Deciding to have PCDF & ACDF surgeries. help!
Posted , 8 users are following.
Hi All! New Here!
Just to warn you this is a little lengthy (embarrassedJ so I truly appreciate whoever takes time from their busy day to read it.
In 2009, I was diagnosed with Thoracic Osteoarthritis, Degenerative Disc Disease, and Fibromyalgia - and in November 2015 diagnosed with Cervical Radiculopathy. As you see, I have dealt with chronic pain for a long time, and I am tired of it – it’s exhausting and limits my day to day activities.
Anyway based on my MRI results and my physical symptoms - the surgeon diagnosed me with Cervical Radiculopathy and *suggested* a Posterior Cervical Decompression (PCDF) as well as an Anterior Cervical Discectomy with Fusion, ( ACDF). No pressure … he told me to just think it over and referred me to Physical Therapy.
Since the diagnosis, I am doing a ton of research and educating myself about my condition and the surgery.
Last week I asked my physical therapist what she thought of the surgery and she said, “I had time to have the surgery later”. (I’m 63 and not clear about what “later” even means 
This week my primary care doctor said outright, that I do not want this surgery because it may not relieve the numbness and pain, and does nothing for the arthritis in my neck, and there will be issues with scar tissue and that my condition is not that bad – yet. He suggested I get a second opinion. I agreed to get a second opinion.
Cervical Radiculopathy Timeline
January 2015 I developed a pinch nerve in the left side of my neck along with the slow progression of excruciating numbness and/or pain in my arm, fingers and thigh. In June 2015, my primary care doctor diagnosed me with pinch nerve and referred me to PT along with the suggestion that I get a back massage. I had tried PT before for my osteoarthritis and hated it. So, I decided to try yoga instead.
Through yoga, I relieved most of the thigh and neck pain and increased my range of motion. However, the numbness and pain in my fingers and in my arm became worse - along with the loss of grip strength. I informed my primary care Dr. in Oct of 2015, he referred me to an orthopedic surgeon, who of course ordered an MRI.
As I said, based on the test results, the surgeon suggested surgery but wanted me to first try physical therapy, this time I went. I started twice weekly therapy sessions in November 2015 and so far it’s effective. After 6 weeks of passive exercises, my arm pain had diminished significantly and the numbness decreased to a ‘low buzz’.
Because I was progressing so well - the week of Christmas 2015 the therapist changed to more aggressive exercises (10 mins on the treadmill, resistance bands, etc) I felt ok while there. However, by the time I returned home after the session the pain in my neck and back was out of control. I had learned many PT pain intervention techniques and I tried them all but the pain escalated. Numbness increased significantly in my thumb. In addition to that I now not only have pain on the left side of my neck but also the right - along with a considerable decrease in my range of motion on both sides of my neck. My grip strength decreased almost immediately and I am dropping things again. Thought it best to cancel my next appointment, ha-ha! Although I feel better, today I am still in pain - most movements makes it worse. At this point, I’m confused and not sure what to do next. My next PT appointment is on Jan 5th and I see the surgeon on Jan 19 to inform him of my decision.
My questions.
1. Without ongoing physical therapy –(i.e. the rest of my life) will the symptoms of Cervical Radiculopathy return? (Anyone have experience with this?)
2. With degenerative disc disease, overtime, will my disc continue to lose height and stack on top of one another causing even more pain? (So far because of this I’ve lost 2” in height.)
3. From the point of being diagnosed with Cervical Radiculopathy what is the longest time anyone has waited in deciding to have the surgery or not to have surgery?
4. Why would waiting for the symptoms to get worse be beneficial to obtaining a positive outcome or to justify the surgery?
5. Finally, why are some medical professionals against having this surgery? Has anyone experienced being discouraged from having the procedure and how did it influence your decision to have or not have the surgery?
I thoroughly understand this is a major surgery with a very rough and long recovery period. To be honest at age 63 – I am more worried about recovering from the anesthesia and if my body can withstand the actual length of the surgery, and those factors are certainly not going to get better as I age.
I also understand that I need to rely on the medical professionals’ opinions however, I have been ‘burnt’ in the past with so-called medical opinions. That is why I am seeking experiences related to this from ‘normal’ folks ---I need a different perspective from people who have dealt with this process.
Thanks so much for any feedback!
MRI Results
At C3-C4, mild diffuse disc bulge results in no significant canal or neuroforaminal compromise.
At C4-C5, posterior disc osteophyte complex with left-sided uncovertebral arthrosis results in mild narrowing of the left neural foramen. The canal and right neural foramen are patent.
At C5-C6, posterior disc osteophyte complex and facet and uncovertebral arthrosis results in mild to moderate canal and mild bilateral neural foraminal compromise.
At C6-C7, posterior disc osteophyte complex and facet and uncovertebral arthrosis results in mild to moderate canal and mild bilateral neural foraminal narrowing.
1 like, 44 replies
TP0873 koko44558
Posted
Please tell me...how was your surgery and was it successful? If you don’t mind, I have several questions for you since I’m going through the same ordeal. Were you in a lot of pain? Did you go to physical therapy soon after? Did you need a home health aide or were you ok on your own? How long are your scars? If you have any tips (or anyone else reading this) can share, I would greatly appreciate it. Thank you very much!
The reason I'm asking is because I'm having surgery next week (ACDF on 4/14 & PCDF on 4/15), but first they'll be removing the hardware that's currently in my neck (I have a failed fusion due to ATV rollover accident).
My neurosurgeon said the ACDF surgery will be 4 hours and the PCDF will be 2 hours. They scheduled my surgery for 7:30 AM which means I have to be at the hospital at 5:30 AM. OMG!
If you could reply and let me know how your surgery went, I would love to chat with you. I pray that you're pain free!
I hope you're doing well, and I look forward to any advice you could provide.
Thank you, and have a great day.
Tracy
koko44558 TP0873
Posted
Although I haven’t posted a comment on this forum in a while I frequently read the comments made by others. I always wanted to give an update on my progress but it became physically painful to type, write, or even sit for any length of time.
As you can tell from my other posts I tend to write a lot – something tells me my response to you won’t be any different especially now that I can type and sit without pain! So bear with me Tracy - Ok? Ok!
The good news is Yes, I had the ACDF surgery on March 14, and I am healing very well.
A little background Tracy before I respond to your questions. I was diagnosed last year with cervical stenosis of the spinal cord and spinal stenosis in the cervical region – C5-C6 and C6-C7. My ACDF surgery involved two discs being removed and replaced with cadaver bone, one long titanium plate was placed over that, and 6 screws were inserted through the plate to hold it all together. Tah Dah! The surgery took about two and a half to three hours to complete.
I didn’t sleep well the night before the surgery like you I had to be at the hospital early around 5 a.m . Once there things start moving fast. After being prepped and questioned to death, I was taken to the holding room. I must admit while waiting to go into the operating room I had a Major crying attack, I just couldn’t stop crying. One of the anesthesiologists noticed my distressed (even though I tried to hide it) and she placed her hand gently on my arm and whispered: “… just hold on a little bit longer”. Well shortly after that she took out a syringe and injected what I thought was water into my IV. I asked was it water to flush out the tubing, she shook her head and said “oh no…you’ll feel better in a moment”, and I did! It was a miracle no more tears LOL! I don’t know what was in the syringe but bless her heart for being there! Saw the bright lights of the operating room when I was wheeled in and that’s about all I remember until I woke up in my room.
When I ‘came to’ in my room I remember complaining of pain, the nurse told me to just press the purple button, and it will help with the pain, oh my goodness did it help. I would go back to sleep until the pain woke me up - press the button and fall back to sleep again. It went like that for the first day.
Day 2 still in pain but not excruciating and the purple button and I became BFFs - until sadly that afternoon they took it away. Thankfully the oral meds worked just as well. Have to mention at times attempting to swallow was more painful than the pain in my neck. So on a pain scale of 1-10, I’d say my neck pain the first day was a 9 but the pain meds really alleviated most of that. The second day about a 7 and with each passing day the neck pain subsided.
Day 3 I was discharged with prescriptions for a muscle relaxer and a narcotic. I took the medication as prescribed along with heat and ice so at home the pain was doable - around a 5. I had read that most people couldn’t sleep with the hard collar on in bed and that it was painful for them to get in and out of the bed, so my sons purchased a recliner for me, which made things much easier ‘except’ for sleeping. I tried to sleep in the recliner but found it better to sleep in my bed (go figure)… I had no problems getting in and out of the bed as long as I used the ‘log roll’ technique. (Google it
. I still use the recliner when I read, watch TV or for short naps.
The only physical therapy I had occurred while in the hospital. Since I live alone they wanted to make sure I could navigate steps. Other than that no physical therapy was ordered - actually I don’t need it. My right arm doesn’t hurt at all and for the most part, everything is back to normal. I cancelled the home health aide once I found out what they did (check BP, inspect and change the dressing on the incision etc) – I could manage those task on my own. What I needed was a housekeeper but my family came through did the shopping, wash dishes, fussed at me when I took that damn collar off -lol! Oh, my incision is a little over 2 inches long and the stitches are dissolvable so in another 3 weeks, they should be gone.
Unfortunately, the pain on the left side of my neck and shoulder got worse. I think how they positioned me during surgery may have stressed the muscles too much. I’m also experiencing very large ‘floaters’ and sharp images of light in my left eye - has to be from the position I was in.
I had my 3-week post-op appointment on Wednesday. My surgeon gave the ok for me to start driving again and I have to wear a soft collar when I leave the house. He also showed me the x-ray of my neck with the plate and screws in it - amazing – all that hardware is in my body!? He recommended a stretching exercise to reduce the tightness in my left neck and shoulder, and it’s helping, however, the muscles are easily aggravated. However, I manage that with a low dose of muscle relaxer, and of course heat and ice. I have taken Tramadol for 8+ years to manage my back pain and if my left shoulder didn’t hurt - I would be medication free today.
I do have to pace myself – if I don’t I get very exhausted - so the house is looking a little messy these days. Also, all the pain medication along with the anesthesia has made my brain a little foggy but I’m sure as time goes on that too will improve. I read and play brain games to help things along.
I am so happy I didn’t listen to the naysayers (including my PCP) who told me surgery was a bad idea. I would do this again! My chronic back pain had become an emotional and physical drain on my life and so very limiting - but now that’s going to change!
Tracy thank you for asking me about my experience. I’m surprised by how much I had stuffed inside about the process of deciding to have the surgery. Writing this I guess has been - cathartic. Can’t explain it but I feel emotionally lighter.
So please let me know how it goes for you – when you’re ready of course. You will find there is an abundant source of support and understanding on this forum. If you have any other questions please ask – I promise to keep my responses – brief (well as much as I can
Heal well Tracy! I’ll keep you in my thoughts…
koko44558
Posted
TP0873 koko44558
Posted
OMG, I'm so happy for you and your surgery was a success! Thank you SOOO much for your response, I'm so glad to hear from you! I'm sorry for playing 20 questions with you, I'm just scared to death. Big mistake - I've been watching videos online about the surgeries and I'm freaking out now.
The incision on the back of my neck will be 5 inches and the front is 3 inches. Did you decide not to have the PCDF or wasn't it necessary? My neurosurgeon is rated one of the top 10 best surgeons in the US, so I'm happy! 
I've been counting down the days since February 19th, and I'm ready to get it over with but everybody's saying how painful it was and they felt like they were going to die (and that's just one surgery - the ACDF). I haven't found any videos where the patient had both surgeries though. My surgeon said he'll put in a new plate in the front of my neck and two rods in the back of my neck with 14 screws. Apparently, C4 is not in very good shape so he's going to fuse C3-T1. See why I'm nervous?
I've contacted a couple rehab places and they said we won't know until after the surgeries if I need inhouse rehab or not.
I'm so happy for you and your surgery was a success! How long did it take for your recuperation and you were able to work?
I apologize in advance for the long post! I look forward to chatting with you and thank you again so much for your response.
Take care and May God Bless!
Tracy
TP0873 koko44558
Posted
koko44558 TP0873
Posted
Sorry it's taken a minute to reply. Typing my last post caused neck spasms. So I will take it easy and keep it brief! I too made the mistake of watching you tube videos of the surgery - after about a month I stopped - they were informative but scary.
Yes I was to have both ACDF & PCDF surgeries....but the
surgeon wants to wait to perform the PCDF at a later date.
I'm retired so returning to work is not an issue. But I'm still trying to get up to speed with daily chores.and shopping
(my favorite activity) wears me out...a lot - a sad face.
Tomorrow wiill be one month since my surgery and I'm doing
pretty good.
Tracy let us know how you're doing.
Heal well!
ellen82139 koko44558
Posted
you must be a week ahead of me my L3/4 fusion laminectomy 23/3
Im feeling pretty chuffed with how I'm doing,doing dusting anything above waist height,trying to be careful not bending or lifting.got a helping hand grabber which is great until I drop the helping hand!!have you had/having physio
koko44558 ellen82139
Posted
I've dropped my helping hand grabber a couple of times. First time I had to laugh...I needed a helping hand to pick up the helping hand....too funny! So far the surgeon didn't prescribe any type of therapy. My next follow-up is May 18th, we'll see what happens then.
Sounds like your recovery is moving along! We are getting through it, despite the helping hand. Take care
lin73759 koko44558
Posted