sleep going into surgery, you will not only be trying to make up for loss of sleep, but you will be recovering from surgery, too. In other words, you need all of your energy and strength to heal. So, sleep and rest and try not to go into surgery exhausted.


    Many will have other ideas and experiences, but I hope this will be helpful.

    Good luck to you and your wife.

    10/26/2012 ACDF C3/4 C4/5 surgery
    No pain; no pain meds - thank goodness!
    04/01/2013 - 5 months + 1 week - FUSED
    Doing some physical therapy for even better range of motion
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  • DaveFusion and FrancineSF have both given you some good advice.

    I have had a lumbar fusion and am just 8 weeks into my recovery from an ACDF. I had nothing like the pain before my neck surgery, compared to my pre-surgery pain which led to my lumbar fusion.
    The reason that I had the surgery in my neck was cord compression. This is not necessarily painful, but is more serious than just nerve being compressed. I was starting to show signs that my cord was being damaged, so had to get the pressure off it.

    I would definately get at least a second opinion, if not more. Once a spine is fused, at whatever level, it will never be the same again. As Francine mentions, once a level is fused, there cannot be movement at that level so the other levels have to take up the slack. This can, but not always, lead to the adjoining levels going which may need another surgery. You don't want to have fusion surgery unless it is really needed.

    As far as losing mobility of the neck, I was told and have read that with one level it will not really be noticeable. With two levels (what I had) there will be some loss, although in my case I was told that as I had already lost some mobility, I would probably be the same. I have read that with 3 levels, there is likely to be loss of movement and some jobs, such as a dental career may not be possible.

    Having a sore throat, swallowing problems and voice problems are very common after this surgery, from moving the oseophagus and trachea rather than the intubation. Generally they are only temporary, unless something is damaged. I still have (after 8 weeks) a numb throat from my chin down to my incision. My surgeon says that this is due to cutting the nerves as he made the incision. He is confident that the nerves will regrow and repair and then the feeling will return.

    I suggest that you continue to research this surgery and prepare a list of questions to ask your surgeon/second opinion.
    People here are always very willing to share their stories too, so ask away!
    I wish your wife good luck and please do let us know how she gets on. :-)
  • Hi Davefusion, FrancineSF and Jellyhall,

    Thank you all for the reply and the very helpful information. I just found this forum yesterday and already received so much useful information. I really appreciate that you can share me with your own experience and I will also keep in mind for all the suggestions that you provided.

    It was scared when we first knew the possibility of taking a surgery. The nature response is trying to avoid or postpone it. The surgery doctor that we visited did not push us much. But he kept mentioning the risk of having the condition without surgery. As he said, any accident, falling down or some unexpected events may get the condition even worse. He also said that it is impossible for nature recovery without surgery.

    We are still making appointments for second opinion. I will try to ask the doctor for more information if possible. By the way, during the after surgery recovery, will the patient wear the collar even for sleep? How long normally do you take for recovery before you go back to work? Will two months be enough? Do you feel that you can use your neck to bend down after the recovery from the surgery?

    Thank you again.
  • ...as always, there will be different responses for each person, but I can tell you what is happening with me.

    Is the surgeon recommending a collar for your wife? Not everyone is given one. It depends on the surgeon and the disks involved. I don't want you to think that because I have one, that your wife will if no one has told you she will need one. But ask, most definitely.

    I wear my collar 23/7. I usually have it off for an hour when I am showering and getting dressed, etc after that. Initially, I had to even shower with the collar on for the first 6 weeks, although I did stop wearing it in the shower at 3 weeks because my neck felt sturdy and the floor of my shower is not slippery. Plus, I intentionally move slowly while in the bathroom. I wear it all of the time. When I am sitting with my head against the back of my recliner or sofa, I open the front of the collar so air will circulate, but I keep my head still.

    At 6 weeks, I saw my surgeon so he could see if the fusion had started and I will see him again at 12 weeks so he can see if it is moving in the direction it should be.

    From what you said, you wife is having a one level fusion, so I am not sure what your doctor is suggesting for time off of work. I started working (from home) at about 1 month. My head was still a little foggy at that point with respect to concentration for long periods of time, something I have heard others experiencing, too. But, it improved quickly after that. I cannot sit for long periods of time. So, I do a little work then I get up and move around and come back and repeat it. I can sit for maybe 30-45 minutes and then I have to move. I am sure that wearing the collar is a huge part of it.

    So much is going to depend on how she responds to surgery and how willing she is to allow herself to take that time and really heal -- really relax. If she can, she will likely do better, in my opinion. Two months does not seem unreasonable.

    I am not yet allowed to bend my neck forward and have not tried. I am not supposed to turn left or right either - but, I have VERY slowly done that and I am impressed that I still have very good range of motion. But, the discs that were fused are higher up than your wife's. You have to ask the surgeon how much that will change. I am certain that bending my neck forward will be far more limited, but time will tell. This is all new to me.

    Feel free to ask more questions. Everyone on here seems to be really helpful. I've only been on it about 2 months or so and have found it helpful - and at times overwhelming if I read too many posts, to be honest. So, I try to balance things.:)

    10/26/2012 ACDF C3/4 C4/5 surgery
    No pain; no pain meds - thank goodness!
    04/01/2013 - 5 months + 1 week - FUSED
    Doing some physical therapy for even better range of motion
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  • oldcat said:
    Hi Davefusion, FrancineSF and Jellyhall,

    Thank you all for the reply and the very helpful information. I just found this forum yesterday and already received so much useful information. I really appreciate that you can share me with your own experience and I will also keep in mind for all the suggestions that you provided.

    It was scared when we first knew the possibility of taking a surgery. The nature response is trying to avoid or postpone it. The surgery doctor that we visited did not push us much. But he kept mentioning the risk of having the condition without surgery. As he said, any accident, falling down or some unexpected events may get the condition even worse. He also said that it is impossible for nature recovery without surgery.

    We are still making appointments for second opinion. I will try to ask the doctor for more information if possible. By the way, during the after surgery recovery, will the patient wear the collar even for sleep? How long normally do you take for recovery before you go back to work? Will two months be enough? Do you feel that you can use your neck to bend down after the recovery from the surgery?

    Thank you again.

    I was also told that there was a danger of serious damage to my spinal cord if I was in an accident or had a fall. It was pointed out to me that there was no spinal fluid around my cord to cushion it and so if my head was jolted, I could sustain a 'bruise' to my cord. That didn't sound very serious to me, but I was told that it was a form of spinal cord injury and could leave me with permanently weak arms and legs or even paralysed.

    For my surgery I had two titanium cages to replace my discs. I have no plate or screws and have not had to wear a collar at all. Before my surgery, I was a bit concerned that when you read about the ACDF people seem to have a plate to hold the cages in place and also wear a collar at least for a short time. I spoke to my surgeon about this and was happy with his reply and explanation of how he gets success with this method and that it is used by many other surgeons here in the UK.

    My mobility is really pretty good. I had restricted mobility before my surgery and think that I am almost back to how I was. I can turn from left to right and can look up and down pretty much as before. I am only 8 weeks post surgery so there is plenty of time for more improvement. I would say that I am still getting nerve pains in my hands and arms (and feet and legs) but I know that I have problems at all the levels below the two that were fused and my surgeon did warn me that I amy need another surgery. He only did 2 levels because he said that there was a much better chance of successful fusion if no more than two levels were done.

    I have been told that I should have 3 months off work, but my job as a Teaching Assistant requires me to look down a lot. I think if I had a different job, I would be able to go back earlier. Most people return to work before 3 months. Francine is in an ideal position where she can respond to how she is feeling and what her body is telling her. Getting up and changing position frequently will be very helpful.

    Keep on researching and asking questions. The support from members here is a great help when facing this scary dilema.
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