Have a question.

Hello,
I am having ACDF surgery on 4/5 and 5/6 on 1-7-18. I understand how they get the disks out, but how do they decompress and trim the vertebrae on the BACK of the vertebrae if they go in through the front?
Thanks

Post Edited (AngelsmamaDorseysdaughter) : 12/29/2018 10:20:04 PM (GMT-7)

Hi,
It is a 2 level fusion. 4/5 and 5/6, cervical. Sorry I didn't make myself plain.
Thanks,
Redswife

Hi Dorseymama if you google picture or drawing of spine it will give you a good diagram of the human spine. The portion of the spine that they work on when doing a Discectomy and fusion is the front part of the spine because that is where the main part of the vertebra is located with the disc between them. Think of disc as like soft rubber hockey pucks sitting between the hard bone of the vertebra. When all these disc's and vertebra are all alternately stacked together it makes the spine and this lets the the spine have flexibility! When they go through the front ( Anterior approach, ACDF is Anterior Cervical Discectomy and Fusion) they push the throat and windpipe and all those structures that are in front of the spine to the side to get at the spine they then remove the disc that is bad from between the vertebra and then put bone (either your own that is taken from some where in your body (in my first ACDF they took the bone from my pelvis) or they put donor bone ( my other Discectomy and fusion they used donor cadaver bone) anyway they put the bone between the two vertebra where the disc used to be,) and the bone you might say grows together with the vertebra making the two vertebra one! (the one above and below the removed disc over a period of time they all grow together and instead of having two vertebra separated by a disc you end up with one large fused vertebra. )

Hope that answers your question, I've had two ACDF's and one posterior fusion with rods and pins put in. I think the ACDF is much much easier and allot less painfull. Good luck to you, and please keep us informed of your progress, as when your on this forum we all care and support each other. I wish you well!

White Beard

Hi, AMDD...I had a 4 level ACDF done this past July. It was not a pleasure but it was not the worst thing either and the results were worth it, definitely. I am not pain free and sometimes I overdo it, like cleaning out a closet and then feeling something not sitting right but it settles back in. The surgery doesn't turn back time but it does alleviate a lot of the pain. I have enough movement in my neck that people do not realize I have had anything done and the scar is already barely noticeable. I am sure I will still get better but no regrets at all.

Sorry your Dr is so difficult. I have had surgeons with great beside manner and those who did not. Hopefully the skill is worth the bad attitude but it is a package. If you can, try Gabapentin perhaps? It provides some nerve relief for me and may buy you time to find the Dr you are comfortable with.

Please let us know!

AMDD, I am so sorry for your pain. Pain medication should be available to those who need it. Obviously you need a repair. Sometimes surgery is the only option. Hope you make progress!

AMDD before I had my first ACDF I had severe burning pain in both arms from my elbows down my arms into my hands and fingers. It felt like when you hit your "crazy bone" really really hard, but the pain wouldn't let up, or go away! It was terrible! It just wouldn't go away!! Back then I was in the military and it took the doctors over 3 months to figure out what was causing it. When they finally found the cause I had to have immediate emergency surgery! They did a C6/7 ACDF! As soon as the surgery was done all my arm pain was completely gone! Also back then in 1985, ACDF surgery was a relatively new type of procedure and I had complications from it. (lost my voice for well over 3 months with swallowing difficulties) My second ACDF in 2009 at C5/6 I had no problems at all after the surgery. One more thing I will tell you, the ACDF is allot less painful and has a much faster recovery time than having a posterior fusion! At least in my opinion, as I had C3/4 fused and stabilized with rods and pins in 2010 and that was done using the posterior approach. I thought that was a very very difficult surgery to recover from! Lots more pain and definitely a lot longer recovery time!! But in the end it did what it was supposed to do and I'm glad I had it done!

You might not care for your surgeons bedside manner but it sounds like he was being honest with you, as no surgeon can guarantee their surgeries outcome! I would definitely be very skeptical of the surgeon if he did!!! Just to many variables involved and everyone is so different!

Anyway AMDD I do empathize with you on your pain! And completely understand why you don't want to wait on having the surgery!!

I wish you well!

White Beard

I wanted to check on you now that you are a couple of weeks out since surgery. How are you doing at this point? Please give us an update when you feel up to it.

Take care.

Thank you for checking on me!!! My husband is here doing a great job of taking care of me, but I feel so alone and scared. He gets worried about me when I talk like this so I try not to worry him. I cried yesterday and it made everything hurt worse so I have to keep it bottled up.

Susie,
Thanks so much!! Do you think the burning will ease up? That's why I had the surgery in the first place. I am so scared it's not gonna work or that something else is going to happen to me.

Jo Ann

Jo Ann, if I recall you had this burning pain prior to surgery. I don't know how long you had it but I do know you had reached the end of your rope & went with a surgeon that you were not totally comfortable with. In other words you were in dire straights.

As I mentioned before, when drs do these surgeries they use various medications that pretty much deadens all pain. Once the patient goes home often within 24-48 hours these medications wear off. I imagine this is what happened with you. Granted the other issues just magnified everything.

When nerves are pinched/compromised they have to heal on their own. When the drs do the surgery they fix the mechanical issues, as in relieving pressure off & around the nerve. Right now there is so much inflammation going on inside, things are irritated. This will get better in time, time is your new best friend. Please be patient with your healing. Remind yourself this is temporary & you will get better, it just takes time, think positive.

What are you doing on your own to help with this pain? If you are not using ice packs, you need to start using them. No more than 20 minutes at a time. You can do a forum search here & will find people that has this surgery all use ice packs & say this helped more than anything. Do not use heat, heat will increase & aggravate the inflammation inside.

I know you feel horrible, you are scared & stressed to the max, I get it. However, remember this, when we get stressed like this our muscles & body will tense up. You need to get your stress level down because tense & tight muscles will make things worse. Again, don't be afraid to ask about doing a short course of steroids. If I remember right, it's a 5 day taper of them, nothing long term.

Keep us posted.

Lou Ann:
Focus as a priority daily dosing with Miralax and monitoring your hydration with clear fluids to ensure that your digestive system is moving.

Your incidences of vomiting were likely warning signs that your intestinal motility was slowing to a crawl and that food material was backing up and causing intestinal distension and distress.

Your small intestine is approximately 20 feet in length and your long intestine 5 feet in length. That is a lot of acerage for digested food material to become retained and cause severe comstipation. Severe constipation where intestinal motility slows or stops is not a joking matter. Contributing factors to
Comstipation: Being more sedentary while healing parallels with the intestinal tract being less active; taking opiates for pain slows intestinal motility as opiates bind to receptors embedded in the mucosa of the intestinal lining; inadequate fluid intake.

Miralax is an osmotic laxative. It has the advantage of drawing water into the large intestine and giving a kinetic/movement nudge to the intestinal smooth muscle. It is often beneficial to take Miralax twice a day when trying to re-start the intestinal system, a morning dose and an afternoon dose. You may need to double the recommended dose for 2-3 days to get initial relief.

Once you have cleared the backlog of retained fecal matter, continue with Miralax on a daily basis. Anyone who is healing from surgery (and especially when taking opiate medication) needs to make sure that they have a bowel program in place. Miralax can be used safely on a long term basis without dependency or “lazy colon.”

It can be helpful to purchase a Nalgene bottle or similar 48 ounce container. Fill with water or water + juice mixture and make sure to consume a full 48 ounces of clear fluid a day. Having a pre-set Nalgene bottle is ever so helpful in making sure that you are hydrating adequately.

If you prefer a more holistic approach to intestinal motility, options include: 1. 8 oz
of warmed prune juice (warm fluids are more stimulating to the intestinal tract) 1-2 x a day; 2. Cod-liver oil, 1-2 tablespoons a day; 3. Aloe Vera juice, 1-2 tablespoons a day; 4. Magnesium citrate as a supplement, either as 500 mg tablets or as a powder called “Natural Calm” by Vitality Holistics; 5. Ground wheat germ sprinkled 2-3 tablespoons sprinkled on yogurt.

If you experience future intestinal slowing, it is important NOT to continue to consume solid foods. Eating and intaking food only adds to the back-up, similar to traffic congestion on the evening commute in Las Angeles. Revert to intaking clear liquids. Apple juice and Concord grape juice both have natural flavonoids that will help ease constipation when symptoms suggest intestinal slowing. Add in additional Miralax. Walk, walk, walk. The smooth muscle of the intestinal tract depends on general physical activity for its motility. A hot shower or bath is also helpful. Gentle stretching of the torso, a form of internal massage, as is appropriate for each person.

I have seen people hospitalized due to severe comstipation. Constipation alone can cause vomiting and intense abdominal pain. A perfect storm of your recent surgery, recuperation and immobility, and opiates likely all contributed to your distress. Giving attention to a daily bowel program will be to your advantage in keeping your digestive tract humming along. Constipation is far more serious then many people recognize.

Your nerve pain will likely be a discomfort that will recede with time. Nerves that have been compressed or inflamed remain irritated after decompression surgery. Time and patience will be your friends. Look for your pain to lessen over weeks and months as the nerves desensitize.

It sounds like the worst of your ordeal is behind you and in the rear view mirror. Best wishes for feeling more like yourself in the coming days.
Karen

Karen,
Thank you. I am actually going for a gastric emptying test tomorrow so I hope it will give me some answers.
Jo Ann

Hi Karen,
Yes it is over with now. The Dr is gonna set me up with a barium swallow test next, since I can't be scoped. Don't know when. I am afraid of cancer, since I smoked for so many years.
Jo Ann