Auric

One conspicuous issue with ACDF forums is the “abandoned thread.” I don’t want that to happen here. But I do understand patients’ desires to get on with life and leave all ACDF-related contact behind. I think (optimistically) that this accounts for the dearth of post-surgery posts.

Things are probably better for me than I realize. I’m still grieving the loss of time and resources to this unwelcome season. But all acute issues prompting my C6/C7 fusion have resolved, particularly the shoulder / levator scapula pain.

My right tricep fibrillates (as it did at times before the surgery). It quivers. It isn’t painful, just strange. I don’t know if it is the feeling of a muscle dying or coming back to life.

Left inner forearm numbness comes and goes. That discussion is on a different thread. I do understand that it’s behaving like an ulnar entrapment, a separate issue. But the coincidence of this issue on the heels of surgery is hard to overlook.

Things are best when I am in motion, standing, moving, lifting.

The doctor released me from the collar after about four weeks. (Recall that I did not have plating done.) He has ordered no X-rays. He feels that surgeons are too occupied with the creation of the perfect neck on film, irrespective of the patient’s actual healing. He says the restoring of foramen height is the vital issue.

He also doesn’t write physical therapy scripts unless the patient is not doing well, and he added, “They often come back worse because of PT.”

I frankly don’t know what to make of this approach. He is extremely phlegmatic on the matter, and after thirty-three years of surgery, he’s quite set in his ways. He comes in, does the hand/arm test perfunctorily, and tells me I’m well ahead of the curve. Then there is a puff of smoke. Gone.

I’m not complaining. But Dr. Corenman, if you could put this approach into a broader medical context, I’d appreciate it. How far outside the box is this hands-off, “let nature run its course” attitude?

Though you have limited access to the test results, your diagnosis is not only appreciated but affirming of the feedback I received today.

The second neuro-surgeon’s opinion came in more conservatively than either of the first two doctors. He said that this is a C7 radiculopathy and needed ACDF on only one segment (C6 – C7). He acknowledged that bone spurs and stenoses were evident elsewhere, but he saw no need for further surgery beyond the one fusion point, considering the limits of my symptoms.

His assessment of what the MRI termed “severe” was moderate. Adjectives are subjective, as you cautioned above. He added that the space between my other C vertebrae was fine, and that I was in no unusual danger of injury. I asked him about my present neck ROM, and he said that too was fine.

The trade-off of so much ROM for my limited symptoms was not worth it at this time. I am going with the one-level fusion.

The initial surgeon characterized himself “as conservative as they come.” And yet, of two other diagnoses conducted with all results and office visits, and two more with only anecdotal or limited access (including yours), all four prescribed more conservatively, from one half to one quarter of the work the original doctor recommended.

Wrist extension and bicep strength are sound. I alternate curl fifty pound dumbbells for eight reps with good form. I will see what becomes of the teres minor issue.

I don’t participate in any sports. I only weight train. I’m soon to be fifty-five, and the gym is a place of refuge. I appear athletic, but I am not very coordinated, agile, or competitive. I only lift.

My bench press has never been strong as a long-limbed individual. But I noted a precipitous drop from 225 to 165 for reps. Overhead military press remains compromised. That lack of strength would come and go in seasons. Now it’s all making sense with this C7 thing. I imagine it was alternately flaring and quieting over the years, and other muscles were compensating whenever possible.

I have pillaged the internet’s ACDF resources, and there are many good sites out there, but this website is a gem among them. Your personal responses have been helpful and alarmingly prompt.

I may start other threads if more questions occur, to keep the forum coherent and searchable. Cheers and thanks to you.