If you have already had facet injections in the area of your thoracic pain, you can generally rule them out as a pain generator. If the cervical facets are causing pain, it is possible that they are referring to the mid thoracic spine but less likely.
A cervical epidural should have yielded at least short term relief if the symptoms originated from the nerves of the spinal canal.
The differential is now down to facets in the lower cervical spine, thoracic degenerative disc disease, neuropathic pain syndrome, Scheuermann’s disorder or a rib/vertebral articulation (as long as the ACDF is a solid fusion). Don’t forget that other structures can refer pain to that area (heart and thoracic aorta among others).
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.