4 level cervical ACDF

swtjen01 · #1 11-14-2013, 01:40 PM

I am scheduled to have surgery in December and I'm terrified. I went to the doctor thinking I could possibly have two ADR and then the other two fused but he said I was not a candidate because I had kyphosis in my neck.

Is that true? Has anyone else had cervical kyphosis and received ADR instead of fusion. I am scrambling for a second opinion and I hope someone on here might help.

The other thing I'm terrified of is losing my singing voice. I can't imagine not being able to sing but I can't imagine living in pain either.

Surprised 1 · #2 11-14-2013, 02:46 PM

Yes, I did have moderate kyphosis of my lower cervical spine prior to surgery and PT. In fact, the surgeon suggested the use of an ADR designed to replicate the natural curve of the cervical region. During surgery he felt that was no longer necessary and put in M6's. My surgery was just about 11 weeks ago and my posture today is so much better than prior to surgery - really quite stunning how much more aligned I feel. I do recall US surgeons saying that because of my kyphosis and osteophytes ADR wouldn't be an option for me - not a problem for Dr. Bierstedt from Germany.

As for voice mine has actually gotten better and I attribute this to being back in lordosis. Of course, everyone is different. Good luck and I hope that you are able to find a good solution to alleviate your pain.

TPatti · #3 11-14-2013, 05:23 PM

I would recommend at least getting opinions from some European doctors before making a decision. I would recommend Dr. Bierstedt(my surgeon) and Dr. Clavel to start.

Harrison · #4 11-14-2013, 10:45 PM

Pls see:

http://www.adrsupport.org/forums/f58...-health-11053/

And pls see:

http://www.adrsupport.org/forums/f50...67/#post102966

Keeled disc designs are VERY invasive. Some doctors still -- after many years of clinical evidence -- are NOT prescribing NSAIDS after cervical disc replacements. This is crazy.

Some day, it will be the standard of care. In the meantime, READ up on this! It's been driving me nuts for years. Using the search above, search for heterotopic ossification. Lots there to read.

Spoon-feeding you: http://www.adrsupport.org/forums/search.php

swtjen01 · #5 11-22-2013, 08:57 PM

I went in for my pre op yesterday and asked my surgeon about getting ADR even though he said I was kyphotic. He said he "could" do it but it would be stupid. :/

But then in my consult with his rude PA she tells me that I may need to have further surgery because of the level of the fusion and so my question to her was ... well then why not do an ADR on at least the top level.

I just don't understand. I actually called back today to talk to the doctor but spoke to her instead. I feel like if I rush into this I'm making a huge mistake. I'm fine with a fusion if I can at least understand the "why" behind it. I understand I'm kyphotic but at this point I'm not trying to have him fix my curve. I told her that if he could fix it then why wouldn't he at least do the top level. I said "mentally" it would alleviate at least somewhat of my issue with the surgery. She then stated that the doctor was treating me "mentally" to which I said oh yes he is. I have to be happy with this decision because I'm the one living with it.

Just very confused and stressed beyond belief. Ready to just cancel my surgery but I'm in pain all the time and I'm in my 30s. I appreciate all the advice and hope that I can talk to the doctor in more detail about this.

TPatti · #6 11-22-2013, 10:10 PM

Have you talked to other doctors including some European ones? Talking more to same doctor is not going to change his opinion. I am not saying that his opinion is wrong but that it should be tested by gathering the recommendations and the support behind the recommendations from others as well to help you make the best decision.

jss · #7 11-23-2013, 10:15 AM

swtjen01,

Condolences on your spine problems, but welcome.

I commend you on doing your research rather than just accepting what your doctor tells you. As I know you're now aware, this research is best done in the months before surgery, not in the days or even weeks before surgery. A four level ACDF may be the best course for you, I don't know; but until you've researched your condition, possible treatments, common outcomes in others that had various treatments, etc... then you can't know either. Unless your condition/situation demands a December surgery, I believe that you will be best served by cancelling your upcoming surgery, researching your options and then selecting a treatment based on the knowledge gleaned from your research.

The surgeon from my first two ACDF's did a good job, but left me with a slight kyphosis at C4/5/6. When he told me seven years later that I needed three more fusions, I first did about eight months of research and ended up having two ADR's. That was four years ago this coming Monday, and so far the kyphosis has not been an issue.

Your case is different though in that it may be possible for your kyphosis to be corrected. In the surgical outcomes forum you'll find a number of ADR recipients that had ADR surgery at a level with kyphosis. Most are successful outcomes; even the ones done in the US. Most of them don't post here any longer, but might respond to a PM.

Whatever treatment decision you make is going to live on with you for another 50 or so years. Taking a few months to research your options seems wise. The best place to start is the "Surgical Outcomes" section of this and any other spine forums that you can find. You will begin to see clear patterns emerge.

Good luck, Jeff

swtjen01 · #8 12-07-2013, 10:10 PM

I never was allowed to talk to the doctor - only his PA. I was told ADR was stupid and then the day before his PA called to say that he was considering ADR for 5/6, 6/7. I then questioned why the bottom levels. My concern was that having four levels fused left me with no options. She ended our conversation stating that the doctor would wait until he opened me up in surgery to see if he could use ADR. I told her once again that I needed to speak to him directly. I never did and I cancelled the surgery.

I then followed up with another doctor in Atlanta who told me I had made the best decision. He voiced the same concerns that I had about surgery. I believe that if your "gut" tells you not to do something you better listen. I still need surgery and honestly when I was told I needed surgery it was for not even 30 days later so I didn't have the proper time to research. It sucks but you have to be your own advocate. I was scared, sad, frustrated and I felt alone in my requests for a detailed explanation.

This site has help me greatly and I appreciate all the advise and well wishes.

Harrison · #9 12-07-2013, 10:15 PM

Hi Jennifer...

As as best you know, can you describe the reason for your kyphosis? Is it the end result of DDD and lifestyle? To have the whole cervical in this shape is (somewhat) unusual. Was it from trauma? Disease?

As arrogant as that doc may have been, it's a shame that he didn't explain his position, which indeed have been helpful.

Sigh, other docs you'll see will hopefully be more helpful!