ACDF neck surgery and riding

[Parrotnutz]

I am wondering if anyone here has had this surgery or has severe cervical herniations causing tingling down arm and what the results are/were?
I am a much older adult amateur , ride dressage, have a couple herniations , but 1 is now pressing on nerves causing pain and tingling down arm. It is no worse with riding, but a couple months of PT and pills, I am no better. I cannot have injections the spaces are too small, so with all the consults I have had a neurosurgeon told me I have 2 choices…do nothing or have ACDF surgery, especially if I want to remain active! Even my PT told me this will not get any better than it is today and over time will only get worse.
Looking for others experiences while I am researching. If it was something that was just a bone on bone problem I would be ok, but cervical problems come with spinal cord problems down the rode, possibly and that scares me.

PS: I have not been riding the past 2 months and it has not improved anything, sigh!

[Brooklyn_Born]

No advice Parrotnutz, but I will empathize! I have had chronic neck pain for almost a year now and it also involves several cervical disc herniations, including a moderate one at C5-C6. I don’t have the numbness or tingling yet down my arm, but I do have the traveling pain. It has really affected my riding time and quality. Like you, it hurts whether I ride or don’t . Yesterday I rode for a bit after my trainer rode my horse, but then spent most of today in really bad pain!

I had the cervical injection, but it didn’t help at all because they couldn’t reach the spot they needed to (like you said, the area is too narrow.) PT didn’t work either, and I refused to try gabapentin for the pain because of the listed potential side effects. I’m trying acupuncture now, but only have had limited success. I am also going to have a consult with a chiropractor this Tuesday to see what he says. Not going to have any neck cracking done, but maybe some gentle manipulation might help put the discs or the vertebrae back in a more comfortable place?

I am getting to the point where I am considering surgery as well. I literally feel your pain and am interested to hear of anyone else’s experiences. Good luck, Parrotnutz!

[Parrotnutz]

Brooklyn,
I tried Lyrica for 3 days and the side effects were horrible so I also will not take gabapentin! All it will do is mask the pain and if I do more damage I will not know if I am on meds is how I feel!
Chiro couldn’t help me…he did gentle stretching and cold laser. The message therapist I go to is a “medical” message guy, not a message envy or commercial place. That helps but only for a day.
I have been going to PT for 2 months now and even my PT guy told me it won’t get better, only worse as time goes on, as I am older.
The neuro surgeon I saw told me its do nothing and live with it until I can’t take it anymore, or have the surgery and if I want to continue an active life style including riding he recommends surgery. The orthopedists think humans shouldn’t ride horses and I should just sit around and knit, lol.
When I find some people who have had the surgery I will report back to you. Online health forums I find are mostly filled with negativity, I think because they are the only people who have time to post, sigh.

Adriane

[Brooklyn_Born]

I’m so sorry, Adriane. I have actually heard of some very good results with neck surgery. I think it totally depends on individual situations. It sounds like you have tried all available other options and are being encouraged to look into surgery by knowledgeable people. My advice would be to have a consult with maybe one more orthopedic spine surgeon and then consider your options. Hopefully other people will weigh in on this forum as well. I too will let you know what I learn!

Nancy

[Paks]

I had a c-5 c-6 fusion done over 20 years ago. My problems wasn’t a disk but a bone spur growing into my spinal cord. I had intermitant weakness, tingling, weakness and periodic pain that felt like I’d wacked my funny bone but it ddin’t go away. The Neurosurgeon said that no physical therapy or medication would work. I could either get an operation or I could wait until I had a fall or was in a car accident then I would have alot in common with Christopher Reed accept that I would be able to breath on my own. So opted for the surgery. It went well. They used a piece of my hip for the fusion. I have a Z plate in there and all is fine some limited motion but not that bad.

Recovery was fairly fast a couple of months if I remember. It was done at Bethesda and the same operation they used to get jet jocks back in the cockpit. So pretty stable.

Now one piece of advice. If you decide to get the operation, use a neurosurgeon not an orthopedic surgeon. Operating on the spine is the hardest thing an orthopedic surgeon does and the easiest thing a neurosurgeon does. You’ll get a better job with the neurosurgon.

[Parrotnutz]

@Paks

I had a c-5 c-6 fusion done over 20 years ago. My problems wasn’t a disk but a bone spur growing into my spinal cord. I had intermitant weakness, tingling, weakness and periodic pain that felt like I’d wacked my funny bone but it ddin’t go away. The Neurosurgeon said that no physical therapy or medication would work. I could either get an operation or I could wait until I had a fall or was in a car accident then I would have alot in common with Christopher Reed accept that I would be able to breath on my own. So opted for the surgery. It went well. They used a piece of my hip for the fusion. I have a Z plate in there and all is fine some limited motion but not that bad.

Recovery was fairly fast a couple of months if I remember. It was done at Bethesda and the same operation they used to get jet jocks back in the cockpit. So pretty stable.

Now one piece of advice. If you decide to get the operation, use a neurosurgeon not an orthopedic surgeon. Operating on the spine is the hardest thing an orthopedic surgeon does and the easiest thing a neurosurgeon does. You’ll get a better job with the neurosurgon.

Thanks Paks! Yes, when I decide to have the surgery it will be with the neurosurgeon! My PT, who I love, said the same thing you did and I, also, am in the same thought process.

A question: I have been reading about swallowing problems after surgery due to moving “pipes”. Now sure if you had it from the front? If you did how was that?

Adriane

[Paks]

@Parrotnutz

Thanks Paks! Yes, when I decide to have the surgery it will be with the neurosurgeon! My PT, who I love, said the same thing you did and I, also, am in the same thought process.

A question: I have been reading about swallowing problems after surgery due to moving “pipes”. Now sure if you had it from the front? If you did how was that?

Adriane

Hi Adriane. Yes mine was from the front. I had no problems swallowing after surgery and my vocal cords were intact (something they worried about back then). I think the only thing that might have gotten worse is my sleep apnea. But that is managed with a CPAP.

[Parrotnutz]

@Paks

Hi Adriane. Yes mine was from the front. I had no problems swallowing after surgery and my vocal cords were intact (something they worried about back then). I think the only thing that might have gotten worse is my sleep apnea. But that is managed with a CPAP.

Thanks Paks!!
I truly appreciate the response! That swallowing “thing” is my big worry…not worried about the actual surgery.
Too keep riding I think I have to do the surgery so I don’t clear yet more neck problems.
We who ride know that anytime we get in the saddle there are risks when falling, but to knowingly cause more hurt to my neck would be stupid I think and cause more pain. Thanks heavens it is not emergent so I can take the time to decide when is the best time to have it done.

Adriane

[Brooklyn_Born]

Thanks for weighing in, Paks. Very good advice. Especially about choosing a neurosurgeon over an orthopedic surgeon, which I was referred to.

[Where_sMyWhite]

FWIW, I’m in the ortho camp. The type of surgeon to perform spinal surgery is a bit of a “religious” discussion as the surgery involves both bone (ortho) and nerves (neuro).

I opted for an orthopedic surgeon for my lumbar fusion.

You might want to get opinions from both types and go with the one you feel the most confident about. I know when I choose my ortho, I went with my second opinion surgeon as he left with a much more confident feeling than the original surgeon I had talked to.

BB, talk to the ortho you were referred to and see which one you feel the “best” about (as, frankly, a lay person assessing the skills of a surgeon can be kind of a trick ).

I also did extensive research on the surgeon I used on the internet to find out if he’d ever been sued (yes, dropped, and he disclosed it without me asking) as well as things like infection rates at the hospitals you might be having surgery at.

[Gloria]

Is replacing the disc not an option for you? I have my surgery scheduled on August 1 with a neuro surgeon. Doc originally more inclined to do fusion, but I told him that I wanted to do artificial replacement if possible, so that is what we settled. He indicated that the artificial disk may fuse on its own. I have had pain and severe weakness from my neck down to left shoulder blade for years. I am finally to the point that I can’t take it any more. I want it gone.

[Mozart]

Ugh. Timely thread. I am in the middle of PT for compressed disc in my neck. I actually have no pain in my neck, just constant numbness and tingling down my right arm and hand. I have had only 2 physio sessions so far and one acupuncture and have not really noticed any improvement, perhaps it is too soon. I have not ridden for a year (for other reasons, unrelated to my neck) but was actually going to swing a leg over this week. Before I stopped riding a year ago I found that I was getting numbness and tingling in my right which I attributed to a right hand death grip on the rein. In hind sight I think that was an early symptom.

There is so far no talk of surgery but this has to get resolved somehow…I do a lot of writing and keyboarding at work and it has become a problem. I will be following this thread for sure!

[Parrotnutz]

@Gloria

Is replacing the disc not an option for you? I have my surgery scheduled on August 1 with a neuro surgeon. Doc originally more inclined to do fusion, but I told him that I wanted to do artificial replacement if possible, so that is what we settled. He indicated that the artificial disk may fuse on its own. I have had pain and severe weakness from my neck down to left shoulder blade for years. I am finally to the point that I can’t take it any more. I want it gone.

I haven’t gotten that far in discussion, yet. From my research on the Internet usually replacement is recommended for the younger patients.The neuro surgeon I went to does lots of replacements so it will be part of my questions and I have a ton of them. Today I had x-rays that he ordered, a few views the orthopedist did not have done. He said he wants no surprises.
My next appointment is the 24th of June when we will go over these and all my questions so I will be armed with enough info to make an informed decision. Really, really difficult. Today was a really bad pain day. I can handle the tingling because if I change my neck position it goes away, unlike the pain. The only thing that helped the pain 2 months ago was steroids which I cannot take again. Anti inflammatories do nothing!

Adriane

[Brooklyn_Born]

I’m so sorry, Adriane! I hope you can find some positive answers on June 24. Let us know. Living with chronic pain js debilitating.

[Parrotnutz]

@Brooklyn Born

I’m so sorry, Adriane! I hope you can find some positive answers on June 24. Let us know. Living with chronic pain js debilitating.

I’ll keep in touch, Nancy, and report anything I find out. Please do the same!

Adriane

[equisusan]

Hello all. I had a Mobi C artificial disc put between C5 and C6 in August 2014 and I was back competing my hunters in 4 months post op. Yes you have a funny feeling like a lump in your throat but it goes away eventually. Can take quite awhile though. Recovery wasn’t bad. I pretty much couldn’t use my hands prior to surgery and I woke up postop able to open and close both hands. Surgery is generally more successful at resolving radiculopathy (all that crap down your shoulders, arms and hands). There are better options for pure neck pain. I used a neurosurgeon but there is no difference between the skills of a neurosurgeon or an orthopedic spine surgeon when it comes to this type of surgery. I know many of both types including family members. More important is board certification and experience. ACDF is more commonly recommended than ACDR I think for several reasons:

1. Insurance approves and pays for it more easily
2. It’s been around a lot longer and surgeons have more experience with it than specific artificial discs
3. The surgeon can get in and clean out all the bone spurs and age related arthritic changes better with ACDF than ACDR so many surgeons won’t recommend artificial discs for middle aged or older.

Having said that… I’m middle aged and my issues were all age related. Degenerative disc disease, forminal stenosis and bone spurs. Last I checked the Mobi C artificial disc was the only one that was approved by the FDA for two levels in the United States. The M6 or other discs maybe approved now as well. Not sure. If you’re interested in an artificial disc you should go to the sites for those artificial discs and look for surgeons who are trained on them in your area and do a lot of them and go and see them and they will tell you whether you are a candidate.

One problem I ran into is that I really needed two levels done and insurance would only pay for one so I had a choice three days before surgery to do one level as an artificial disc and the other level as a fusion and I declined to do the fusion and only did my worst level with the Mobi C disc. Since then I have heard of a lot of people that have fought the insurance companies and got them to pay for both levels and I wish I’d done that. So I still have one crappy disc and I deal with that and maybe will need additional surgery in the future. In Europe they do a lot more artificial discs than in the US. The primary consideration against ACDF aka fusion is that over time the adjacent levels will likely need additional surgery. On average probably 10 to 15 years after your first fusion you’ll need another.

I belong to a Facebook group that is very helpful and if you are interested search for it. It is called cervical disc replacement surgery. I hope this has been helpful information for you. Feel free to PM me if you need anything else.

Susan (bionic hunter princess)

[Paks]

@Where'sMyWhite

FWIW, I’m in the ortho camp. The type of surgeon to perform spinal surgery is a bit of a “religious” discussion as the surgery involves both bone (ortho) and nerves (neuro).

I opted for an orthopedic surgeon for my lumbar fusion.

You might want to get opinions from both types and go with the one you feel the most confident about. I know when I choose my ortho, I went with my second opinion surgeon as he left with a much more confident feeling than the original surgeon I had talked to.

BB, talk to the ortho you were referred to and see which one you feel the “best” about (as, frankly, a lay person assessing the skills of a surgeon can be kind of a trick ).

I also did extensive research on the surgeon I used on the internet to find out if he’d ever been sued (yes, dropped, and he disclosed it without me asking) as well as things like infection rates at the hospitals you might be having surgery at.

My husband recently had a lower back fusion with disk spacer done. The surgeon was duel qualified in both ortho and neuro. if you can find one like that that it’s the best. For spine I will always go neuro surgeon not ortho. Neuro’s also tend to be more conservative about cutting and exhaust all resonable options first.

[Parrotnutz]

Hi Susan, bionic hunter princess!
Thanks so much for your info. I am over 60 so not thinking they will do a disc replacement but of course it is one of my questions and I have a list full. I am thrilled to hear you were back in the saddle quickly
Question: Did you have to wear a collar at all? I spoke to a woman who had many discs fused and she had a collar for a long time but she had a more serious problem to start with.
I wrote the wrong date, my return visit is the 22nd and meantime I do have another opinion appt set up with another doctor. I don’t think there is any other options at this point but I am making my friends happy, lol

Adriane

[Where_sMyWhite]

@Paks

My husband recently had a lower back fusion with disk spacer done. The surgeon was duel qualified in both ortho and neuro. if you can find one like that that it’s the best. For spine I will always go neuro surgeon not ortho. Neuro’s also tend to be more conservative about cutting and exhaust all resonable options first.

Mine was ortho, 5 levels of disk replacement (I was bone on bone) + T10-S1 fusion. The otho I used specialized in spinal surgeries only.

He did use a vascular surgeon for the anterior approach to insert disks L3-4-5. He also used a specialist (not a surgeon) to monitor neural function during surgery.

The challenge with spinal surgery is that it involves (as you noted) both nervous system as well as bone “work” as the spine is an integrated “package”.

I am more the convinced a neurosurgeon would have had to do basically the same thing… sigh.

[equisusan]

@Parrotnutz

Hi Susan, bionic hunter princess!
Thanks so much for your info. I am over 60 so not thinking they will do a disc replacement but of course it is one of my questions and I have a list full. I am thrilled to hear you were back in the saddle quickly
Question: Did you have to wear a collar at all? I spoke to a woman who had many discs fused and she had a collar for a long time but she had a more serious problem to start with.
I wrote the wrong date, my return visit is the 22nd and meantime I do have another opinion appt set up with another doctor. I don’t think there is any other options at this point but I am making my friends happy, lol

Adriane

Well this is one of the areas that I believe ACDF and ACDR differ. I left the hospital after surgery with my surgeon telling me I should move my neck. He gave me a soft collar but he said don’t wear it unless you need it and I really only ever wore it at night to sleep. However with my type of surgery they’re not trying to get something to fuse they want it to move and eventually the vertebrae grows extra bone on the end plates of the disc. I think there is a lot of difference between surgeons and how they handle postop for ACDF. Some seem to use hard collars and bone stimulators while others use soft collars and the recovery seems to be closer to ACDR

I dont know where you are but here is the Mobi C site and it says up to 67 I think
http://www.cervicaldisc.com/faq