Spinal Disorders & Back Pain For discussion of all spinal cord injuries, spinal issues, back-related pain or problems.


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Old 07-25-2013, 06:18 PM #51
ginnie ginnie is offline
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Default Hi DB

Everyone is different. However I am alot better. I had C3-7 done. I have good mobility but I am careful in what I do. I have DJD so there is risk to other verterbre. No more electric like shocks, no neurological pain and I am three years out. Doing fine. First months were painful in recovery, then it started to really get better. I did PT from week #4. I wish you all the best. ginnie
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Old 07-27-2013, 09:01 PM #52
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Frown ACDF Surgery

Hi Dave,

I'm supposed to have the ACDF surgery for C5/C6 next week, and I'm so afraid of effects of the surgery. Please let me know how you feel two years after the surgery. It will really help me make up my mind about getting the surgery. I want to know if my body normal after recovery and if I can go back to doing my normal activities. Your answer will be very helpful.

Hope you're doing okay. Thank you in advance.

Best,
Daud, U.S.A



Quote:
Originally Posted by 6pack View Post
I am 1 week post op from ACDF surgery where I had C5-6 / C6-7 completed. Initially, my neurosurgeon convinced me to go with Iliac Crest bone graft as this provides best success rate for fusion. I was so glad when I awoke from my 5.5 hour operation to find my hip bone fully intact! Until they open you up they have no way of knowing if a bone graft will be necessary.

Just back from my 1 week check up with my family Dr. and he's very happy. Incision is almost healed. I did get some sleeping pills from him to help me get a better sleep. I'm feeling very well and the arm pain and finger numbness is gone. Most of my pain is in my upper back which is caused from muscle spasms. My throat is really quite good; just a little hard to swallow liquids. Eating is no problem. I've read so many negative posts I wanted to ensure everyone knows there are successes!! Most people who have a positive outcome don't bother posting! If anyone has any questions, I'd be happy to answer as best as I can.

Dave
Calgary, Alberta
Canada
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Old 07-28-2013, 07:09 AM #53
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Default Hi Jdaud

You will do just fine. Make sure you asked the doctor the condition of the verterbre above and below C5-6.
When I had C6-7 done, I didn't have alot of pain or trouble. Just take it easy. Sleeping on one of those elevated back rests helped me alot. I hope you have a real quick recovery. ginnie
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Old 07-29-2013, 11:40 AM #54
6pack 6pack is offline
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Hi Daud,

The surgery definitely resolved my arm pain, however I still experience significant neck pain. My range of motion is excellent and overall I'm doing well. I was off work 3 months, during which time I wore my collar 7x24 with the exception of showering. If you have any questions, please feel free to drop me a note.

Good luck!!
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Old 09-14-2013, 03:36 PM #55
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Default multi level acdf

Hello everyone! Can anyone point me to any literature/studies showing that people who have had surgeries/fusions get NO better results than people who have had physical therapy? My wife is contemplating recommendations for 3 level acdf c4-7 with a bulging discs at c3. We are concerned this could be the first of potentially many surgery if we agree to have this first one.
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Old 09-14-2013, 04:45 PM #56
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Default Hi Kean

If your wife, and the cervical issues say SEVERE on the MRI. That is when it is good to seek another opinion. You have every right to question what might happen down the road. The vertebra above and below the surgical site need to be strong enough to handle the hardware. I had C6-7 done, and five years later was fused C3-7. Domino effect can occur. I wish your wife all the best. Good to try all the PT you can. ginnie
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Old 09-15-2013, 12:24 PM #57
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Quote:
Originally Posted by kean View Post
Can anyone point me to any literature/studies showing that people who have had surgeries/fusions get NO better results than people who have had physical therapy? My wife is contemplating recommendations for 3 level acdf c4-7 with a bulging discs at c3. We are concerned this could be the first of potentially many surgery if we agree to have this first one.
Hi Kean, Welcome.

IMO your concerns are valid & well-founded/justified.

While not directly related, in looking/searching for answers to your query I came across the best answer I've ever read to one of the most common questions we get on this forum—"Should I get surgery?"—in the form of a study abstract. It is, IMO, SO good that I'm going to quote it here and save it for future reference.
Quote:
Cervical spondylotic myelopathy and radiculopathy are common disorders which can lead to significant clinical morbidity. Conservative management, such as physical therapy, cervical immobilisation, or anti-inflammatory medications, is the preferred and often only required intervention. Surgical intervention is reserved for those patients who have intractable pain or progressive neurological symptoms. The goals of surgical treatment are decompression of the spinal cord and nerve roots and deformity prevention by maintaining or supplementing spinal stability and alleviating pain. Numerous surgical techniques exist to alleviate symptoms, which are achieved through anterior, posterior, or circumferential approaches. Under most circumstances, one approach will produce optimal results. It is important that the surgical plan is tailored to address each individual's unique clinical circumstance.
http://www.hindawi.com/journals/aop/2012/919153/
Now back to the original question, I found this article: Physical Therapy or Neck Surgery?

This is the study referenced in the above article: Surgery Versus Nonsurgical Treatment of Cervical Radiculopathy: A Prospective, Randomized Study Comparing Surgery Plus Physiotherapy With Physiotherapy Alone With a 2-Year Follow-up.

http://www.ncbi.nlm.nih.gov/pubmed/23778373
Quote:
CONCLUSION.: In this prospective, randomized study of patients with cervical radiculopathy, it was shown that surgery with physiotherapy resulted in a more rapid improvement during the first postoperative year, with significantly greater improvement in neck pain and the patient's global assessment than physiotherapy alone, but the differences between the groups decreased after 2 years. Structured physiotherapy should be tried before surgery is chosen. Level of Evidence: 2.
Others may be cited in posts here—try Searching the archives—on PubMed, the various medical journals (JAMA, BMJ, The Lancet, etc.) and elsewhere. On Goggle, it sometimes helps to preface search criteria with the words "scholarly" or "study".

Hope this helps,

Doc
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Old 09-15-2013, 12:29 PM #58
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Quote:
Originally Posted by ginnie View Post
The vertebra above and below the surgical site need to be strong enough to handle the hardware. I had C6-7 done, and five years later was fused C3-7. Domino effect can occur.
Hi Ginnie,

In researching my above response to Kean, I came across the precise(?) medical term for this effect/phenomenon—adjacent segment degeneration (ASD).

Now I know what to call it, and how to find/reference it.

Doc
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Old 10-19-2013, 12:56 AM #59
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Hi i'm from Indonesia. Glad to know this forum and read a lot of information about cervical surgery.
I am only 38 female and is being scheduled for cervical myelopathy surgery by next week. My ortopaedic surgeon suggest an acdf on c5-c6.
After reading all posts i am a bit frightened that the surgery might bring my condition worse than before. The most scary thing that i might have to re-do the fusion on the up and down level of the previous surgery.
I have numbness in my both hand palms, severe pain in my neck when i am standing too long and i have difficulty in walking also..
Until now i still dont have firm decision for surgery.
.
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Old 10-19-2013, 10:57 AM #60
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Quote:
Originally Posted by choco2013 View Post
After reading all posts i am a bit frightened that the surgery might bring my condition worse than before. The most scary thing that i might have to re-do the fusion on the up and down level of the previous surgery.
Hi Choco, welcome.

Reading posts about the bad outcomes may give an unbalanced impression because successful outcomes don't usually need or participate in support groups like this one; they are out getting on with their lives.

That said, some studies, and reviews of multiple studies, have concluded:
Quote:
CONCLUSION:

Compared with a structured physiotherapy program alone, ACDF followed by physiotherapy did not result in additional improvements in neck active range of motion, neck muscle endurance, or hand-related function in patients with radiculopathy. We suggest that a structured physiotherapy program should precede a decision for ACDF intervention in patients with radiculopathy, to reduce the need for surgery.

Physical function outcome in cervical radiculopathy patients after physiotherapy alone compared with anterior surgery followed by physiotherapy: a prospective randomized study with a 2-year follow-up.
(emphasis mine)

My own surgeon told me that the hospital (a major medical center) he is affiliated with does fewer of these procedures nowadays because as many patients are the same or worse afterward than are better. They prefer/recommend physical therapy and pain management instead. However, every case is different, and decisions/recommendations are made on a case-by-case basis.

Have you been through physical therapy, and if so, what were the results?

Have you gotten multiple opinions on whether surgery is necessary?

I just came across this article that may provide some additional information to discuss with your doctor before agreeing to surgery.

Is Anterior Cervical Discectomy with Fusion (ACDF) Safe and Effective?

Some members here have expressed that spinal surgery is better/best performed by a neurosurgeon rather than an orthopedic surgeon, or at least to have a neurosurgeon on the surgical team. In my opinion, a neurosugeon or neurologist should at least be consulted before agreeing to surgery.

Other members here may have additional or different advice and opinions.

Best wishes,

Doc
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