2-3 Level Fusion (ACDF) - advice please
 

I'm scheduled for surgery in 4 weeks to have a 2-3 level fusion in my cervical spine. My neurosurgeon will decide whether it will be 2 or 3 after my updated MRI which is tomorrow. But for now we know he will be fusing C5/C6 & C6/C7.

Is there anyone that has had this surgery that can offer advice on pain management, recovery, sleeping after surgery, anything that you wish you knew before your surgery? It's always helpful to hear from someone who has already "been there & done that". Would appreciate hearing how long it took for recovery and did you feel relief from the pinched nerves right away? (I have pinched nerves in my hands and neck which is excrutiating).

Is there anything you wish you knew before surgery that you know now?

Thank you!

Hi ~ You have pinched nerves in your HANDS??? Or are the nerves in your neck affecting your hands?

I can tell you that I'm not a fan of surgery, only because most of the time your pain will NOT be relieved. The surgery only fixes mechanical problems - your pain will most likely still be there, and sometimes it's worse than before. There have been articles from the Amer. Society of Surgeons that stated that MOST of the surgery performed on spines in the U.S. had the SAME results as did physical therapy!! So in other words, the surgeries were useless. That went for the fusions too, as stated in the article. I've had 2 open spinal surgeries, and I'm worse now than I was before the surgeries - I have more pain than I had before.

Also, after spinal surgeries, you will undoubtedly have the "domino" effect, meaning that the levels either above/below the surgical site will fail - thus requiring further surgery. It's a never ending cycle unless you just opt for physical therapy. The only reason I would ever opt for further surgery is if my SPINAL CORD was being impinged.

I'm sorry you have to have surgery. You will need to talk to your doctor about post-op medications because they ALWAYS undermedicate the patient. Be firm about wanting adequate pain medication. The recovery is "longish." If you mean how long does it take to be fully fused -- that takes about a year - sometimes longer. As far as how you feel - it's different for everyone and it's hard to say. You will need some help for probably the first week. Sleeping - you will have to wear a collar for awhile - most docs have you wear a soft collar at night. They aren't too bad. It may take awhile before you feel relief because the nerves are very irritated - nerves heal at the rate of 1" per month. So it depends on your own case.

I hope I've answered a few questions. God bless and take care. hugs, Lee

Same situation
 

cath1 I had exactly the same situation. My surgeon ended up only doing C5/C6 & C6/C7. I am concerned that he opted not to do C4/5. I go for my 6 week check on Wed.
My best advice for pain management is to take everything that is recommended on a strict schedule in the beginning (both the pain and muscle relaxer). I found out the hard way it takes at least 1 1/2 hours for pain meds to help with the pain if you wait and see how you are doing. Really listen to the limitations that your surgeon gives you. I am still sleeping in the recliner, but everyone is different. I think there is a thread what I wish i had known before surgery or items to have. Anyway, items to have in the house: soft foods mashed potatoes, applesauce, instant oatmeal, lots of soup, ice cream, sherbert, yogurt, thin pasta and any other drinks you like. A must is a stool softener. In the hospital I refused the iron since that also clogs up your system. Have plenty of pillows, sweats and sweatshirts so you do not have to worry about wash.
I felt an immediate relief from the symptoms of the pinched nerves: numbness, tingling and pain. The pain from swallowing was severe for me because I had a reaction to the bone protein.
What I was told no BLT (bending, lifting or turning)
Good luck and keep us posted.

Cath 1 I had my C4to 6 fused in 05 and did just great. I was given the choice of surgery or a wheelchair, someone feeding me, and wearing diapers. In other words I would have been paralized and it was so urgent I had it a week after seeing my NS. Never regreted of course and am so thankful to have been saved from the chair. I ride a Hoveround now due to deteration of my spine and my neck is again ruptured at C6 to C7.
It was not that painful and my best advice is to tell you to have a good recliner to sleep in for a while. I slept on ours and it was so much better than the bed due to having a hard collar on for some weeks.
I hope everything turns out well for you and healing is quick' Hugs

PS my spelling is awful. LOL

Hello Cath1, I had a 3 level ADCF C4-C7 in Feb/09. You may want someone with you for the frist week or two, soft foods and liquids as your throat will be sore, I still experience swallowing issue due to a cyst that formed from a hematoma on my incision. Lots of pillows to keep you elevated in bed, I could not do the recliner, I wore a hard collar for 3 months, used liquid morphine for the frist month and still have to use oxycodone today as I got the gift of the domino effect, C3-4 has herniated and I still have ostoephytes at C4-5 and C5-6 levels, cervical radiculopathy, cervical stenosis and recently dx with TOS(thoracic outlet syndrome) I am in constant severe chronic pain and headaches 4-5 times a week, and have had to apply for CPP disability as I am unable to return to work, both my neurosurgeon and family doctors have wrote me off work and my LTD will be done in May. Cath1 everyone is different when it comes to surgery and healing and some have wonderful success and some not so much, but if your pain is intolerable and your symptoms are relentless then do what you need to do and stay positive, I only wanted to get better and be pain free even quit smoking after 25 yrs per my surgeon as he stated smoking will stop the new bone growth and fusion, sry for long post and Good Luck with surgery! Bunz
B

Hi Cath1, posted already but wanted to say I am from Ontario, had my surgery in Windsor, where in Canada are you, if you don't mind me asking. Bunz

In Windsor Also
 

I'm in Windsor also, having my surgery at Hotel Dieu Grace Hospital, my neurosurgeon is Dr. Jhawar. I like him, and I've been given an 80% chance of complete success (meaning it will cure all my neck, hand and arm pain and I will gain all my strength back in my hands). I'm trying my best to not be put on disability, I've been off work on WSIB since May 31st.

The nerves are pinched in my neck, which are running down my hands. My father is on disability for degenerative disc disease, and I too have been diagnosed with an advance form of it for my age (I'm only 40). I realize everyone has degeneration with age. I was told the same thing about smoking but I've never smoked a day in my life. He also told me that smokers usually have spine problems more severe than non-smokers.

I'm sorry to hear that you are still having problems. Being limited in ability is horrible, these last 8 months off work feel like I'm on house arrest since I can't even drive anymore the pain is so severe.

Who was your surgeon if you don't mind me asking? I have a few friends and family members who have also had this surgery in Windsor, so far everyone has had successful outcomes and I'm hoping for the same!

Take care,
Cathie

The pinched nerves are in my neck and radiating to my hands. I've already been tested for carpal tunnel and ulnar nerve, and went through 6 months of physio, accupuncture, massage, traction, etc.... and then the MRI and CT scans showed the DDG and osteophytes in my neck causing the problem. I was told by my surgeon I will be required to wear a hard collar (at all times) for at least 6 weeks. So the recliner or couch will be wear I will sleep I guess. I am worried about the pain relief, I've been weaning myself down off the high doses of Oxy for 6 weeks now to get my tolerance down and avoid rebound pain after surgery. I will bring in my own meds if need be to get relief! LOL

Thanks for all the advice, I'm having the surgery no matter what, I have lost all quality of life right now, can't even drive, so I would rather take the risk for domino effect than stay like this forever.

Appreciate all the information.. .told my hubby to start learning how to make home made soup! :o)

Hi Cathie, I am actually in Chatham but had my surgery at Hotel Dieu Grace. My neurosurgeon is Dr. Shamisa, he is a wonderful man and I liked him right from the start. I do not blame him for any residual symtoms or new dx, he sent me to different docs and tests to finally discovered I have TOS. If I recall correctly Dr. Shamisa gave me the same chances of success and had also advised that if the radicular pain was still there after 2yrs then quite possible would have permanent nerve damage. I have been dealing with my cervical issues since 2006, and it was a long process. You know the steps, xray then ct scan and finally the MRI, then it took 2yrs to see Dr. Shamisa and have surgery. I wish you complete success with your surgery and a healthy recovery! Let me know how you make out with your MRI results and if your family or friends have had Shamisa for their surgeon. Thank-you Bunz

One of my very close friends also had Dr. Shamisa for the same surgery. She had it 7 years ago, and is now completely recovered. So it definately depends on the person and their problem. Dr. Jhawar (my dr) is in the same office as Dr. Shamisa. I've heard good things about both. You are correct, it has been a very long process, I'm off on WSIB, and it started with physio, then xrays, then ultrasound, then CT and MRI, then a second MRI last night. (It was very hard laying still last night for the 20 minute scan due to pain and twitching, but hopefully they got good images!)

I hope and pray not to end up on disability, it is so frustrating not to be doing and enjoying all the things I was only 1 1/2 years ago. This last month I'm not even driving anymore, which is hard since I live in Belle River and everything is 20 minutes or more driving to Windsor.

How long were you in the hospital after your surgery? Did you get a morphine drip or did you ask for one? How long before you were able to shower after surgery. Silly questions, but I'm getting nervous and my mind is racing thinking of all the things I don't know.

This forum has been very helpful for information, you're the first person on here that is only 1/2 hour away from my house though! LOL... small world.

Thanks for answering all my questions! very appreciated.
Cathie

good luck and relax
 

I understand the concerns. I had the same when I had my surgery 12/9/2010 2 level ACDF. The surgery usually lasts about 2-3 hours. People are in the hospital anywhere from 1-5 days depending on your recovery, insurance and doctors. I was in for 5 days due to excessive swelling (uncommon). I had a pump with didulad the first 12 hours (don't remember). Then I had morphine shots because I could not swallow. The only IV I had was antibiotics and fluids (48 hours). Then I had the nurses crush the meds and place in applesauce, pudding or italian ice. I had oxyicodone then down to hydrocodone along with flexril (muscle relaxer). I came home with scripts for hydrocodone along with flexril (muscle relaxer) and Ambien to help me sleep. I had a sponge bath while in the hospital. Once I came home I was allowed to shower. It felt SO good. Just ask for some special plastic non stick covering for the steri strips that cover the incision. Swallowing and swelling was my biggest issue not pain from the surgery. The incision area did not hurt at all. I also had a drain above the incision that I did not expect. That came out on day 3. Let me know if you have any other questions. The waiting is the worst. Once it is over you will be relieved. I no longer had the tingling, numbness and pain. I felt that way as soon as I was coherent in the hospital. Good luck and keep us posted.

Cath ~ I just wanted to warn you that this surgery probably will NOT ease the pain - and if you have nerve damage, you may still have the numbness. Usually after surgery we're left with the same pain and sometimes worse. So just wanted to remind you of that.

God bless you and best of luck. Let us know how it comes out. Hugs, Lee ;)

Thank you! That did answer a lot of my questions. Yes, the waiting is the worst! Take care.

Hi Cathie, Yes it is a small world! I agree with frenchfri1003 post. My surgery took almost 5 hours. When my Dr drilled the holes for the screws they did not fit properly so he used bone cement to fill in the holes and redrilled. I was in the hospital for 1 nite, originally told 2, but the head nurse saw me straighten my bed sheet after using the washroom (she was a B****), and said if she can make her bed she can go home, I told them I was not ready, ( my husband was livid) but was discharged without seeing Shamisa. I was readmitted 2 days later with swallowing issues due to a large(golfball size)hematoma on my incision . I was given morphine injections, no drip, and discharged 3 days later. I would have to go back later that month as a stitch broke, and had to have the hematoma drained. It was day 2 that I showered, my husband put a lawn chair in the tub (my head felt heavy and I felt weak) and he washed my hair, sitting while showering was actually the easiest way for me. My girl friend came over 3 times a week to braid my hair. Cathie, the hard collar has blue velcrose pads, make sure you get 2 sets so you always have a dry set after showering, my husband always did my collar and I just stood very still. Sorry you had pain issues during your MRI, I am claustrophobic(?)and I do not like the MRI machine, I take a little pill and then it is still all I can do not to squeeze the red ball and scream lol. Happy Thoughts, Positive Attitude, and no Stress, makes for good surgery, as frenchfri1003 stated Relax! Well my hands are numb arms are throbbing and too long of a post. Talk soon, Bunz

Thank you for answering my oodles of questions. I have been taking notes, wrote down the part about the spare set of velcro, awesome idea! I will learn from your little bedsheet mistake and definately not look to strong so the mean nurse doesn't send me home too early! lol.... poor nurses in Windsor are so overworked, I do feel bad for most of them. Most are nice (some are just mean and should not be nurses, should be border guards or something.. lol) I'm working on the happy and positive thoughts, I think the January blahs have hit and my mood is difficult from being cooped up in the house (I'm not able to drive right now). But you're both right, positive attitude = postive outcome. I will try to make today a happy day.

The neuro called, and my surgery is now scheduled for March 2. I go in for one final appt. with Dr. Jhawar on Feb. 2 to get fitted for my collar, etc. In the meantime, I have piles of WSIB forms to fill out since my case got transferred to a new long term case manager.

take care, have a great day. Cathie

Hi Cathie, congrats on your surgery date, things you will need, yogurt, ice cream, popsicles, jello, cream soups, oatmeal, smoothies, ensure etc. Frequently used things close by I had a couple of baskets in my room, lozenges, kleenex, bandages and dressings, lotions, deodorant, toothbrush/paste, powders, wetones, lipbalms, mouthwash, these are usally the small versions, bendy straws, stool or chair beside bed to help you out, lots of ice for fluids feels good on the throat, garbage can, bell, bedtray, cold pacs, slippers, pj's and robe, or comfy clothes, books mags, crosswords etc. Organize things at home to be within easy reach to avoid bending and reaching, walk a lot after surgery, have someone with you for the frist week as you will need them, for the hospital take pj's, robe, brush/comb, toothbrush/paste, lipbalm, and comfy clothes to wear home. Hurting again, maybe more later Bunz

Awesome! I read the list outloud to my husband... he's on nurse duty for 2 weeks post-op!!

Good Luck
 

THe bendy straws and stool softeners are a must along with all of the soft foods. There are 2 types of hard collars. I had a Philadelphia which is just pink hard foam. I used that for showering and wore a soft collar. My OSS did not believe in the Miami J hard collar. Maybe you can get fitted for all 3 types of collars. When they discharge you, make sure you have plenty of scripts for pain meds, muscle relaxers and even a sleep aid. Good luck with the surgery. The waiting is the worse part both before surgery and waiting to feel better and have bone growth.

ACDF Surgery level 2
 

Hi, Just wanted to chime in, Im here in NYC, just had level2 ACDF on the 28th of Jan.
It was supposed to be level one, surgeon and neurosurgeon changed mind in the OR. I had severe right arm/hand pain, burning for a long time. Was losing use of the hand and arm most recently. I will say this; the surgery has completely cured that. My hand and arm are perfect!
Be prepared for pain though! Today is one week, and the pain is still there in the neck area. But most bothersome is my throat. It was fine in the hospital, so was my voice. This got worse three days ago. I can barely swallow water and I feel like food is coming up and stuck there.
Still on pain meds, I will be going to see the Doc today because I cannot sleep nor eat at all with this throat. At least the main objective was successful ;)

Hi there, thank you so much for writing. It sounds like your symptoms and surgery resemble my own. My hand and arm and traps are a big part of my pain, the pinched nerves are relentless. I have been told a lot to expect the sore throat, it sounds like you really are having a hard time with that if even water is difficult to swallow. It's nice to here that your hand and arm are better though. I don't even remember what its like to be out of pain anymore.

Are you able to even use lozenges for relief? Perhaps you have a throat infection or something since you got worse post op? Please let me know how your doctor's appt. goes and what he says or prescribes for you.

I hope you are feeling better soon... I have 3 more weeks to go, but I have been asked to be put on a waiting list so if I can get in sooner I will jump at the chance, just want to start healing soon.

Take care! and get well soon! :)
Cathie

Pending cervical ACDF at 4/5, 5/6 and 6/7
 

Hi, I have just read your post about statistics from Amer. Society of Surgeons regarding advisability of surgery versus physical therapy. I have tried physical therapy three times and got no improvement. I am scheduled for ACDF at C4/5, 5/6 and 6/7 in two weeks, and I am terrified. My NS told me that there is a 90% chance of improvement....with the actual improvement in pain being 50%. IF that is true, I would think that the surgery would be worthwhile. I presently have no real quality of life. BUT I am terriefied after reading many posts from people who say they did not have good outcomes. How can I access the information you are quoting? Thanks

Hi ABBB, Welcome.

:Hum: If there's only a 50% chance of actual improvement in pain, what's the 90% chance of improvement in - the surgeon's standard of living? :rolleyes:

Most people who even consider spinal surgery do it in hopes of alleviating pain, paralysis, or something life-threatening; what other reason is there to chance going under the knife? And 50/50 is, IMO, pretty much a crapshoot. My surgeon advised against surgery for that very reason with similar odds.

http://en.wikipedia.org/wiki/Failed_back_syndrome

There are many options in pain management between PT and surgery, and many that don't necessarily involve daily narcotic medications (though those aren't necessarily the evil they're made out to be either - they provide a quality of life for many that's otherwise impossible).

You read about more bad outcomes than good outcomes because it's the people with bad outcomes who have reason to find support groups and write about them. People with good outcomes are continuing with their lives, and have (no offense to anyone here, but it's natural and true) better things to do.

Were your 3 courses of PT with the same therapist? IME their knowledge, skill, and experience can vary as much as any doctor's, and finding the right therapist can make as much difference as finding the right doctor.

I DO hope you've gotten at least 2 opinions, and asked about alternatives like ED, MED, pain management, and any others. Doctors base their recommendations on what THEY are knowledagable and experienced in doing - not what another surgeon may be able to do more easily/safely. (It's not like Miracle on 34th Street with Macy sending customers to Gimbels.)

Google: questions to ask neck surgery

Doc

my original post, now 11 months post op
 

Hi, welcome, and so sorry you have to be on this forum (nobody comes here for good reasons)

This was my original thread, and I am now 11 months post op from my fusion. My neck has healed quite nicely, I have 90% range of motion, with levels C5, C6, C7 fused with titanium plate and screws. I still do have pain, unfortunately, but it is by no means as severe and life debilitating as it was before the surgery. Given the circumstances and outcome I still would have the surgery again. But it was definately not a fun year!!

I still have a lot of issues with my hand, and am very seriously considering a second surgery on my ulnar nerve to release the pressure on the nerve in my hand. In fact I'm set to sign the paperwork and book the date for surgery on March 8th to proceed with it.

I am still on pain meds, not nearly as much as pre-op, but I am on a low dose pain patch and percocets to help with the residual break thru pain. I continue with physiotherapy 3 times a week, and will probably continue to go for a long, long time.

I can't tell you whether you should or shouldn't have the surgery, but the odds you gave are the same as what I have been given for the second surgery on my ulnar nerve. As a graphic designer who can't use her hand anymore I would take those odds as a chance to release the pinched nerve rather than have it continue to get worse throughout my life. The longer the nerves are pinched the more likely the nerve damage is permanent.

Do your homework on all the information about your surgery, learn as much as you can about your surgeon. Making an informed decision is half the battle.

I wish you luck in your decision. I do not regret having my surgery, I'm now able to drive again and do a little bit more activities that I used to be able to, and I get a bit stronger each week. And I'm thrilled to be able to move my neck and not be laying in bed all day.

BTW.... Dr. Smith is correct, those who have great outcomes do not post on forums because they have moved past their surgeries and gotten on with their lives. It's only those who are still having problems that seek out more information. :rolleyes:

Take care,
Cathie

hi lee
dear cat
i couldn't have said it any better
myself
cat exhaust ALL
confirm ALL results
as many opinions as possible
as for yourself lee
God be with you
i live your pain
AND SOME SO ON THE MONEY
WISHING YOU BOTH RELIEF
YET TO FIND OUT IF I FUSED AFTER SURGERY #2
POWERFUL MEDS SOMETHING I HATE POWERFUL
WORD I KNOW I SHOULD BE OFF THEM AFTER SURGERY
NO SUCH LUCK AFTER 2ND SURGERY NEW ADDITIONAL
PROBLEMS AND OLD ONES ARE BACK
NOW PLATE CAGE SCREWS ? FUSION AS PER LAST
CT STILL HAVEN'T FUSED THAT WAS OCTOBER
THEN THE CANCER THING
anyhow take good care

**************
Hi, I had C-3 to T-1. I had slept on ice for about 11 years. (ok !! years. Pain meds mess up my bowels.) I went to a specialist who recommend a Doctor at a teaching hospital. I also have Fibromyalgia so he was well versed on that as well.

The surgery (done anterior and posterior) went well and I knew I had surgical pain when I woke up but I knew the neck pain was gone. No more ice for me.

I go to a pain specialist and she is a anesthesiologist and I get infusions that take care of the pain. I don't take many pain pills. She does "denervations. I would be in a wheel chair if she didn't work her magic on me.

Just go to sleep in a good mood and dream it's going to work. Have faith.

M

question
 

For those of you that had ACDf, did anyone experience your vocal cords not working after the surgery?

The more I read, the scared-er I get.. LOL..

thanks.

It's scary no matter what, I think that's natural to be scared! :o

I did have a sore throat and hoarseness for about 2 weeks, but my voice was totally fine. I had some swallowing issues for quite a long time, like a lump in my throat, but it went away. Once in a while I still struggle to swallow large vitamin pills, but that's about it.

Although my teenagers would have loved me to loose my voice, they didn't luck out! :winky:

Cathie

don't be scared yes it does happen
it changed mine
slightly more when coughing
a very noticeable
and know of a small # of people
good question
take good care

Hi - I just had four level C3-7 completed on 6MAR and here I am. Key thing prior to surgery, gt as healthy as you can - walk - drink water - dont smoke and dont drink, I am not saying never again but get your mind and body ready for what it is going to go through. Practice being positive - you are strong and you will get better! I had more than enough at home when I got here, plenty of gatorade, water (most important), books and a good place to sit (pillows!). It is hared to relax and I am learning the true meaning of being bored!