ACDF surgery recommended for C3-C7 - is it worth it?

Posted by almina @almina, Jul 11, 2023

I am 54 years old. In 1991 I had a motorcycle accident and broke my jaw. For the majority of my adult life I've had lower back issues but still maintained a pretty active life and have even run a few half marathons and many shorter races, etc.

About 5 years ago I started experiencing numbness in my hand.. throughout the years it has moved up into my shoulder. Last year (Sept) i had really bad neck pain, which forced me to go back to the orthopedic and had an MRI. I then started physical therapy. The pain went away after about a week but the numbness has never gone away and continues to become more intense. Since then I've had 3 other bad neck experiences where the pain was at a level 10. So a total of 4 bad neck pain episodes and 24/7 numbness. After 7 months of PT I went back to an orthopedic who said I could try shots, etc. but that my discs are not growing back. Two of them are "gone" and I'm bone on bone.

Yesterday I finally got in to see the Neurosurgeon who was very good and thorough. He explained my MRI and recommended ACDF surgery for C4-C7. The more I read about it, the more freaked out I get.

Would love to hear from others about your experiences - is the surgery worth it? How tough is the recovery?

Here is the written portion of my MRI:Impression
1. Multilevel multifactorial central canal stenosis, moderate to severe at C4-5 and moderate at C3-4, C5-6 and C6-7. No cord signal abnormality. 2. Multilevel foraminal stenosis, severe bilaterally from C3-4 through C5-6 and severe on the left at C6-7. 3. Multilevel facet hypertrophy, severe on the right at C4-5 and C5-6. 4. Mild reversal of the expected cervical lordosis with mild anterolisthesis of C3 on C4. Dictated on: 11/2/2022 11:22 AM Signed by: James Y Wu, M.D. 11/2/2022 11:34 AM
Narrative
EXAMINATION: MRI CERVICAL SPINE W/O IV CONTRAST CLINICAL INFORMATION: Cervical pain, degenerative disc disease and radiculopathy. TECHNIQUE: MRI cervical spine without contrast utilizing multiplanar multiecho technique. COMPARISON: Radiographs dated 10/11/2022. FINDINGS: GENERAL: Mild reversal of the expected cervical lordosis with mild anterolisthesis of C3 on C4. Multilevel disc degeneration with severe height loss from C4 through C7. No fracture or aggressive osseous lesion. Unremarkable cord signal. INDIVIDUAL LEVELS: C2-C3: No disc herniation or stenosis. Ankylosis of the right facet joint. C3-C4: Mild anterolisthesis, disc osteophyte complex, severe right much greater than left facet hypertrophy, moderate central canal stenosis and severe right greater than left foraminal stenosis. C4-C5: Disc osteophyte complex, severe right much greater than left facet hypertrophy, moderate to severe central canal stenosis and severe right greater than left foraminal stenosis. C5-C6: Disc osteophyte complex, mild facet hypertrophy, moderate central canal stenosis and severe bilateral foraminal stenosis. C6-C7: Disc osteophyte complex, mild facet hypertrophy, moderate central canal stenosis and severe left foraminal stenosis. C7-T1: No disc herniation or stenosis. Mild facet hypertrophy.

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Profile picture for janetb1027 @janetb1027

I have an upcoming ACDF C4-C7 and wonder if anyone has had a multilevel ACDF and what the recovery is like? Thank you for any help.

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@janetb1027 I had a single level ACDF of C5/C6 that was done without hardware. I agreed to stay in a neck brace until fused and that took 3 months. The first 2 weeks were the most painful, and my throat hurt for 2-3 weeks. That is expected because of the surgical path. Swallowing is a bit tricky and painful. It was like half my throat didn't know how to swallow, but that did improve and recover. I think it is easier for me to swallow wrong even now after 10 years, but I pay attention and don't talk while swallowing.

It is very tiring and I needed to sleep a lot as my body directed energy toward healing. It took 6 weeks until the pain subsided. It took 3 months until I wasn't always reminded that I had just had surgery. After 3 months, I went through rehab and physical therapy.

The pain was not terrible. After surgery, all the spine generated pain was gone, and the new healing pain was because of the surgical path. The drugs nauseated me, so I didn't take pain medication after I left the hospital, and I could tolerate it fine. If you stay calm, it lessens pain. Constipation is a real problem after the anesthesia and pain medicine, so follow doctor's recommendations for dealing with that.

The scar does tighten up and cause some pain. It takes a full 6 weeks to heal and tightens after that. I periodically stretch my scar to keep it looser. I also have thoracic outlet syndrome which is very close to the scar, so that helps.

I have not had further issues, and it has been 10 years. This surgery gave me back the control and use of my arms and was a good decision, without it, I would have become disabled.
A 3-level surgery is more involved and probably has hardware installed. Some patients feel pain with pressure changes from approaching storms. Every patient is different, but that was my experience.

Do you have questions that you want to ask your surgical team?

REPLY
Profile picture for Jennifer, Volunteer Mentor @jenniferhunter

@janetb1027 I had a single level ACDF of C5/C6 that was done without hardware. I agreed to stay in a neck brace until fused and that took 3 months. The first 2 weeks were the most painful, and my throat hurt for 2-3 weeks. That is expected because of the surgical path. Swallowing is a bit tricky and painful. It was like half my throat didn't know how to swallow, but that did improve and recover. I think it is easier for me to swallow wrong even now after 10 years, but I pay attention and don't talk while swallowing.

It is very tiring and I needed to sleep a lot as my body directed energy toward healing. It took 6 weeks until the pain subsided. It took 3 months until I wasn't always reminded that I had just had surgery. After 3 months, I went through rehab and physical therapy.

The pain was not terrible. After surgery, all the spine generated pain was gone, and the new healing pain was because of the surgical path. The drugs nauseated me, so I didn't take pain medication after I left the hospital, and I could tolerate it fine. If you stay calm, it lessens pain. Constipation is a real problem after the anesthesia and pain medicine, so follow doctor's recommendations for dealing with that.

The scar does tighten up and cause some pain. It takes a full 6 weeks to heal and tightens after that. I periodically stretch my scar to keep it looser. I also have thoracic outlet syndrome which is very close to the scar, so that helps.

I have not had further issues, and it has been 10 years. This surgery gave me back the control and use of my arms and was a good decision, without it, I would have become disabled.
A 3-level surgery is more involved and probably has hardware installed. Some patients feel pain with pressure changes from approaching storms. Every patient is different, but that was my experience.

Do you have questions that you want to ask your surgical team?

Jump to this post

@jenniferhunter Thank you so much for taking the time to post such a nice reply. I appreciate all the information as I’m a little bit scared right now. I know it will be for the better though. I will let you know how I get on. Thank you again! Janet

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