Laminectomy cervical, with fusion and Instrumentation , 1-4 levels

@janagain
Hi, Jan.

I had ACDF surgery c5-c6 in 2022 and ACDF surgery on c6-c7 in June 2025 (last month). I see my surgeon at the 6 week mark in August and will find out if he recommends/releases me for PT.

I have not had posterior surgery but may need it in the future due to where a large osteophyte complex is located (too close to a nerve to remove it from the front). I have heard it is painful from the back of the neck and have experienced the pain of lumbar surgery (l3-l5) in 2024. It was the most painful surgery I ever had but survived (I am female and 56). Make sure to have your home setup well pre-surgery and helpers on standby plus grabbers within reach. You won’t be able to lift things for a while.

What type of surgeons have you worked with? Are they highly rated with positive reviews? I have an orthopedic spine specialist/surgeon who did my surgeries. He needed to decompress my spinal cord and nerve roots which caused cervical myelopathy and radiculopathy. My symptoms before surgery were daily headaches, neck/shoulder and shoulder blade pain/stiffness/knots, arm/hand weakness/numbness (dropped things and handwriting worsened), bladder control issues and walking slowed (felt like I was wearing heavy boots). Many symptoms improved but I also have carpal tunnel (had surgery on right hand which helped and need to get the left done). My problem is congenital spinal stenosis (born with narrow spinal canal), degenerative disc disease, neurogenic claudication and small fiber neuropathy so this will be a future of surgeries for me. 😔

My neurologists didn’t really help me much other than testing. EMGs/nerve conduction studies can help identify what levels are compressed in your spine that cause communication issues to your upper and lower limbs. This information can help a surgeon narrow down levels of problems to focus on (using MRIs, EMGs, clinical exam, symptoms, etc.).

What levels were you originally told were a problem? Were you told you had bone spurs/osteophytes, compressed nerve roots, disc bulges/herniations, or flattening/compression of spinal cord? Do you have hardware or n the front and is it staying in there? Will you be getting additional hardware in the back of your spine?

My concern, if I were you, would be knowing what my MRI/ct scan/EMG/nerve conduction studies show that confirms there is a compressed nerve and/or spinal cord compression that will be relieved/improved with the new surgery. Were the first 2 surgeries failures in decompression or is this new degeneration/compression? What did the first 2 surgeries fail to decompress? Did the fusions fail? Did you start PT too soon or twist your neck in ways that caused problems for the fusion or hardware? Did you make sure not to take NSAIDs while recovering since they make fusion more difficult? Do you have osteoporosis and did this contribute to the problem and if so, did you get treated to strengthen your bones before this surgery? Smoking is also known to be a problem for healing after spine surgery.

You are right that you may be able to regain some strength if you do not have permanent damage to a nerve or portion of your spinal cord (if compressed for a long time). My hope is that this surgery will definitely provide some relief and a chance for your nerves to heal.

HI- Warm wishes from Chicago-feeling your concerns. Simlar situation- My posterior with laminectomies and laminotomies with fixation using rods and screws AND anything else that may be needed is sch for 8/4/ I am terrified. # other surgeons all had varying degrees to work on from C3-C7. One suggests a ACDF w C5-6 corpectomy. Another says ACDF C4-7. One says ACDF C5-7. I have been dealing with recurrant so had postponement on ACDF. Now been postponed due to UTI's and every 3 months now EGD's with Dilations. Since i already have issues with swallowing and Esophageal Lichen Planus, I agreed to Posterior but this is the hardest one to work through- longer on table, longer in hospital, longer recovery, much more pain overall. Absolutely petrified. Told by my gastro that yes, anterior plating can affect swallowing but not severely, to the point of a feeding tube. Just feeling like can't swallow completely. I already have that so how much worse can it get? These UTI's can interfere with fusing- and told I have colonized MRSA, and now maybe even colonized Pseudonoma Klebsiella. I am allergic to a great number of antibiotics. Have bilateral hips and knees. Filled with inflammation and arthritis, T2 Diabetes, hypertension, osteoarthritis and pseudo gout. At 72 wondering - is it worth it.. to go through all that pain.. chances are pretty slim I'd be paralyzed yet that is the big push they all use. Starting to wonder how true that really is, and what are the chances?

I had a spur grow from c6 into my spinal cord. Had i fell over i would have been paralised from the neck down. so they took it out with 2mm to spare cage over c567. A am about 4 years afterwards now and i think my biggest help are nerve blockers above the cage but more so up in the base of my skull ocipital area due to the most horrible pressure caused by no movment around the cage area puts all the pressure above. I did try ablation but i seriously get better results from nerve blockers they can last 6 months to 3 years for some people. I think you just need to work out what can ruin it eg: lifting heaving shopping bags, lifting grandchildren. My biggest killer of pressure (not wrecking it) ..... travel in a car and being on the computer ......... once you work out how NOT to ruin the blockers then it is a matter of working out how many times you need to go back and do it. i have had all mine done in hosptial but taking the step of having it done out of hospital. If the MRI isnt showing too much movement of the screwws or cage/plate then there really isn't anything else they can do. I would never go back in to have it re done but at least it is now away from my spinal cord. Take care and wishing you all the very best

In 2001 I had C2-C7 posterior, outcome was good. IIn 2003, I had C-2 to C-7 fused, caged and screws and bone grafts. All the former disks were removed; my outcome was good. My pain before surgery was horrible, I couldn't raise my arms more than 4 inches. The hardest part was a 3 month recuperation each time, but losing the pain made it worth the procedures. At this point there are not many options left to consider, try to meditate every day before surgery, then after same routine. On You Tube there is a section for meditation put that on and get in bed.
It worked for me through 7 joint replacements. I wish you good luck.

Thank you for your response. You've been through alot but it sounds like you did well. I mean, how many cervical surgeries can you have in one life? I'm ready to get it over with however my blood results showed an elevation in wbc's and I've got a UTI. What's scarey is , I didn't feel like I had a UTI. I've had 2 cervical surgeries over the last 5 years. That makes this one #3 and it's a big one especially since they are going in posterior. You're right about running out of options. I had an EMG that showed I've lost 90% strength in three muscles in my arm. It's almost not working at all. I started to drop everything and become quite clumsy. This has been going on for a year when I had 3 cervical vertebraes fused. The doctor did not work on the correct one? I don't know but my arm is getting worse and it's involving the right arm also. My new Neurologist said he's going to do his best. If I can stop the progression, that would be a step in the right direction. I have never really tried meditation. It's a great suggestion and I'll give that a try. Thank you so much for sharing your experience with me .

@chrisanon You do have a lot of concerns. Do you think those issues have been addressed properly by the surgical team? Infection is a big risk after surgery. I had a lung infection 5 days after my surgery because I wasn't clearing phlegm well enough due to a physical problem that I have, and I needed to be on antibiotics. Being under general anesthesia slows things down and causes more phlegm in your lungs that needs to be cleared. I also had done Mupiroicin ointment inside my nose to prevent a staff infection as directed by the surgeon. If you have spinal cord compression or instability in the spine, it does increase risk of paralysis if an injury should happen in addition to that condition.

As for swallowing issues with ACDF, I can tell that I do not have as strong of a gag reflex on the side that was the surgical path, and I can choke more easily with swallowing, but I can swallow just fine. I do not have any spine hardware and no metal plate. I stayed in a neck brace 3 months until fused. I did recently stretch out the surgical scar tissue which helped me have better sensitivity in my throat which improved it a bit. My ACDF surgery was 8 years ago.

Do you have concerns and questions you need answered by your surgeon before your surgery?

@janagain I will be thinking of you tomorrow. It sounds like that will be a big surgery with the instrumentation that will change things in how you can move. I don't have that, but I can imagine it must be difficult. It's also difficult living with extreme weakness and having to function. It must be a hard choice to make, but I do wish you well and good healing to be your best when you get past this procedure. How are you doing tonight? Just remember, you are among friends here and every little bit helps.

Thanks, Jen. Did you have an EGD dilation for the scar tissue stretch or some other way of doing that? Massage? Thinking had to be EGD. Not fun. Sick of them. Every 3 months now.

Hi Jennifer!
It was canceled due to some high lab results. Going to take a round of antibiotics and try again in 10 days.
This surgery is a biggie, especially when they go through the back of the neck. I just never regained the strength back in my arms after the last surgery that was done almost a year ago. So tonight, I'm just doing what I enjoy since everything has been cleaned and organized with all my energy/nerves. I'm joking but I have been finishing up piles of this and piles of that and getting them put away. I just want to come home and peacefully rest! My arm is to the point where it's almost useless. I sure hope it's not too late. I'm just so puzzled as to how I got here when I assumed the previous doctor was going to fix the problem. I'm not kidding ...at the first appt back to his office he said, " I can't help you anymore" And I got very uncomfortable with that statement. I should have asked him why he can't help me anymore. The good news is I have a new Neurologist out of UCSD and he's going to have to work a miracle.
Thank you so much for the good thoughts

@chrisanon I am not sure what EGD Dilation is. My therapist does myofascial release which is essentially a hands on stretch with a shearing motion to counter the pressure from the tightness. You just wait until it releases, and then they may change direction or apply a stretch in a different direction

Here is a link where you can learn more.
Myofascial Release Therapy (MFR) for treating compression and pain
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/.