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Here I thought I was all set with ACDF and the second opinion blew it out of the water!


I'm new here and found the site while searching for information on the problems I've been having on my left side (neck pain, shoulder and arm pain) that have been nailed down to compression between C6-C7 on the left side.  Interestingly, the right side is also compressed but shows no symptoms.

After getting and MRI and orthopedic spine surgeon, he recommended ACDF (two levels - C5 to C6, C6 to C7).  I was just getting my mind around that, have the pre-op screening set up and surgery scheduled for next week.  It was pretty whirlwind based on the pain I'm feeling.

Today, I had a second opinion with a neurosurgeon and he said that ACDF would be good but so would nerve decompression and he recommended nerve decompression at the C6-C7 level on the left side.

And now...I'm confused!!!  Two doctors, two different recommendations and I need this done!  Agh!!!

I'm open to opinions from others who have been in this boat or had one or the other surgery.  From what I can tell:
  • Recovery is about the same
  • Long term recovery is shorter for nerve decompression
  • I'm not really concerned about adjacent disc disease with the fusion
  • Fusion is going to open up ALL the disc areas for the two levels so down stream compressions may not be an issue.
Thoughts, comments, opinions?



  • Since I'm new here I have no answers for you, sorry!! I do want to say good luck with whichever procedure you have done. I don't blame you for being confused.
  • Did the second surgeon explain how he was going to decompress the nerve?
    I would go for a third opinion. Unless your told that waiting for a fusion surgery is risking permanent damage or paralysis I would take the least invasive path.  Once done you can't put back what a surgeon takes out.
    I personally took the conservative approach before  surgery with blocks and physical therapy.  I tried everything from 2993 until I had a laminectomy in 2008.  In the end I had a 3 level fusion in 2014.  
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
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  • georgejonesggeorgejones Santa Rosa Beach, FlPosts: 24
    I assume decompression does not involve surgery. If so that would be my option. Like you, I only had one side affected with muscle loss in my shoulder, arm and hand.  I had  ACDF at c5-7 and everything has gone great but I would have loved to have had an alternative.
  • dilaurodilauro ConnecticutPosts: 12,892
    In these situations it would be best to get a third opinion, especially when it  comes to surgery.   When two doctors differ on the approach, you want a third doctor to voice in their input.  You want to have 2 doctors in agreement as to what should be done
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
  • dilaurodilauro ConnecticutPosts: 12,892
    Decompression is a way in surgery to eliminate the pressure or narrowing of your nerve roots. A laminectomy is another term for a decompression surgery There is also decompression therapy. So which one has been recommended for you?
    Spinal Decompression therapy
    Spinal Decompression Surgery
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
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  • @dilauro - I've been through Cortisone shots, Chiropractic, PT, Massage Therapy, Fascial Stretch Therapy, Neck traction and acupuncture. Nothing lasts more than a day or so. 

    Essentially, I've been through all the 'therapies' and the only thing not tried is a nerve block. 

    A laminectomy was recommended. 

    I did seek out a 3rd doctor and he recommended fusion as well (after we had to drive into the city, wait in his waiting room for an hour, then another 30 minutes for him to come in and evaluate, I had to start pacing back and forth because everything just became "uncomfortable").

    However, after over 6 months of this, I'm out of options.  CrossFit, standing for long periods of time, sitting for long periods of time (removing photography and photo editing and a comfortable work environment), being able to interact at social events for more than an hour and driving my '66 Vette have all been removed at this point as they are not enjoyable.  

    So I'm scheduled for fusion.  Here's hoping.....
  • As I understand it ACDF stands for anterior cervical discectomy and fusion. I don't know why the second doctor would recommend discectomy making it sound like a different procedure.
  • itsautonomicitsautonomic LouisianaPosts: 2,561
    • I'm not really concerned about adjacent disc disease with the fusion
    Is there a reason for this, I would think everyone who needs a fusion has to be a little wary about this or at least have discussed/understand the risks of it with doctor.  Maybe the pro's outweigh the con's for you and that is totally understandable, but it could also be I am just ready to get back to life and don't care what is down the road.  The latter approach sometimes can be dangerous because with every surgery the risk you are worse off exists.

    I agree with above,  sometimes that third opinion can mean so much and lead you down a good direction and its always good to consider the reputation and skill set of the doctors giving opinions.  You have to weight a better doctors opinion a bit higher in my opinion.  Only hard thing is when the third doctor has something different than other two, then it gets interesting. 
    Do your due dilegence, trust you know your body and question everything if it does not fit. Advocate for yourself and you will be suprised what will be revealed trusting your body and instinct.
  •  I agree with Itsautonomic..adjacent segment disease is something to be concerned about. My lumbar spine autofused one level above the L4-S1 after a TLIF. This is important, especially if you have DDD and arthritis. Chances are you will need another spine surgery down the road if warranted. However, if decompression surgery is done, then there's a chance of developing instability (spondylolisthesis, retrolisthesis) that would require..a fusion. Yes, it's a lot to consider but hopefully your doctor will guide you in this decision. 
    Ol' Spiney..Micro-D L4-L5, TLIF L4-S1 -post op central HNP L4-S1,stenosis, retrolisthesis, EF, facet arthropathy, lumbar& cervical DDD. FBSS- Medtronic pain pump & SCS
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