Cervical fusion of C3-C7 after L4-L5 and S1 - What to expect?

@coachdavid In general according to my doctor, lumbar spine surgery is a more difficult recovery that cervical surgery because you are bearing most of your body weight on the lumbar spine. I have only had a cervical spine fusion at C5/C6. Cervical spine issues can cause sciatic pain if there is spinal cord compression, and that can affect balance. I was walking with an uneven gait like a limp because of spinal cord compression. My recovery was good and by 3 months, I felt pretty good. Your fusion will involve more levels and you'll have some limits on your neck movement and head turning. Every patient is different in their recovery and results from spine surgery, but it may be an easier surgery. @upstatephil may have some experience to share as he has had both lumbar and multi-level cervical spine surgery.

No doubt, the recovery will be long and tiring. The scar tissue can also cause pain from tightness. You may be interested in this discussion about myofascial release. My PT did this for me to address my surgical scar tissue and it really helped me.

Neuropathy - "Myofascial Release Therapy (MFR) for treating compression and pain"
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

@coachdavid - First off, Jennifer is a veritable font of great advice backed-up by her amazing knowledge and personal experiences.

I had an ACDF at C4-7 in Feb 2023. I also had a four-level lumbar procedure in May of 2023 - so I can make some comparisons of recovery between those two surgeries, which may help you gain perspective as to what to expect in your case (though you know every recovery is different...).

My recovery from the lumbar work, rated 1-10 (10 is the toughest), was about 9.0 (9.999 at times). The ACDF recovery was much, much easier...maybe a 7.0? I had the ACDF on a Tuesday afternoon. I was released from the hospital late morning on Wed (less than 24 hours later). After one night in a nearby hotel, we drove 7+ hours home (I was snoozing most of the time). I did have some uncomfortable days at first but after a few weeks - I felt pretty darned good!

While my experience may not be yours...I would set my expectations as "better" in recovery than from your lumbar surgery.

My best!

@cachdavid - You are telling my story! Thank you for sharing and I look forward to the responses. Jennifer certainly has great advice. The Mayo message boards are full of shared experiences that have really answered a lot of my questions. I just found my surgery list, it's unreal.
2015: Left anterior foraminectomy C6-7.
2016: Lumbar Stenosis with neurogenic claudication 2017, XLIF with lateral plate to RIGHT laminectomy L3-
L4, L4-L5 Lumbar Stenosis , fusion 4-5, posterior decompression Lumbar 3-4 , Left to right. Translateral
interbodies .
2017: Fusion 4-5 Repair broken pedicle screw sitting on nerve and Lumbar 3-5 Lamenectomy.
2018: Went the the ER with acute bilateral low back pain with sciatica laterally unspecified MRI Lumbar
degerative disc disease. Spine surger for placement of Rods and pedicle screws.

2024: Multilevel Lumbar spondylosis L2-3 3-4 4-5 spinal canal decompression bilateral. Severe left sided neural foraminal narrowing of L5-S1. C2-3 to C7-T1 facet artriopathy and uncovertebral osteophytes with severe bilateral neural foramina stenosis. I can hardly keep up with all of the work that I've had. Fusion surgery coming up in June.

Thank you.

@janagain - Wow! That's some list of surgeries! Wishing you the best in June. You are a veteran for sure...

I have been diagnosed with stenosis between C4 and C5. I've been doing therapy which has been helping. Will I eventually need surgery. I've read that it may not help.

@seminariosanchez9 - Welcome to Mayo Connect. This is a great place to ask questions, read of others' experiences, and to learn.

Don't permit others' negative experiences to cause you undue concern or deter you from a needed surgery. Some surgeries don't work out the first time. But many spinal surgeries do fix the problems...I've had three trips to the OR - all planned - and have experienced terrific, corrective results.

Get a second opinion, go where they have the best diagnostic equipment, select a very good medical facility, and engage a top-notch neurosurgeon. You can do a lot to manage your risk of surgical failure by following a determined process of investigation and good decision making.

Every spine surgery is different. While it's interesting to hear what others have experienced, their experience is unlikely to be exactly your experience.

I'm putting in questions and comments. I've posted in the past about L4L5 potential fusion surgery. I also have issues in the cervical spine, osteophytes and various stenosis from C2 to 7. I'm trying to determine if the cervical issues could be the cause of abdominal discomfort, but my PCP and first neurosurgeon say that it would not likely cause that. I'm seeing a gastric surgeon that did laparoscopic gallbladder surgery a year ago, on Tuesday. I'll ask him if he thinks there is a correlation, or if my abdominal discomfort could be abdominal adhesions. I'm putting off the L4L5 fusion until I find out about the abdominal issues. I've had two neurosurgeons review my MRI's, one says L4L5 fusion, the other says that fusion wouldn't help and that if I were his father he still would not recommend fusion. I'm getting a third opinion, in the works don't know when it will be.
Questions for upstatephil, janagain, and coachdavid: Any of you had any abdominal discomfort (cramping, sometimes pins/needles, sometimes feels like a strained ligament or muscle). Bowel is functioning fairly normal, but I'm not sure what "normal" is any more since before and after the gallbladder surgery. I just can't see a fusion surgery recovery time you all talk about given the abdominal issues I'm having.
I have a feeling that the cervical issues could be causing things, but trying to get an answer from any Dr. isn't easy.
From what I'm reading, the cervical surgery is a bit easier recovery than lumbar, but as others have said each person's journey is unique. Try to get the best advice and answers that you can with a Dr that you trust in a facility you also trust.

I'm scheduled for a 4-level ACDF in a couple of weeks and am pleased to hear of Phil's (@upstatephil) recovery. I keep googling different symptoms I've been having, and all of them could have come from the cervical myelopathy! I'm curious - for those that have had an ACDF, did your symptoms all go away?

@birdiemomma - I had my 4-level ACDF as step one in a three-step process to address the real symptom: Complete leg numbness happening with fearful frequency. My objective was to address my lumbar area to reduce the likelihood of causing permanent and irreversible nerve damage. Wheelchair?

I know you asked about my ACDF not my lumbar work. But they are connected in my case. The neurosurgeon explained that the twisted body positions required during the lumbar work necessarily placed significant strain on the cervical spine. A weak cervical spine might lead to spinal column damage as a side-effect of the lumbar work. So, fix the cervical spine then work on the lumbar region.

Long story short: I did the ACDF to prepare for lumbar work rather than to manage any cervical spine related symptoms.

With that said - I would consider my ACDF work a complete success. No pain. No symptoms. The titanium plate impinges on my neck twist-range...but the underlying stenosis had about the same effect...

How can I help you?