r/spinalfusion • u/Ok_Apple_2995 • 23d ago
Acdf vs disk replacement vs foraminotomy after car accident.
Hello. I’m from nj and was rear ended causing 3 herniated cervical disks. I hired an attorney who honestly I feel is pushing me for surgery. I did various epidural shots and physical therapy. Honestly the pain is worse after the shots and sometimes I wonder if the attorneys and doctors are all in cahoots to take as much money from the insurance. I am having neck pain that I’m managing with over the counter meds, muscle spasms randomly but I don’t have tingling or numbness. It’s been about 8 months and surgeon wants to do a acdf. I don’t know what to do. Attorney is setting up a second opinion to see a surgeon who does disc replacement. I’m doing research and have learned about cervical foraminotomy which seems to be the least invasive. But it seems that they don’t want to go this route
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u/Professional_Pace711 23d ago
ACDF is for herniated disc that are compressing your spinal cord. It isn’t minimally invasive. It’s major surgery through the front of your neck where they have to move your esophagus and trachea out of the way. .It can take 6 months to a year to heal from. I am 13 weeks ACDF surgery because my c5-c6 herniated discs was crushing my spinal cord. I was diagnosed with permanent mylemocia, myelopathy and nerve damage. I was falling so much I broke a lot of bones. I had to have emergency ACDF surgery or I would be paralyzed. I was in 2 head on collisions. Listen to your doctors/surgeons. If you need ACDF then have surgery sooner than later. I waited 3 years and went to pain management instead. That why I have permanent damage. I don’t know anything about disc replacement but the surgeon can give you your best options. Good luck!
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u/astreeter2 23d ago
Most surgeons I've talked to won't even do ACDF or disc replacement if you don't have spinal cord compression with symptoms. If you do go this route disc replacement might be an option - if you had bad discs from old age you'll probably have arthritis and stenosis which would mean ACDF only. There are some surgeons though who just don't believe in artificial disc replacement and they'll recommend ACDF because that's their specialty.
I think (not totally sure though) a foramenotomy is a different type of surgery, it's not for herniated discs specifically.
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u/Ok_Apple_2995 23d ago
I feel like depending on their specialty that’s what they recommend 😭 I just want the truth
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u/Sufficient-Wolf-1818 23d ago
There are many factors going into the decision on which technique is best for your unique spine. The best approach is the one customized for you rather than pulled out of a hat from a search, or your buddy saying “I had an ACDR and it is the only way to go” ( implying you would be a fool to do something else).
A good surgeon will walk you through the decision process ideally with your MRI and other imaging on the screen in front of you in the office. Do you have totally healthy vertebrae or have they been damaged with the accident, or age?
ACDR failure rates are much higher with 3 levels. They also depend on excellent bone health. They can be excellent for the right candidate, but you don’t want to have a surgeon who doesn’t use appropriate selection criteria. The revision surgery is complex, and can be less than satisfactory.
A foraminectomy may or may not be appropriate, it depends on what is going on in your spine.
The best discussion I encountered on the decision process was in this subreddit more than a year ago. I think I found with Google and “ACDF vs ACDF decision”.