HealingWell
Search Close Search
☰

Can ACDF be successful if I have severe osteoperosis?

Support Forums
>
Chronic Pain
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 7/14/2018 1:50 AM (GMT 0)
Hello. I posted a while back, but here is the recap: ACDF C5-6 C6-7 August 24, 2017. After the surgery, I had a Dexa scan and it showed I was severely osteoporotic (T scale -3.5) due to a parathyroid tumor. I finally got the tumor out June 5th after much rangling with insurance.

First: Is there any hope I will heal (ACDF fusion), and if so, how long should I be patient. It really hurts.

Secondly: The only medicine that has ever helped with the severe muscle spasms is diazepam, but the doctors are super squirley about prescribing it. They have no problem prescribing drugs I cannot take like oxy, hydrocodone, baclofen (and the other three muscle relaxants), and Fentanyl. I have severe reactions to these drugs so they sit in the drawer. How do I ask for the one drug that actually helps without looking like a drug addict? (I haven't taken any since the end of February 2018, so I don't think I am an addict.)

Finally: Thank you straydog and everyone for your previous help. You may have saved my life.

Mary
Posted 7/14/2018 2:58 PM (GMT 0)
Mary, so good to hear from you again as it has been awhile. Here is what I can pass on to you about osteoporosis & fusions. Surgeons will have patients use a bone stimulator at the time of surgery to help the fusion fuse. My thinking is, when your surgeon did your surgery he would have seen the osteoporosis & would have ordered this.

If I remember right, you finally did get an xray several months after surgery & it checked out ok as far as the fusion was concerned. You have 2 real possibilities as to why you ended up with chronic pain after your surgery. You had none of the follow-up care after surgery, including physical therapy. Physical therapy is crucial afterwards to help strengthen muscles & get some mobility back as an example. The other thing, is some people can have spine surgery & follow the usual protocol & still end up with chronic pain. It is a real potential. The drs can fix the mechanical side of things only.

You are right about getting a dr to rx Valium at a low dose. Pretty much if a patient is lucky after surgery, the drs will rx a few weeks worth & then they get put on something else. There is no right or wrong way to ask for Valium, it is just taboo with drs because of the addiction issues associated with it. Exactly like the current opioid crisis!! Here is an old muscle relaxer that is not rx'd much any longer, but was quite effective for many. It is called Robaxin, this may be something to consider asking the dr to try.

What are you currently doing to try to get a dab of relief? What about your activities? I know you are prone to being really, really active. We do have a member named Seashell that is retired from being a hands on physical therapist. I hope she will see your post & maybe have some ideas for you.

If I can remember some other muscle relaxers I will come back & post them. So good to hear from you.
Posted 7/14/2018 6:48 PM (GMT 0)
Hello Susie, thank you for responding. I have been seeing a pain specialist who did trigger point injections last Thursday. No miracle, but some relief. He has referred me to the pain clinic and I am waiting for their call. Current x-ray shows concern for hardware failure, so I had an MRI which shows nothing since the hardware was in the way. The MRI written report said there were no bulging discs. Hmm I do not have discs, so he should have been looking for absence of discs, and I have asked the pain specialist to have another radiologist read the scans. The good news is that my new insurance will pay for rides which make going to these appointments bearable. (145 miles round trip).

I did try the Robaxin and it was horrible. Vertigo, Nystagmus, total impairment, and that was on half dose. I had the same reaction to Baclofen, Soma and Flexeral. I see my primary on Monday and will ask about Zanaflex. Maybe it will be different.

Also, the pain is making my blood pressure pretty high. 161/101. So I have been taking my BP (doctor's orders) twice a day and recording my pain level. At home when I am able to rest and not be in a car all day, my BP is lower as well as my pain level. I do not have cardiac issues and my BMI is 19, so I do not have classic high blood pressure.

I just hope I got the tumor out soon enough for my bones to recalcify a bit so the ACDF can solidify. I hope it is not too late. (The parathyroid tumor took the calcium from my bones and kept in my blood). The neurosurgeon either didn't know or didn't care. Cutters gonna cut.

I have been on light duty for 2 1/2 years and I am going a bit nuts. I want to not hurt so much, and I want to be able to do stuff even if I am never able to split wood or use the chain saw again. I want an expert to tell me to rest for another 6 months, or to tell me this is as good as it gets. Either I am disabled, or I am not.

At least I got myself to a good PC and got my insurance straightened out. The bill for the tumor was 55 thousand dollars. Lots of stress about that, but I got a letter last week, and the ins will pay. Big relief.

That's all I know. Thanks for listening.
Mary
Posted 7/15/2018 12:47 PM (GMT 0)
Mary, I had trigger point injections done for years. They helped with the muscle spasms somewhat. I was working & any help was better than none at all. I hope the Zannaflex agrees with you. I was on it several years. It took me a couple of weeks to get past the side effects which is typical with muscle relaxers.

The comment of no bulging disc is for the entire cervical spine that is good news. What did the dr think about having the MRI read again? If this were me, I would request a referral to a neurosurgeon for a consultation & have him review the MRI. These neurosurgeons know exactly what to look for in the slices of an MRI. Far more experience there. You need to know exactly what you have going on.

The odds of splitting wood, heavy lifting or anything that physical is not something a person should be doing with a fusion. The risk of breaking the hardware is far too risky. People have to learn to live with limitations & accept them unless they want to take that big of a chance. I don’t know anyone that would want to take that kind of a chance.

I am glad to see that you have found a good PCP. But, talk to this dr about a consult with a neurosurgeon to see what things look like. I would not rely on a PCP or pain mgt drs opinion, that is out of both drs realm of practice. A good neurosurgeon will never tell a patient you have to have surgery unless there is a high risk of paralysis. Instead a patient is given options. Pain can drive a person’s BP up. I have dealt with this for over 20 years. But with that said I am on 3 BP meds, a long history of that. If I can keep the pain level at a tolerable measure the BP meds work. I am not sure what advice you were given with it being high, I was told to not be doing any strenuous activities when that high.
Posted 7/15/2018 10:52 PM (GMT 0)
Mary:
The Good News is that the removal of a problematic parathyroid adenoma (benign) “fixes” the problem that was at the source for your accelerated osteoporosis.

It was the parathyroid adenoma that was excreting high levels of parathyroid hormone (PTH) that was leaching calcium from your bones. PTH induced osteoporosis shows marked improvement 6-8 months post adenoma resection. Literature reports bone density improvement of 20-25%.

One important caveat: All parathyroid glands need to be inspected to make sure that not more than one gland has a PTH secreting adenoma. There are 4 parathyroid glands. There are cases where more than one parathyroid gland is involved. Surgeons should check each of the 4 parathyroid glands at the time of surgery.

Do you have an endocrinologist following your post-operative care for the parathyroid adenoma? Adding an endocrinologist to your team would be valuable. At least for periodic follow-up and monitoring. An endocrinologist can also advise you as to whether an osteoporosis medication would be appropriate. Do your own research. Not all osteoporosis medications are alike in their biochemical effects. Some osteoporosis medications have risks/warning that include acute kidney failure, necrosis of the jaw, and risk of pathological fracture of the long shaft of the femur, tibia, or humerus.

The best self-care for osteoporosis is weight-bearing. Walking is ideal. Yoga (through its sustained postures and stretching of tendons that anchor one bone to another bone).

You have endured a lot over the past year. I hope that you find a bettering of your health in the weeks to come.
Karen
Posted 12/8/2018 5:24 AM (GMT 0)
Hello anyone who was waiting for my update. I didn't see Seashell's post from July until just now. All good information, thank you. Are you still on Palliative Care? To answer some of your questions, yes, I have an endocrinologist at UCSF who I trust. I asked her to do a bilateral exploration and eyeball all 4 parathyroid glands. Surgery report says she did. She took out one adenoma. I get my Calcium and PTH checked again in a couple of weeks. The best news is: drum roll...I have NO SPINE PAIN! I have been seeing a new neurosurgeon and he did a super awesome surgery a couple of weeks ago. He took out the 3-level ACDF hardware and also placed a Prodisc-C at cervical level 4-5. I woke up in a morphine haze, but after that, no pain. Maybe a bee sting on my incision. I can't believe it took 4 years to get a doctor to believe me and fix me right. It feels good to be vindicated, but even better to not have that life-sucking pain. I truly thank everyone here for your support and encouragement. Also, I did ask for the Zannaflex and it did help some. It lost it's effectiveness after about a month, but hey, every bit of pain relief helped. I was ready to stop living if this surgery didn't work. I can't wait to finally start physical therapy in 3 to 4 weeks.
~~Mary
Posted 12/8/2018 7:35 PM (GMT 0)
Mary, what a wonderful story to read about the artificial disc replacement! We have had only one other member several years ago that had this procedure done. Like you, she said it was incredible to wake up & find the horrible pain gone, just some post op pain. I am so happy that you found another surgeon that took care of your issues.

Please keep us posted about your continued success.
Posted 8/9/2022 2:16 AM (GMT 0)
This Message is for Mary,
I have Osteoporosis (not too bad)-2.8 and I need an ACDF on 2 possible 3 levels. I treat my pain with nerve blocks and it helps a lot. How are you feeling now and what did you do with the osteoporosis? I'm terrified in doing a domino effect. I don't have spinal cord compression only nerve pain. I hope u read this...
✚ New Topic ✚ Reply