Neck Pain: Cervical
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Mon, 11/02/2009 - 21:11
8 Days from C-5/6 ACDF, Only Intermittent Flareups, need advice.
Hello All,
I'm eight days from a single level ACDF on my C-5/6. I am getting nervous and having reservations about the surgery. I am wondering if my life will ever be the same; I'm 32 years old and in good physical shape. I have posted here before but I will stress that I had an MRI back in April of '08 and it stated " Bulge" and "Stenosis" at C-5/6 and minor at C-6/7. The NS verbally told me that it looks like I have two herniated discs, one of them minor. The main difference that I see in me from all the postings I see here is that my pain is not 24/7. It shows up out of the blue and lasts about three weeks. During this process the pain level slowly goes from a 10 down to a 1. Anything can set it off again, such as getting up from a chair, doing a pushup, etc. My "flareups" used to show up every few months, the last few have been weeks apart. I'm an air force pilot and can't fly again until I get it resolved. My question is if the surgery is the right call? Do I need to have 24/7 pain for this or should I just trust that there is an underlying condition? I have tried PT and most recently had a nerve block.
It would take too long to battle for an ADR with my insurance and the air force. I guess I have read too many horror stories on this forum about ACDF's. I want to be able to play golf, jog, lift weights, and even ride my motorcycle when I recover. Its a tough decision.
I am running out of time and want to make sure I am doing the right thing for my body.
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Howdy! Fellow pilot here (jets and helicopters). It is great to hear you aren't in pain 24/7. I herniated onto the cord 1st at C5/6 and a year later, C6/7 - again onto the cord. I'm not in the military anymore and I don't know what kind of bird you fly, but I will say this, a hard landing alone can make a minor hernia blow out or progressively worse!
Remember in aviation, we are constantly in a "3-D" environment. For me had my C6/7 went while I was flying, I could have been in major danger of losing control as in the last few years most of my flying was helicopter, and the right arm (after yawning blew C6/7 - instant numb and lost most arm function and strength) is for the cyclic! You have to decide what is best for you, but too consider any affects inclusive to your 24/7 life and all it entails. All the Air Force and Flight Surgeon is going decide on is based on flight and dynamics, *you* have to decide what is best for you overall. Before my C5/6 was fused landed fairly firm due to strong crosswinds - after I taxied in, I couldn't move from the cockpit for 15 minutes because of the pain! Just some "3-D" points to ponder. Hope it all turns out well for you!!
Brenda
To fly is fine, but to hover divine!!
ACDF C6/7 & Partial Corpectomy with Instrumentation Aug. 2009 - Top of fusion separated still not fusing
ACDF C5/6 & Partial Corpectomy with Instrumentation Mar. 2008
Ulnar Subcutaneous Transposition and Guyon’s Release Apr. 2008
C2/3 Disk Bulge / Stenosis / Per NS - DDD (new) Oct. 2009 – No symptoms at this time: Left posterolateral disc osteophyte complex resulting in moderate crowding of the left C3 nerve root exit zone. Chronic moderate left-sided foraminal narrowing related to uncovertebral joint thickening and posterolateral towards foraminal bulging of the disc.
Lyrica
I'm not a pilot but was driving when my discs finally truly gave out. Had I needed to land a plane, it would have been frightening to say the least.
I had intermittent pain for years, saw chiros, got manipulations, etc but none of it did me any good when my discs decided they were done.
As for being able to get right back to your normal life, I can understand it. I was 32 when it happened to me and extremely active. Your recovery is going to depend not so much on the surgery but post op care, physical therapy (which I never had), your stress level and most importantly, the condition of the rest of your spine.
One thing to keep in mind - if you have some problems at more then 1 level, it is possible that after having the 1 level replaced, you could have further deterioration happen more rapidly to the other disc or discs. This did happen with me, with the discs immediately above and below my ADRs.
37 yr old- problems started at 33.
DDD thoughout cervical & lumbar. Foraminal narrowing in numerous areas, some tears and bulging. All of that is post 4 surgeries....
11/2005 - 2 level cervical disc replacement with donor graft for C5-C7.
Pain continued but less severe after surgery.
8/2008 - Severe, sudden neck pain while lifting 10 lb box led to realization that C5-C7 never fused.
Posterior fusion, laminectomy and wiring done again on C5-C7. Fused this time.
11/2008 - Peristent hip, leg and foot pain led to MRI showing foraminal narrowing and some bulging. Had a 2 level lumbar laminectomy.
Felt great for about 6 months, got up to walking 5 miles per day, pain suddenly started increasing till it was the same as pre-surgery
04/2009 - Removal of wiring and re-attachment of displaced muscle to C5-C7 due to constant pain.
Present - Severe, debilitating chronic pain began again in 10/09 from head to toe, all on left side. MRIs show DDD through cervical and lumbar areas plus a handful of bulging discs.
Current meds: Flexeril, Soma, Valium, Lyrica, Celebrex, Vicodin and/or Ultram.
Update 11/02 - Saw an excellent neurologist who has tentatively suggested myofascial pain syndrome treatment and am hopeful once again.
EMG scheduled for 11/10, starting Lidocaine injections 11/11
Had a 2-level ACDF 7 weeks ago. I am 36 and was in good physical shape prior to my disc herniations.
My pain started as intermittenant and over the course of 6-8 months it became a daily nightmare. It got so intense surgery was the only option.
I was very concerned about the fusion surgery. Read lots of horror stories and wondered if my life would ever be back to normal again.
Now that I am 7 weeks post-op, I am extremely happy with my results. I am doing light cycling and ellypitcal and lifting 10 lb weights at home on my arms and chest. Nothing overhead. Missed two weeks of work and couldn't drive for 4 weeks.
It is my hope to resume playing recreational sports again (mainly basketball). I am not sure how realistic that is but the doctor seems to think that its possible 6 months post-op if all looks good.
I would ask your surgeon about the timing of your procedure. No reason to rush the surgery if you can handle the pain and arent doing any permenant damage. I would also ask about the minor herniation at 6/7. Given the odds of disc failure above and below the fused vertebrae it seems odd that they wouldnt correct both at one time.
Best of luck to you.
ACDF on C5-6 & C6-7 on 9/18/09
Right before my surgery I too was not in constant pain but the "flare ups" were more and more and closer together. I had a 3 level ACDF and do not regret it....
Libby
1/13/09 - 3 Level ACDF with Hardware C4-C7
Thanks for the replies! Its true I am beginning to get nervous as I am down to 7 days before the ACDF. I know that I will probably have another fusion done in time to my c-6/7. Its just hard to justify this seeing as how, since my last flare up subsided a month ago, I have been running 5-6 miles a couple times a week, doing pushups, etc. I can still feel that something is amiss when I try to pop my neck or something like that...but its not pain. On the flip side, when I have the flare ups it seems like surgery is an easy decision.
How many of you that call your surgery a success still live with daily pain FROM the surgery?
Despite all of the problems I'm still having 3 yrs later, I wwould call mine a success in that it did get me back on my ffeet and able to function until problems progressed again later.
At the time, I had no choice as the discs were too severely herniated to even bother trying anything else. My lumbar surgery was a different story and if I knew then what I know now, I'd not have done it.
My flare ups had also eased up a bit pre cervical disc replacements. I think in part, it is mental as you know what the source of your pain is (which in itself is a huge relief at times) and know it can be fixed. Also, I'm guessing you're receiving some decent meds that help with the current pain tho it still breaks through. Only you can know if it's really the right choice for you and that really depends on just how bad your pain is.
Wish you all the best with it.
37 yr old- problems started at 33.
DDD thoughout cervical & lumbar. Foraminal narrowing in numerous areas, some tears and bulging. All of that is post 4 surgeries....
11/2005 - 2 level cervical disc replacement with donor graft for C5-C7.
Pain continued but less severe after surgery.
8/2008 - Severe, sudden neck pain while lifting 10 lb box led to realization that C5-C7 never fused.
Posterior fusion, laminectomy and wiring done again on C5-C7. Fused this time.
11/2008 - Peristent hip, leg and foot pain led to MRI showing foraminal narrowing and some bulging. Had a 2 level lumbar laminectomy.
Felt great for about 6 months, got up to walking 5 miles per day, pain suddenly started increasing till it was the same as pre-surgery
04/2009 - Removal of wiring and re-attachment of displaced muscle to C5-C7 due to constant pain.
Present - Severe, debilitating chronic pain began again in 10/09 from head to toe, all on left side. MRIs show DDD through cervical and lumbar areas plus a handful of bulging discs.
Current meds: Flexeril, Soma, Valium, Lyrica, Celebrex, Vicodin and/or Ultram.
Update 11/02 - Saw an excellent neurologist who has tentatively suggested myofascial pain syndrome treatment and am hopeful once again.
EMG scheduled for 11/10, starting Lidocaine injections 11/11
I am thinking of postponing the surgery and seeking a 2nd opinion. I would rather have nothing at all done with a back up of an ADR. The military just makes everything more difficult.
Howdy Scott,
"If in doubt, check it out" has validity! Honestly, if you are not sure, or even for peace of mind get another opinion. Some folks get 3,4 etc. NOTHING wrong with that at all.
You have to go with what you are comfortable with. Please keep us posted. Take care.
Brenda
ACDF C6/7 & Partial Corpectomy with Instrumentation Aug. 2009 - Top of fusion separated still not fusing
ACDF C5/6 & Partial Corpectomy with Instrumentation Mar. 2008
Ulnar Subcutaneous Transposition and Guyon’s Release Apr. 2008
C2/3 Disk Bulge / Stenosis / Per NS - DDD (new) Oct. 2009 – No symptoms at this time: Left posterolateral disc osteophyte complex resulting in moderate crowding of the left C3 nerve root exit zone. Chronic moderate left-sided foraminal narrowing related to uncovertebral joint thickening and posterolateral towards foraminal bulging of the disc.
Lyrica
My symptoms never subsided before my surgery, so it was a no-brainer for me. I also consider my ACDF a success, but I've never been pain-free in my neck for any length of time.
Have you asked your surgeon what the likely result is if you wait to have surgery? For so many of us, surgery is the only option because we were either risking permanent nerve damage and/or our cervical spine was so unstable that one car accident might result in the loss of use of limbs.
One thing that almost every member will tell you is to go with your gut. If you feel deep down that surgery might be the wrong thing to do and you feel you should seek a second opinion, then do it. It's never wrong to get another opinion, ever.
Take care and good luck with what you choose. And please keep us posted.
Cath
October 21, 2008 - ACDF, 3-level (C4/5, 5/6 6/7), with hardware and eight screws. C4/5 and 5/6 fused, still movement at C6/7.
February 2009 - Lower back pain and sciatic pain.
January 6, 2010 - Scheduled for TLIF at L4/5.
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Each forward step we take we leave some phantom of ourselves behind. ~John Lancaster Spalding
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I am in no way affiliated with the medical profession. Any recommendations I make are based on my personal experiences only, so do not take my comments as medical rules.
Well I have decided to go through with it on Thursday. I have read enough success stories now even from people that were not in any pain going into the surgery like me. Hopefully I will be one of the people that don't have any problems. My goal is to be running by Christmas (lofty goal?), lifting light weights (enough to make a difference) by February, and riding my motorcycle recreationally by March.
Thanks for all the advice...I know that just because I feel fine right now doesn't mean there isn't an underlying problem that needs fixed before permanent damage.
At least I am looking at some time of work...paid of course since I am in the military.
Scott W.
I really didn't have much pain right before the surgery, just tingling and ache in my fingertips. And even that wasn't constant. Of course it's all gone now.
You may not be running by Xmas, but definitely exercising. I remember the jolting of running wasn't a good thing to feel until about 7 weeks. And riding bikes wasn't an issue, but wearing a helmet was. They actually told me to ride a stationary bike for execise, or a real one without a helmet. Which was funny, because it was a helmet that started my neck problem in the first place!
Sounds like you'll have to have the surgery some day anyway... I know I wished I had done it a long time earlier!
ADCF Level 1 - C5-6 surgery on 3/24/2009. Titanium plate and cadaver bone replacement. Four months later I was completely fused and ready for any activity. No PT, and the doctor said "See ya in a year!" Success story so far!
The only bummer is that I have a minor C-6/7 herniated disc that might require surgery some day. I will just go for the ADR on that sucker if it ever becomes a factor.
Question, they don't just graft one side of the vertebrae do they? What I mean is when I had my nerve block they only injected the left nerve root, but I am having symptoms on both shoulders, arms, hands, etc.
Good Luck Scott.
Let us know how how it goes.
MRI 12/07 L4-5 Herniated w/Nerve Impingment. L5/S1 Posterior Central Protrusions- indents @Thecal Sac. L4/S1 Moderate Facet Anthropy. 6/08 MRI and Flexion Extension Xrays- revealed grade 3 Retrolisthesis L5/S1, Spondy L4
Constant LBP and Bilateral Radiculopathy going on 17 months. PT, MT, Chiro, Traction, Selective Nerve Root Injections........ You name it I probably did it.
*****L4-S1 PLIF 7/28/08******* Considered a perfect success!
Newest problem: Shocking sharp pain in neck, shoulders and elbows, burning painful hands, and constant numbness/tingling in both hands.
MRI C6-7 disc protrusion with right lateral recess narrowing, C5-6 disc protrusion & spondylosis with bilateral neuralformen bony stenosis.
I am currently waiting for my neck surgery to be schedule ACDF C5/C6/C7- Insurance has required conservative treatment (PT and elecromagnetic therapy).
Hello! I just went for my last run for awhile..I guess its something to be said that I could even do that before my surgery, which is in the morning.
At my pre-surgery testing yesterday they asked me what my current pain level was and what prescriptions I was taking.. I said "0 and none"..which sounded odd..I then told them that sometimes my pain is a 10 and sometimes it's fine. I am tired all the time though but I doubt its from that.
We'll see..hopefully i'll have a speedy recovery.
Howdy Scott!!
Good luck with your surgery, you will be fine I am sure. From what you've posted so far, you are in great shape, and that is a big plus on your recovery! Plus your attitude is right in there as well.
As far as the fusion itself, there are videos on this site that shows really well what they do. They don't necessarily take "all" of the disk out, but a good portion of it. Depending what you decide for the grafting, it is a solid procedure between the two vertebral bones. Good luck, let us know how it goes!! *HUG*
Brenda
ACDF C6/7 & Partial Corpectomy with Instrumentation Aug. 2009 - Top of fusion separated still not fusing
ACDF C5/6 & Partial Corpectomy with Instrumentation Mar. 2008
Ulnar Subcutaneous Transposition and Guyon’s Release Apr. 2008
C2/3 Disk Bulge / Stenosis / Per NS - DDD (new) Oct. 2009 – No symptoms at this time: Left posterolateral disc osteophyte complex resulting in moderate crowding of the left C3 nerve root exit zone. Chronic moderate left-sided foraminal narrowing related to uncovertebral joint thickening and posterolateral towards foraminal bulging of the disc.
Lyrica