ccb711MemberFebruary 26, 2012 at 8:04 amPost count: 8
I had 3 ACDFs on Nov 14, 2011.
Turned too quickly, shoe did not move on carpeting, and I fell to the left, hitting knee, shoulder and elbow.
No immediate issues, but by evening I was aching in shoulders and neck.
Ibuprofen and heating pad helped. Added flexeril at neuro nurse’s suggestion. Nurse indicated fusions are healed enough not to cause any damage, but possibility of damage to disks above and below the fusion. She said they would Rx a steriod pack if the aching continues. (I do not like to take the steroids).
Since I have been doing PT exercises for neck and right arm (some exercises, such as semi-pushup using door jam, affect both arms), I’m having trouble determining which symptoms are from exercise vs the fall.
What you tell you patient in a case like mien? When would you recommend a patient be seen for other damages to the neck?
Thanks for a responseccb711MemberFebruary 26, 2012 at 8:10 amPost count: 8
Sorry for the typos.
Question should have been worded: What would you tell your patient in a case like mine? When would you recommend a patient be seen (or xray’d) for other damages to the cervical spine?Donald Corenman, MD, DCModeratorFebruary 26, 2012 at 10:07 amPost count: 8459
I have a number of questions. FIrst- what was the graft material used; PEEK cages, allograft (donor bone) or your own bone? Second- what was the time from surgery to the fall? Third- was a plate used in the front of the neck? The reason for question is that these grafts heal at different rates.
With a fall and recent surgery, I would consider a new X-ray. In my practice, I do not use NSAIDs until the graft is incorporated. That is 6 weeks for autograft and 12 weeks for allograft (donor bone).
If there is significant aching, an oral steroid is not a bad idea. There is some risk to the discs above and below but normally, one fall will not cause a new tear in and of itself.
Dr. Corenmanccb711MemberFebruary 26, 2012 at 10:32 amPost count: 8
Surgery was 14 weeks before the fall. I had an allograft with titanium plate in front, 8 screws.
Neuro Dr said my bones were softer than he expected when putting in screws. Bone scan was fine and endocronologist indicated he hears this a lot from surgeons, but no real explanation.
That was a bit of a concern for me that fall could have loosened screws if my vertebrae were not as hard as they should be.
I’ve been taking ibuprofen since day 1 post-op because I chose not to take the steroid pack for the arm feeling like it was “asleep” post-op.Donald Corenman, MD, DCModeratorFebruary 26, 2012 at 11:54 pmPost count: 8459
Was your arm symptomatic (asleep) prior to the surgery? Many times, numbness is present prior to surgery but is “covered-up” by the pain that is present. After surgery, the pain disappears but the numbness is “uncovered” as the pain recedes. However, is this new numbness that was not present prior to surgery?
NSAIDs prevent inflammation. Inflammation is necessary to allow fusion to occur. Taking an NSAID can retard bone formation so is generally not recommended after an ACDF.
You are about 3 months after a fusion. The vertebra- allograft interface should be reasonably stable after this period of time. I do think a new X-ray would give some additional information.
Dr. Corenmanccb711MemberFebruary 27, 2012 at 4:50 amPost count: 8
Before surgery, I had the tingling, numbness in right arm for about a month before the pain started in upper arm, but arm did not feel “asleep”. However the “asleep” feeling went away in a day or 2 post-op. Could have been positioning while in surgery or when sleeping first night with the collar?
Since I’ve been taking NSAIDs (400mg 2-3x per day) (and 81mg aspirin for heart) since surgery to reduce inflammation, does that mean the allograft might not be healed? I certainly can stop taking the ibuprofen if it is preventing healing. Wouldn’t a steroid pack also prevent healing?
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