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Complications post operatively with ACDF w/allograft and BMP
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Complications post operatively with ACDF w/allograft and BMP

Doctor,
I am a 42yoF. Up until 5/2011 I was working FT in a Trauma Center (RN) and PT as a Flight RN.  I was injured during a trauma with a combative pt resulting in 2 herniated discs (C5-7).  After multiple meds, 2 epidural injections and severe nerve pain I had my first ACDF 8/2011 (use of the birdcage and screws).  I had almost immediate relief of the numbness and radiculopathy in my right arm/hand.  I used a Bone Growth Stimulator for 12wks but over time (4 mos) I was still having significant pain to the neck/shoulder/scapula areas.  My neurosurgeon would only x-ray me in his office and always came back with the same story..."I'm not seeing as much bone growth as I'd like to see but some people just take time."   He then sent me to PT for a month without relief of the pain.  Upon my re-evaluation end of 12/2011 and  I asked if I should return to work like  he said "I suppose so..there's nothing more I can do for you.  If it hurts don't do it".  This wasn't acceptable to me as my jobs are extremely physically demanding.  Not only was I in a lot of pain but was fearful of causing more damage.  I immediately asked for a second opinion.  (Workman's Comp) That was approved but it wasn't until March 2012 that I was seen by the new MD (an orthopedic surgeon that specializes in ACDF's).  He did some thorough x'rays in his office and came back with a very concerning look.  He basically said that after 8 mos I had absolutely no bone growth what so ever.  He confirmed with a 2nd diagnostic (CT).  It was recommended that I have a revision of the ACDF but with allograft and BMP.   I had the revision 7/10/12 and the surgeon told me that when he went in to remove the old hardware it basically fell out in his hands.   The surgery was a success initially to the point that all of my pain was resolved.  However....I have had significant issues with airway compromise and severe headaches.  I had to go back to the surgeon 48hrs after discharge from the hospital b/c my lips would become cyanotic with menial tasks (ie: ADL's).  He put me on steroids and it helped short term.  I'm still having significant issues.  I cannot bend over, laugh, yell, sneeze, cough without getting a severe headache (which goes away as quickly as it comes on).  I can best describe it as being similar to a "brain freeze" when eating ice cream or drinking ice water too fast.  The airway issue....I can't even bend over to do a load of laundry or brush my teeth before bed without becoming dyspneic.  I am almost concerned with a possible dural tear but that would only explain the HA's not the dyspnea. Help!!
Avatar_dr_f_tn
Hello and hope you are doing well.

The dyspnea may not be related to the spinal disorder. It could be due to cardiac or lung disorders. It could also be due to systemic causes like anemia. Please consult your primary care physician. He may even ask for blood tests and an X ray. Lung function tests could further help in evaluation.

Hope this helped and do keep us posted.
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