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Neurology (Expert Forum)
3 Months Post ACDF
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3 Months Post ACDF
by JohnyH, Mar 21, 2007 12:00AM
On Jan 11th 2007 I had ACDF without plate or screws C6/C7 with only a soft collar perscibed. Its been a long road to recovery and I understand that most people are feeling "good" at this point.
I am still in a great deal of pain it seems to be only at the base of my skull and bewtween the shoulder blades. I find the team that did my ACDF almost impossible to communicate with. In fact rude in most cases.
My family was completely stunend by my doctors comments or lack there of. He actually had the nerve after when I was in the ICU to tell my family they were allowed to ask him ONE question so it beter be good.
I am afraid that this lack communication and poor after care instruction could result in disability for the rest of my life.
I am told by my doctors team that they do not recomend or perscribe P/T in cases like mine. That is not normal from all I have read. I feel that could actally be the root of why I am still so "disabled" at this point.
I understand it takes time for the fusion to occur however I have been told that no other doctor will see me until the surgeon that did my ACDF would release me to be treated by someone elese I find that hard to believe but I have heard that from two medical souuces at my family doc and from my referring doctor.
I believe with a supportive medical team I could overcome how difficult this has been I am 35 years old and too young to live disabled from what should have been a fairly common mediccal practice. Is there anywhere I can turn for help?
I am still in a great deal of pain it seems to be only at the base of my skull and bewtween the shoulder blades. I find the team that did my ACDF almost impossible to communicate with. In fact rude in most cases.
My family was completely stunend by my doctors comments or lack there of. He actually had the nerve after when I was in the ICU to tell my family they were allowed to ask him ONE question so it beter be good.
I am afraid that this lack communication and poor after care instruction could result in disability for the rest of my life.
I am told by my doctors team that they do not recomend or perscribe P/T in cases like mine. That is not normal from all I have read. I feel that could actally be the root of why I am still so "disabled" at this point.
I understand it takes time for the fusion to occur however I have been told that no other doctor will see me until the surgeon that did my ACDF would release me to be treated by someone elese I find that hard to believe but I have heard that from two medical souuces at my family doc and from my referring doctor.
I believe with a supportive medical team I could overcome how difficult this has been I am 35 years old and too young to live disabled from what should have been a fairly common mediccal practice. Is there anywhere I can turn for help?
Doctor's Answer
by Forum-M.D.-SH, Apr 10, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
I am sorry to hear that your are feeling pain and the sense of being disabled after your ACDF (anterior cervical discectomy and fusion). It is very common to have some pain after the surgery, but when pain persists for months there are several possibilities. Number one, you should always be concerned about non-union of the bone graft. If the graft does not fuse, then the spine does not stabilize and the extra motion could be causing pain. Neck imaging, usually a follow-up MRI, can assess for this. Number two, the cause of your neck pain/head pain was not due to the C6/7 disc, and although this was repaired, the cause of your pain has not been treated. This is where a neurologist can help you. While it is quite likely the case that another surgeon, is unlikely to want to pick up your case without negotiating with your surgeon, a neurologist approaches your problem with another perspective and an open mind and would be a good place to start for a second opinion. Number three, inadequate after care, your should wait a minimum of 4 weeks after ACDF to begin physical therapy, and in the begining it is only massage and passive exercises to relax the muscles involved. More active physical therapy can follow in time, but one should not expect to be recovered for 8 months or so. If you are smoking, you should stop now. Smoking leads to poorer bone fusion rates and more complications. Your family doctor/PCP or neurologist can also precribe physical therapy. Finally, there is always the fear of 'nerve damage' due to the surgical procedure, while this is a rare occurance it is often questioned. This is another thing a neurologist will be able to help determine. If you are not already on a medication for neuropathic pain, I would recommend neurontin, lyrica or elavil. The standard post-surgical meds (percocet, vicodin, etc) are only good for acute pain, work for about a week or two and are highly habit forming.
I hope this has been helpful.
I am sorry to hear that your are feeling pain and the sense of being disabled after your ACDF (anterior cervical discectomy and fusion). It is very common to have some pain after the surgery, but when pain persists for months there are several possibilities. Number one, you should always be concerned about non-union of the bone graft. If the graft does not fuse, then the spine does not stabilize and the extra motion could be causing pain. Neck imaging, usually a follow-up MRI, can assess for this. Number two, the cause of your neck pain/head pain was not due to the C6/7 disc, and although this was repaired, the cause of your pain has not been treated. This is where a neurologist can help you. While it is quite likely the case that another surgeon, is unlikely to want to pick up your case without negotiating with your surgeon, a neurologist approaches your problem with another perspective and an open mind and would be a good place to start for a second opinion. Number three, inadequate after care, your should wait a minimum of 4 weeks after ACDF to begin physical therapy, and in the begining it is only massage and passive exercises to relax the muscles involved. More active physical therapy can follow in time, but one should not expect to be recovered for 8 months or so. If you are smoking, you should stop now. Smoking leads to poorer bone fusion rates and more complications. Your family doctor/PCP or neurologist can also precribe physical therapy. Finally, there is always the fear of 'nerve damage' due to the surgical procedure, while this is a rare occurance it is often questioned. This is another thing a neurologist will be able to help determine. If you are not already on a medication for neuropathic pain, I would recommend neurontin, lyrica or elavil. The standard post-surgical meds (percocet, vicodin, etc) are only good for acute pain, work for about a week or two and are highly habit forming.
I hope this has been helpful.
It sounds now like your symptoms may be myofascial.
The pain before the ACDF was accross my right shoulder and down my right arm and hand. Closer to the time for the operation my right arm pain was not as bad but had intense pain in the middle of my neck and one doctor described it as "your chin seems to be at one with your chest" I was like that for at least 45 days prior.
immediately after waking up after surgery I had intense pain across my base of my skull right at the hairline. I could have sworn that is where they cut into that area. My incision I could barely notice but it felt like a deep cut had been made right at the hairline in the back of my neck. I had never felt this pain prior.
Physical tests show improvement in strength in my right arm. There are times of electrical pain that run down my right arm and fingers but typically lasts for only a 30 – 45 minute episode a couple of times a day.