[Before & After] On the left, you can see the patient previously underwent a single level fusion of the neck (ACDF). Unfortunately, I commonly see patients like this whose surgeries only address one or a few of the many issues they have. If the discs above or below a fusion are unstable, arthritic, or crooked (scoliotic), the transfer of stress from the fusion to those levels makes those issues, and often the pain, worse.
On the right, I performed an anterior fusion of each collapsed disc because they were stuck in a collapsed position and needed support in the front to realign his spine. He also had instability (excessive shifting) of his spine at 4 other levels and his previous fusion failed to heal. This can only be seen on flexion and extension X-rays. Many surgeons never order flexion and extension XRays and base surgery on the MRI alone, leading to inadequate relief of symptoms, or worsening symptoms. To stabilize his spine adequately because it was abnormal at so many levels, his anterior surgery was followed by a posterior fusion to maximize the potential for his fusion to heal and his pain to resolve.
Often a larger surgery, when necessary, results in more immediate pain relief than a smaller, inadequate surgery. Every patient is different. Some need microscopic surgery. Others need more complex surgery. You’d be surprised how well patients do with larger surgeries, when that’s what they needed all along. It’s more effective than fusing the spine piece-meal, one level at a time, over and over. ~Dr Cyr #SASpine
