Deciding to have PCDF & ACDF surgeries. help!

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.

 

Hi, you have a lot to bear and to decide!

You are in the right place though!

It will not take too long for you to get the answers you want and you need.

I want to send you a good word and to wish you the outcome you are looking for.

Everything is possible!

Wish you the very best !

thanks so much for the words of support and welcome! 

After I wrote that it dawned on me I'm probably reaching out for support ...some other voices besides mine and doctors.

 

You are very welcome!

No, koko, you are not giving such an impression!

This is what Forums are for - to exchange experiences, to give suggestions when we know about the issue.

When I don't know I reply anyway with a good word.

Myself I feel great when I get a reply - it makes me feel I am not alone.

Hello

i had acdf 2 years ago amazingly good results and am now awaiting back fusion on the 20th

hope you soon get sorted I nurse and am the biggest wimp going but the neck was okayx

thanks again iellen !

Hello Ellen!

I appreciate you taking the time to reply. I'm a wimp too lol!

It's good to know the results of your ACDF surgery went well. My surgeon said it's about improving my 'quality of life' and  pain should not dictate everything I do or can't do. Makes sense to me!

wish you well on your upcoming surgery please keep me posted.

Dear Koko44558,

First of all, bless your heart.  I'm sorry you are going through so much pain.  I am 61 and I was hurt in a car accident in 2003 and I have been through PT, injections, neurostimulators, drugs, 5 back surgeries, and accupuncture.  I think your PT person is pushing you too hard.  It may sound crazy, but I would suggest either massage therapy, or accupuncture if your insurance will pay for it.  I agree that the surgery might not help with the pain or numbness you are having.  I would suggest trying injections to see if they help - have you had any of those? I don't remember reading it in your treatments.  One last thing, my daughter mentioned a book, I am trying to find out what it is, that is a psych thing.  The book says that if you are trying to sleep or rest, but you can't because a particular part of your body - say your neck, is hurting, hurting, hurting.  All of your attention is on the pain in your neck.  Focus on the feeling of the soft pillow on your check, and find any other pleasant feeling, however small, that you can focus on, and allow yourself to drift towards that pleasant feeling.  Just that little bit has helped me sometimes.  If I find out the name of the book, I will share the information.  I've had 5 back surgeries, some of which have increased my pain, so please consider surgery to be your last option.  Best of luck to you. Remember, you are one of God's precious ones, and angels are watching over you.

Hey Linda! I appreciate the reply!

I have a physical therapy session tomorrow. I have a great therapist! I responded so well to the therapy, I too thought I could handle more – not the case – back to square one!

Finding ways not to focus on my pain is a priority for me and over the years, I have collected an arsenal of pain management techniques and strategies. I agree massage therapy is the best – but I am no longer able to fit the cost into my budget. Acupuncture I have not tried yet – actually I believe my insurance covers it, so I may look into it later. Please let me know about the book I am always searching for new and better ways to cope with the pain. Thanks for offering that resource.

Linda you definitely have a very positive outlook about life to have endured five back surgeries, you seem to be doing ok and that's probably a result of your positive attitude! (I made the mistake of watching YouTube videos of the surgeries – yikes). 

See … this is the type of feedback, support, and encouragement from you and others that is going a long way to help me get things into perspective. I feel better just from the couple of times I have posted on the site. Thank goodness, I found you guys

 Thanks again Linda! 

Hey there Ellen, I have a question (if you care to answer

 You said you are satisfied with the results of your surgery. Was it difficult for you to make the decision to have the acdf surgery? 

No koko because I was in agony and felt as though I had a paralysed arm too.

My goodness Ellen, I'm sincerely glad the surgery worked for you - it's encouraging. thanks for the reply! 

Hi Koko,

Those surgeries are both very serious.  I had similar ones to my lower back - 3 fusions in 2 days.  Lateral fusion and a cage (through my left side) which damaged my femoral nerve so now I have aching and burning in my left thigh all the time. And an arterial fusion the same day L3-L5. Next day a fusion in my back - L2-S1.  The fusion at L5-S1 has failed twice.  And yes, the surgery was very rough, and painful with a long recovery period.  I quit working last December because I can't sit any length of time any more.  The surgery did not help with any of the existing pain I had, and in fact created more.

 

I'm close to your age - 61. You have to have your heart checked and a blood test and other tests before they let you have the surgery.

My daughter has a lot of the same types of problems in her neck that you have.  She got a serious of injections that actually helped!  You might want to try that.  I'm having sympathetic nerve blocks right now for my legs which are helping (well not with my thigh)  but with the numbess and tingling and pain in my feet and legs.  

Good luck.  Be careful.  Also, google for reviews of the doctors you are trying before proceding.  You'll learn a lot about your doctor that way.

Take care,

Linda

Hey Linda!

Thanks so much for sharing your experience - it was Very helpful.

In particular, I am glad you suggested I google reviews about the surgeon. (I’m surprise I didn’t do it before, I google everything - that’s how I found this forum lol!)

Anyway, I did my research (exploring multiple sites) and I am extremely pleased with the results. According to his peers and patients, this surgeon appears to be a highly skilled & respected orthopedic surgeon. On the local, state, and national level, he consistently ranks high as a top orthopedic surgeon. I also read over 50 patient reviews (there were many more) - no complaints other than the wait time for a first visit.  He has 36 years’ experience as a spine surgeon – for me this is a very good thing , no on the job training ha,ha!

One of his specialties is combination back surgeries i.e. cervical/posterior surgery... as in my case. He performed 17 of this type of surgery in 2013 - not sure how many in the past 2 years, but I'll ask at my next appointment.

 I must say I did feel comfortable during my 1st and 2nd appointments with him and now after researching his medical background my confidence has grown.  So, I’m sticking with him. He is now officially “my" surgeon vs "the" surgeon. I am aware he can have an ‘off day’ or the results of the surgery may turn out different than expected … but I’ll take the chance as well as his suggestions for remedying the issues with my back.

Thanks again Linda for the suggestions! I sincerely wish you and your daughter the best on your road to recovery.  

Koko, So wonderful to hear.  It makes me feel really good that I was able to offer someone advice that actually helped!  I'm glad you can feel confident in your surgeon - that really counts for a lot.  Good luck to you - I'm sure it will all turn out right!

 

Hi I'm now postponed for back op such a crap week had HR bitch really having a go and op has been put way back because the NHS is so full

Oh no Ellen!...So sorry to hear. You were all set and then they

cancel?? That has to be awful....I can't imagine

(couldn't figure out where to post this so I posted it as a reply to me

Hey again!

Beginning with my first embarrassingly long post … I felt better after writing my situation out. Then came your comments of support and experiences and that really helped me begin to get things in perspective vs just freaking out! I complete PT next week and see my surgeon the following week so now it is decision time.

I have decided to have the  ACDF & PCDF surgeries. Some folks (medical, friends, & family) say …“well the pain and damage is not bad enough yet”… and I say … I do not understand why I would wait for more damage and pain to occur before doing something ‘now’ to head it off. It just seems to be a more proactive choice. For Me.

However, my decision is not based purely on alleviating my back pain, there is something about my spine ‘crumbling’ that just does not feel right. I recognize this is a major medical decision and a major surgery but if it does not work out…that will be on me. Nevertheless, after much research and weighing the pros and cons I have a great deal of confidence in my choice and more important in the surgeon.

Ok that’s my rationalization!

I’ll update my posts as this journey progresses as well continue reading and responding to posts on the forum!

Thanks guys! (For Real, Thank You!) Hugs! 

Hi koko, go forth!

All the very best and keep in touch with all of us!

X

Hi Koko, Yeah, I put off surgery for about 4 years about my injury (a lady ran a red light and totaled my car) and I think I may have ended up worse off because of my delay.