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4 level ACDF or 2 level ACDF? After 1 year of conservative management.

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Old 01-23-2017, 09:04 AM   #1
kimheng
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Smile 4 level ACDF or 2 level ACDF? After 1 year of conservative management.

Dear Admins, Moderators and Members,
Please advice whether I need 4 level ACDF or 2 level ACDF?
Below are my MRI reports taken on 02-OCT-2015 and 08-DEC-2016.

HISTORY
C Sondylosis
MRI, Cervical Spine of 02-OCT-2015:
Sagittal Me2D, T1w and T2w and axial Me2D images of the cervical spine from C2-3 to C7-T1 were obtained. Radiographs performed previously.
The cervical spinal alignment is preserved. The cervical vertebrae return a normal signal. The cervical cord show normal signal.
No significant spinal canal stenosis at C2-3.
At C3-4, there is a mild osteochondral bar which is effacing the anterior CSF space without significant canal stenosis.
At C4-5, there is a large central osteochondral bar which is indenting the cord centrally. There is bilateral exit foraminal stenosis due to uncovertebral hypertrophy.
At C5-6, there is a moderate-sized osteochondral bar which is contacting cord and causing mild canal narrowing. There is also bilateral exit foraminal stenosis. Cord returns normal signal.
At C6-7, there is a small osteochondral bar which is effacing the anterior CSF space without significant canal stenosis. There is bilateral exit foraminal stenosis due to uncovertebral hypertrophy.
The C7-T1 disc space is unremarkable.
There is no prevertebral soft tissue swelling and craniocervical junction appears unremarkable.
IMPRESSION
Severe canal stenosis with central cord indentation at C4-5. No evidence of cord edema or gliosis.

MRI, Cervical Spine of 08-DEC-2016:
HISTORY: Known cervical spondylosis on conservative management. Now with worsening neck pain.
TECHNIQUE:
Sagittal T1W, T2W and GRE; and axial T2w and GRE sequences of the cervical spine were obtained. Comparison was made with the prior MRI study date 02 Oct 2015.
FINDINGS:
There is normal alignment of the cervical spine. The craniocervical junction and cervical cord are normal in appearance. Several osteophytes are note.
At the level of C2-3, no significant stenosis is noted.
At the level of C3-4, there is a left paracentral dice bulge narrowing the spinal canal. The disc abuts the cord, but the adjacent cord signal is normal. There is mild narrowing of the left neural foramen.
At the level of C4-5, there is a central disc protrusion with thickening of posterior longitudinal ligament. This disc-ligamentous complex impinges the cervical cord (Se4/13). The cord is not atrophied and no abnormal cord signal is seen. The neural foramina are narrowed by the bilateral uncovertebral hypertrophy.
At the level of C5-6, there is a broad-based left paracentral disc protrusion. Together with osteophytes the disc osteophyte complex results in severe asymmetric left sided spinal canal narrowing. This appears more severe than in the last study. The cord is deformed with no visible surrounding CSF space. However, no abnormal cord signal is noted. Both neural foramina are preserved.
At the level of C6-7, there is a broadbased central disc bulge. The disc-osteophyte complex causes mild narrowing of the spinal canal. The cord is spared. The neural foramina are preserved.
IMPRESSION:
Spinal canal stenosis at C4-5 and C5-6 levels, appearing to have progressed.
No evidence of cord edema or myelomalacia.

Thanks and Best Regards,
kimheng
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Old 01-24-2017, 01:16 PM   #2
kimheng
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Smile

Dear all,
I had decided to go for 4 level ACDf, my main concern is about the range of motion.
Anyone had 4 level of ACDF from C3 to C7 and have good results?
Thanks,
kimheng
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Old 01-25-2017, 02:05 PM   #3
kimheng
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Thumbs up

Dear all,
I need some support for my decision of operation, cos the 4 level ACDF is I request the surgeon to operate for me, cos I don't want come back in 1 or 2 years time.
Thanks,
kimheng
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Old 01-27-2017, 11:31 PM   #4
KatherineLB
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My Mood: 4 level ACDF or 2 level ACDF? After 1 year of conservative management.
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Quote:
Originally Posted by kimheng View Post
Dear all,
I need some support for my decision of operation, cos the 4 level ACDF is I request the surgeon to operate for me, cos I don't want come back in 1 or 2 years time.
Thanks,
kimheng
Hi KimHeng

Although I can't provide you with any information regarding your results or questions, I wanted to let you know that I really feel for you!

I'm only just discovering what's happening with my back - and have no idea what it means, let alone what treatments are available.

Deciding on surgery must be very daunting!

I wish you all the best and a fantastic outcome.

I hope someone with some experience is able to respond to you

X

Last edited by KatherineLB; 01-27-2017 at 11:31 PM. Reason: typo
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Old 01-27-2017, 11:54 PM   #5
Jo*mar
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My Mood: 4 level ACDF or 2 level ACDF? After 1 year of conservative management.
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Old 01-28-2017, 08:34 AM   #6
SynchroChick
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Quote:
Originally Posted by kimheng View Post
Dear all,
I had decided to go for 4 level ACDf, my main concern is about the range of motion.
Anyone had 4 level of ACDF from C3 to C7 and have good results?
Thanks,
kimheng
I had 3/level....C4-7....March 10, 2016. Range of motion comes back enough if you work it. Physical therapy was a must for me.
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Old 04-02-2017, 02:42 AM   #7
kimheng
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Smile Post ACDF 4 level Surgery

Dear All,
I had my surgery done on 13th-Feb-2017, the surgery was successful and now I am recuperate at home. Now which is 48 days after surgery, I did had a review with my surgeon. He told me that I still not suitable for physiotherapy but only this few days, then I feel that I have stiffness aching pain around the neck. My appointment with the surgeon is two month later.
May I ask whether I can do some neck exercises???
As the fusion of my neck is not fully healed yet.
Thank You & Best Regards to All,
Kim Heng
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Old 07-13-2017, 11:27 PM   #8
Marla978
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Default Anterior c3-c7 w/ graft 8 screws & plate also c2-t1 posterior w/graft 10 screws 2 rod

I had surgeries on May 19 & May 22nd, 2017.. i am tryi g to find out what my recovery should be like. i know i have to wear this hard brace, but when i do my arms hurt and my shoulders tighten up.. when i take it off, seems to chill alittle. I know it was a huge surgery but i am now getting impatient, bored and still sore. Anyone out there go through this and have a time line? The doctor just trying to get me a bone graft stimulator. Thoughts? I am 8 weeks out today, in good physical shape to look at me but hurt between my shoulders, traps and arms.
Thanks for any feed back!
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Old 07-14-2017, 09:18 PM   #9
kimheng
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Quote:
Originally Posted by Marla978 View Post
I had surgeries on May 19 & May 22nd, 2017.. i am tryi g to find out what my recovery should be like. i know i have to wear this hard brace, but when i do my arms hurt and my shoulders tighten up.. when i take it off, seems to chill alittle. I know it was a huge surgery but i am now getting impatient, bored and still sore. Anyone out there go through this and have a time line? The doctor just trying to get me a bone graft stimulator. Thoughts? I am 8 weeks out today, in good physical shape to look at me but hurt between my shoulders, traps and arms.
Thanks for any feed back!
Hi Marla,
For your info, I had ask my surgeon about how long it take for total recovery. His reply is one year. For me now is about 5 months the pain and stiffness still there, My surgeon advice that not to do physiotherapy yet, hopefully I can start physiotherapy next month. My next appointment with him is next month. For your case, you should be patient and let the fusion of the bone take place. Hope we can recovery in one year time. All the best for your recovery.

Last edited by kimheng; 07-15-2017 at 07:14 AM.
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Old 07-19-2017, 06:42 AM   #10
Marla978
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Default Thank you!

I received a bone growth stimulator on Monday so hopefully this bone growth process will go a little faster. I just want to get out of this hard brace and drive a car again. At least there are people out there that have gone through this before ! There is really not a lot of information on recovery.
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