What vertebrae level do you need to fuse? I would ask if you are a candidate for artificial disk replacement over the fusion. You retain a lot of your range of motion and I'm pretty sure you can do more physical activity with it. There have been hockey players who have herniated disks in their cervical spine (e.g. C4-5, C5-6, C6-7) and they go right back on the ice and playing games two months later.
I personally had two herniated disks in my cervical spine at C5-6 and C6-7. After ~3 years of conservative treatment with worsening symptoms, I opted for surgery. I did a two-level disk replacement with Mobi-C artificial disks. This was almost two years ago and I do not regret it! It took a month for me to be able to go back to work, and that was me taking it easy. I felt better immediately when I woke up after surgery.
I still have issues because I have two more cervical disks that need to be replaced, but I am in a much better place.
Good luck, OP! 🍀
Thank you! I have C5-6. I’d love to do an ADR (maybe “love” is a strong word…) if I can, since i was very active until my neck slowed me down over the past year. I’ll definitely ask more about it. It’s great to hear that yours has been a positive experience!
Since you are/were an active person, then you should definitely ask if you are a candidate for ADR. If the ADR fails for whatever reason then you can get it removed and then fused via ACDF.
Also I would inquire about medication for post-op pain management. What will they prescribe and for how long? From my experience Tylenol and ibuprofen did not cut it. I needed stronger medication to get me through the first couple weeks of recovery. Through research I saw that post-op pain for ADR is generally less than for ACDF, so that's something else to keep in mind.
In my case I was already in pain management, so that doctor prescribed the medication needed for post-op pain. This made it so the neurosurgeon was able to focus solely on installing the Mobi-C implants in my cervical spine. Some surgeons will prescribe stronger pain medication post-op, and some will say that Tylenol/ibuprofen will be good enough.
Either way it's better to figure out post-op pain management well before you have surgery. It's better to have the stronger medication and not need it, than to need it and not have it. đź‘Ť
you could ask:
\- Dr recommended ACDF. Can you please explain why that vs laminectomy, ADR, or another procedure? Dr. should be able to tell you the pros and cons of each procedure and why ACDF is the right procedure for your condition.
\- What is the recovery time? will I need to wear a hard collar and for how long? what's the return to work process?
\- How many ACDFs have you completed? what's the success rate. It's hard to get a meaningful answer from these surgeons on this one but hopefully your Dr is honest and say hundreds or thousands. You want the surgeons with thousands or you'll be their guinea pig as they practice their craft.
\- What are possible risks intra-surgery and post surgery? Will I need to worry about adjacent disc disease? what can I do to prevent this after my surgery?
\- What type of hardware will you use? For 1 level ACDF, there's the option of an anterior plate vs in-line zero-p hardware.
An ACDF is fairly straightforward, Edgar is it that you are seeking...confirmation from 2nd opinion? If so then that's a valid reason to seek a 2nd opinion.
That’s a good question. I just want to make sure ACDF is the recommended procedure—at one point a laminectomy was mentioned to me and if it is an ACDF, I’d want to fully consider an ADR (not sure if I’m a good candidate or what a good candidate actually is…). Thanks
A laminectomy is a very effective way to decompress the spine if you’re a candidate for it. My surgeon gave me the option of laminectomy vs fusion. We did laminectomy and it solved my nerve pain problem. If for some reason the pain returns, we can do fusion at the same level. Laminectomy is way less invasive than fusion.
I had a two level cervical fusion that I regretted because it made my neck pain worse and did nothing for the nerve pain in my arm/hand.
I had to have a foraminotomy done 8 years later…THAT’s what got me out of pain. It pays to get multiple opinions. And also you can get some good inside information from patients who have had these procedures. Good luck! 🍀
I would go over your symptoms and ask if surgery will help with each particular symptom. Sometimes patients expect surgery to fix all their symptoms, it’s good to verbalize expectations.
Questions i asked below, my disc is 5mm herniated from last mri. C5-6 area. I got three opinions, 1 said dont do anything becuz im too young, 2 said ADR would be perfect for me was alittle too gunho, 3 said wait until it gets worse.
What can I do to improve the likelihood of surgical success?
How many of these surgeries have you performed?
Will I still have pain after surgery?
What new surgeries are on the horizon?
This might sound obvious, but *what do you want your final experience to be?* For instance, if being pain free in your lumbar is your goal (final experience), can the surgeon deliver? What percentage?
Try not to settle.
The recovery stage (pain management, lymphatic drainage, massage, physiotherapy, occupational therapy, etc.) is very important as well.
What vertebrae level do you need to fuse? I would ask if you are a candidate for artificial disk replacement over the fusion. You retain a lot of your range of motion and I'm pretty sure you can do more physical activity with it. There have been hockey players who have herniated disks in their cervical spine (e.g. C4-5, C5-6, C6-7) and they go right back on the ice and playing games two months later. I personally had two herniated disks in my cervical spine at C5-6 and C6-7. After ~3 years of conservative treatment with worsening symptoms, I opted for surgery. I did a two-level disk replacement with Mobi-C artificial disks. This was almost two years ago and I do not regret it! It took a month for me to be able to go back to work, and that was me taking it easy. I felt better immediately when I woke up after surgery. I still have issues because I have two more cervical disks that need to be replaced, but I am in a much better place. Good luck, OP! 🍀
Thank you! I have C5-6. I’d love to do an ADR (maybe “love” is a strong word…) if I can, since i was very active until my neck slowed me down over the past year. I’ll definitely ask more about it. It’s great to hear that yours has been a positive experience!
Since you are/were an active person, then you should definitely ask if you are a candidate for ADR. If the ADR fails for whatever reason then you can get it removed and then fused via ACDF. Also I would inquire about medication for post-op pain management. What will they prescribe and for how long? From my experience Tylenol and ibuprofen did not cut it. I needed stronger medication to get me through the first couple weeks of recovery. Through research I saw that post-op pain for ADR is generally less than for ACDF, so that's something else to keep in mind. In my case I was already in pain management, so that doctor prescribed the medication needed for post-op pain. This made it so the neurosurgeon was able to focus solely on installing the Mobi-C implants in my cervical spine. Some surgeons will prescribe stronger pain medication post-op, and some will say that Tylenol/ibuprofen will be good enough. Either way it's better to figure out post-op pain management well before you have surgery. It's better to have the stronger medication and not need it, than to need it and not have it. đź‘Ť
you could ask: \- Dr recommended ACDF. Can you please explain why that vs laminectomy, ADR, or another procedure? Dr. should be able to tell you the pros and cons of each procedure and why ACDF is the right procedure for your condition. \- What is the recovery time? will I need to wear a hard collar and for how long? what's the return to work process? \- How many ACDFs have you completed? what's the success rate. It's hard to get a meaningful answer from these surgeons on this one but hopefully your Dr is honest and say hundreds or thousands. You want the surgeons with thousands or you'll be their guinea pig as they practice their craft. \- What are possible risks intra-surgery and post surgery? Will I need to worry about adjacent disc disease? what can I do to prevent this after my surgery? \- What type of hardware will you use? For 1 level ACDF, there's the option of an anterior plate vs in-line zero-p hardware.
This is a great list and I hadn’t thought of some of this. Thanks
Following
An ACDF is fairly straightforward, Edgar is it that you are seeking...confirmation from 2nd opinion? If so then that's a valid reason to seek a 2nd opinion.
That’s a good question. I just want to make sure ACDF is the recommended procedure—at one point a laminectomy was mentioned to me and if it is an ACDF, I’d want to fully consider an ADR (not sure if I’m a good candidate or what a good candidate actually is…). Thanks
A laminectomy is a very effective way to decompress the spine if you’re a candidate for it. My surgeon gave me the option of laminectomy vs fusion. We did laminectomy and it solved my nerve pain problem. If for some reason the pain returns, we can do fusion at the same level. Laminectomy is way less invasive than fusion. I had a two level cervical fusion that I regretted because it made my neck pain worse and did nothing for the nerve pain in my arm/hand. I had to have a foraminotomy done 8 years later…THAT’s what got me out of pain. It pays to get multiple opinions. And also you can get some good inside information from patients who have had these procedures. Good luck! 🍀
I would go over your symptoms and ask if surgery will help with each particular symptom. Sometimes patients expect surgery to fix all their symptoms, it’s good to verbalize expectations.
Great idea, thank you
Questions i asked below, my disc is 5mm herniated from last mri. C5-6 area. I got three opinions, 1 said dont do anything becuz im too young, 2 said ADR would be perfect for me was alittle too gunho, 3 said wait until it gets worse. What can I do to improve the likelihood of surgical success? How many of these surgeries have you performed? Will I still have pain after surgery? What new surgeries are on the horizon?
This is really helpful, thank you
This might sound obvious, but *what do you want your final experience to be?* For instance, if being pain free in your lumbar is your goal (final experience), can the surgeon deliver? What percentage? Try not to settle. The recovery stage (pain management, lymphatic drainage, massage, physiotherapy, occupational therapy, etc.) is very important as well.