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ADCF Surgery for Cervical Instability

I'm scheduled for my third ADCF fusion surgery on January 12, this time at C4/C5 for cervical instability. My first ADCF was April 2007 at C6/C7 and second was C3/C4 March 2014 for a broken facet joint. C2/C3 and C5/C6 auto fused the last three years. Once C4/C5 is fused, I'll be fused from C2 thru C7, thanks to being rear end whiplashed 39 years ago. By body tried to auto fuse C4/C5 since my March 2014 surgery, but failed because of too much movement at C4/C5. I've ended up with a "fish hook" osteophyte that extends from the bottom of C4 to the middle of C5. I am concerned about stability of C1/C2, but multiple spine surgeons claim that level is fine. I hope they are correct, because I was told the C4/C5 joint was fine three years ago.

My question to readers of this post, has anyone had ADCF surgery for cervical instability? I had one surgeon recommend surgery from the rear of my neck, but he would not do the surgery. I think the surgeon that will be doing this surgery said to me last time is was in his office that he had to justify this procedure as "Gross Cervical Instability". I hope that I can get some quality of life back, because these last three years have been terrible.


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Comments

  • joowee40joowee40 Mississippi Posts: 165

    Yep you know mine is going to be bc it's unstable but mine with be posterior. Wishing u luck and I'll be watching for updates!

  • nutcase007nnutcase007 United StatesPosts: 274

    @joowee40 - Do you have a surgical date? The orthopedic spine surgeon that was brought into my case recommended a posterior cervical spine stabilization from C2 to C7 using rods. I have a lot of questions for my neurosurgeon when I have the pre-surgical consult on December 27. I am concerned if he will be able to get my cervical spine properly supported with only an ADCF. The diagnostics on my right cervical facet joints show a lot of damage.

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  • Nutcase, I’m surprised they’ve done all of them anterior so far due to the scar tissue! From my understanding ( and I might be wrong) when they have to go into the higher cervical levels, then most go posterior due to having more visualization of the area needed for fusion as well as proper placement. Like Joowee, I’m also facing posterior surgery due to a non fusion of C-5 through C-7. My surgeon advises he’ll go 1 level further and 1 level lower due to the accelerated degeneration of those disk, so keep us posted.

  • nutcase007nnutcase007 United StatesPosts: 274

    @DavidG - I am also surprised that all of my surgeries, including this upcoming one have/will be performed anteriorly. This is an outstanding question for my neurosurgeon on my upcoming pre-op office visit.

    The surgery at C3/C4 was performed by the same surgeon that is scheduled to do my upcoming C4/C5 surgery. I also have questions for him how he will deal with overlapping because plating already exists at C3/C4 and now he will be adding plating at C4/C5. The C3/C4 fusion was performed with a carbon fiber cage implant. I expect he is planning to do the same with this surgery. His subspecialty in neurosurgery is complex spine issues.

  • Nutcase, I definitely would ask that question, or maybe even get a 2nd opinion! He has nothing to lose but guess who does?

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  • nutcase007nnutcase007 United StatesPosts: 274

    @DavidG - This surgeon is the only spine surgeon that I've found that will perform surgery on me. I've got complex hematology issues, so I've had multiple surgeons that will not consider doing surgery on me. Yes, I will be asking questions. On my 10th second opinion over the last three years, I had an orthopedic spine surgeon that recommended a posterior approach with rods. I know that the orthopedic surgeon was consulted by my neurosurgeon. They both told me that they have cross consulted with each other on many cases over the years. I hold a copy of the letter that the orthopedic wrote his recommendations.

  • joowee40joowee40 Mississippi Posts: 165

    I'm in a holding pattern until I get my Work settled down and hire a new staff person to replace someone who just left that covered things while I'm out for surgeries. Probably going to be spring before I do surgery and mine will be 3 thru 6 bc he needs to fix 4 and has to go up to 3 to gain stability ornths whole thing would crumble...nice visual huh?

  • nutcase007nnutcase007 United StatesPosts: 274

    I had my pre-op consult with the neurosurgeon who is scheduled to do my ADCF at C4/C5 fusion in two weeks. I double checked with him that he remembers that I already have had two ADCFs, at C3/C4 and C6/C7.

    I asked how he will manage plating since I'm already plated on C4. He informed me that he has received approval for an implant device that will go into the disc space after the disc is removed at C4/C5. This device does not need plating since it contains its own screws within the device.

  • joowee40joowee40 Mississippi Posts: 165

    Wow that's something new.. what is it I wonder? I really wish he would go in anterior on me and I would not have such reservations. He said somethiing about scar tissue etc and my vocal issues from first acdf. Did you get all your questions answered?

  • nutcase007nnutcase007 United StatesPosts: 274

    @joowee40 - I got most of my questions answered. My remaining concern of my next level down at C5/C6, I didn't like his answer. He claims that C5/C6 has auto fused, After this C4/C5 fusion, I'll be fused from C2 to C7. I'm concerned that C5/C6 is being held together by one bridging osteophyte and with the fusion one level up, could break because of the added stress. His reply was, "it should be okay". Doesn't give me a good feeling.

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