Triple Anterior Cervical Discectomy and Fusion (ACDF)

Posted by Phil, Alumni Mentor @upstatephil, Feb 5, 2023

I am set for a C4-C7 ACDF in ten days time. Most posts on Mayo Connect involve one or two levels while I'm having three levels. I imagine the more levels the more complicated both the surgery and recovery. Can someone share their experiences? Thanks!

Interested in more discussions like this? Go to the Spine Health Support Group.

Profile picture for Jennifer, Volunteer Mentor @jenniferhunter

@upstatephil Hello and I want to welcome you to Connect! The good news about having lower cervical levels fused is that you should be able to turn your head with a lesser degree of compromise. Most of head turning is C1 & C2, with a little help from C3 & C4.

I don't think your surgery will be more complicated, it will just take a little longer to do 3 levels. Removing and replacing discs with cages or bone spacers is a pretty standard procedure, and the surgeon may seed the fusion with bone spurs that are removed during surgery. Do you have compression of spinal nerves in the foramen at those levels? That would add a bit more work if the foramen need to be cleared of arthritic bone.

Did your surgeon show you the imaging and explain why 3 levels need to be decompressed? They should justify the need. Sometimes an adjacent disc isn't perfect, and they add that into a planned surgery for another level which gives them a bigger insurance payment. I hope that isn't the case, but I have heard of this with another patient. She questioned him on the extra level he was adding, and he backed off and only fused one level. With fusions, the extra stress on the neck afterward can cause a domino effect that makes other levels go bad, so "less is more" is better, or a more conservative approach if a fusion isn't really needed at an adjacent level.

My fusion was C5/C6 done at Mayo and the recovery from that wasn't too bad. It took about 3 months to heal and for the fusion to solidify. The incision heals in about 6 weeks. I was in a neck brace all of that time because I opted for no hardware, and stayed immobile until fused. After that I had to rehab with physical therapy to get strength back. I didn't do well on pain meds after surgery, so I didn't take any. I found that I could handle the healing pain OK without drugs and avoided constipation from pain meds that away. I just rested and slept a lot. The nerve pain caused by the spine problem was gone when I woke up from anesthesia, and I just had the pain from the surgical path. My surgery was done before permanent damage had occurred from spinal cord compression. I didn't have compression of nerves at the spinal nerve roots.

Hopefully some other members will join the conversation. Good luck with your surgery!

Jennifer

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@jenniferhunter who may I ask did your surgery at Mayo?

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Are we not able to mention Dr’s names?

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Profile picture for bostongal23 @bostongal23

Are we not able to mention Dr’s names?

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@bostongal23 - you may.

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Profile picture for bostongal23 @bostongal23

@jenniferhunter who may I ask did your surgery at Mayo?

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@bostongal23 My surgeon is Jeremy Fogelson at Mayo in Rochester. I had a fusion of C5 C6 done without hardware. I stayed in a neck brace until fused. I had excellent results and highly recommend Dr. Fogelson.

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Profile picture for Jennifer, Volunteer Mentor @jenniferhunter

@bostongal23 My surgeon is Jeremy Fogelson at Mayo in Rochester. I had a fusion of C5 C6 done without hardware. I stayed in a neck brace until fused. I had excellent results and highly recommend Dr. Fogelson.

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@jenniferhunter Dr Nottmeier at Mayo in FL is doing C3-C6 in Oct. He said I will be in a collar for 4-6 weeks.

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Profile picture for bostongal23 @bostongal23

@jenniferhunter Dr Nottmeier at Mayo in FL is doing C3-C6 in Oct. He said I will be in a collar for 4-6 weeks.

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@bostongal23 I wish you a great recovery. My surgery was only one level, and I expect your recovery from a 3 level surgery will be a bit more involved than my experience. I hope that you will share as you recover. I am always interested to hear about patient experiences with other Mayo surgeons. Mayo exceeded my expectations and made a big difference in my life.

Good luck!
Jennifer

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Profile picture for Jennifer, Volunteer Mentor @jenniferhunter

@bostongal23 I wish you a great recovery. My surgery was only one level, and I expect your recovery from a 3 level surgery will be a bit more involved than my experience. I hope that you will share as you recover. I am always interested to hear about patient experiences with other Mayo surgeons. Mayo exceeded my expectations and made a big difference in my life.

Good luck!
Jennifer

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@jenniferhunter Thank you for your kind words, i will be sure to come back post surgery. I was suppose to have surgery last month and due to much fear of this procedure i cancelled it until after a trip we have had planned for over a year to Europe. I wish now I had it done as i am so done with dealing with pain.

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Profile picture for bostongal23 @bostongal23

@jenniferhunter Thank you for your kind words, i will be sure to come back post surgery. I was suppose to have surgery last month and due to much fear of this procedure i cancelled it until after a trip we have had planned for over a year to Europe. I wish now I had it done as i am so done with dealing with pain.

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@bostongal23 I was a scared patient too and spent 2 years trying to get a surgeon to help me. That made me face those fears and I was also working on it. I learned to overcome them. The surgeons didn’t understand my symptoms and wouldn’t take a chance on me until I got to Mayo. I did start a discussion about ways to face fear and you can find it if you go into my profile. That changed my life and gave me confidence to face other difficult circumstances. Thanks for your kind words too! What helped with pain before surgery was my physical therapist using a Dolphin Neurostimulator on the nerve roots in my neck. It was set for a frequency that blocks the neurotransmitters that are conducting the pain impulses. That gave me relief for about a week. I’m glad you had your trip and it will be something good to think about as you begin to heal. It can be a turning point to your future.

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