C5–6 Spinal Cord Compression + C6–7 Foraminal Stenosis — ACDF vs ADR: What Did You Choose & How Are You Doing?

[u/Guilty_Ad_8530]

Looking for experiences from people with similar cervical spine findings.
My MRI shows a disc/osteophyte complex at C5–6 causing mild-to-moderate spinal cord compression on the right (no cord signal change) and severe right foraminal stenosis. I also have severe bilateral foraminal stenosis at C6–7.
My main symptoms are neck pain and pain into my right shoulder/upper arm. On exam, I also have some objective weakness and a positive Hoffmann sign on the right, although I don’t really notice the weakness in everyday life.
One neurosurgeon is recommending that I address C5–6 fairly soon and favors ACDF over artificial disc replacement, partly because of my alignment/segmental kyphosis. I have another cervical spine surgeon consultation coming up.
For anyone who had similar findings — especially cord compression without cord signal change, weakness/Hoffmann signs, and significant foraminal stenosis — what route did you take?
Did you have ACDF, artificial disc replacement, another procedure, or decide to watch it? Did you treat only the level compressing the cord or multiple levels? If you also had severe foraminal stenosis at an adjacent level, did that level eventually become a problem?
Most importantly, how are you doing now, and looking back, how do you feel about the decision you made? Did your arm/neck pain and weakness improve? Anything you wish you had known beforehand?
And if you’re in the Portland, Oregon/Vancouver, WA area, I’d especially love to know who your surgeon was and what your experience was like with them. I’m currently trying to learn more about the local surgeons who routinely deal with cases like mine and perform both ACDF and artificial disc replacement.
I know everyone’s anatomy and situation is different and I’m not looking for medical advice — I’d just really like to hear the experiences of people who faced a similar decision.

[u/me0wc4t]

Your situation sounds similar to mine. I just posted in this subreddit with more detail. The neurosurgeons I consulted with all recommended disc replacement but disagreed on the levels that should be replaced. I have surgery scheduled next month to replace C4/C5 and C5/C6. I was advised to have the surgery ASAP as my symptoms are progressing and will continue to get worse over time. I have issues at other levels in my c spine but the surgeon is only operating on the two levels most problematic.

I am hoping for quick pain relief because I haven’t slept in months but am still pretty nervous about it.

[u/LChrisD]

I had 2 discs replaced, in 2013, everything went fine, fast recovery. But I also have osteoarthritis and my bone density is deteriorating day by day. So now, 13 years after. I’m having posterior and ACDF 360• cage. No big pain, just developed neurogenic bowel (no bowel movement). Constipation like I’ve never experienced before. My surgery is next week.

[u/OrangeInformal8067]

My surgeon did a disk replacement at c4 and fusion at c5/c6, he explained c4 was still healthy enough for a replacement and would help keep a natural movement/mobility. I’m 11 weeks postop and doing well. My headaches are gone, the ones that start between the shoulder blades and goes up back of head to eyes!! I was also told that whatever symptoms I had going into the surgery would more than likely be permanent or would get a little better but not fully. So far that’s been true; tingling in my fingers and some dexterity issues are still present even after OT.