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  • shipper
    Participant
    Post count: 2

    I had a laminectomy at c3-4 and c4-5 about 1.5 years ago. Six months ago I started noticing a clicking or popping noise when I turned my head or looked up. A couple of months later I began having a tingling on the left side of my face which has worsened to numbness and tingling on both sides and back of my head with some tingling down both arms to the top of both hands. Is it reasonable to suspect new problems at c1-2-3 or is it more likely that the pins and screws of the laminectomy are causing the problem. I get some relief wearing a soft collar and using Naproxen Sodium at the max dosage. I had Phrenic nerve damage resulting in a disabled diaphragm so I have no motivation to return to my Neurosurgeon which limits my options for advice. Thank you for sponsoring this forum and any comments you might make.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    First, you did not only have a laminectomy but had a laminectomy and fusion. Using “pins and screws” means you had a fusion along with the laminectomy. “Hardware” is used to immobilize the vertebra to allow for a fusion. I assume you had cervical stenosis (narrowing of the spinal canal causing cord compression) along with instability which led to your initial surgery.

    Your current symptoms could be do to cervical instability at the levels above or below, cervical degenerative spondylolisthesis (facet disease causes “popping and clicking”) or a pseudoarthrosis (lack of fusion) of the previous surgery.

    You need a consultation with an experienced spine surgeon to determine what your current symptoms are due to. I am sorry to hear your initial surgery caused phrenic nerve injury (reduced diaphragm strength and difficulty breathing due to lack of connection between the diaphragm and the brain).

    Could you please give us a small history of your phrenic nerve injury and how you have compensated for this injury?

    Thank You

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    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.
    shipper
    Participant
    Post count: 2

    I noticed shortness of breath immediately after the surgery, but it was 3 months before my pulmonary physician ordered an x-ray with sniff. I use an Advair Diskus and have learned how to lay in bed at night which was my most difficult position. I am 75 and, although in reasonable condition, not extremely active so I’ve learned to adjust to my shortened breathing. About 15 years ago I had a cervical fusion at c5-6 and c6-7 with cadaver bone and a plate (because it was an old injury) and 6 screws. I now have 12 screws, a plate and some pins which will probably hinder me from boarding an airplane. I’m beginning to feel like an old car that’s been wired together to keep running-I’m a good example of your CNS type of patient.

    I have wondered if my earlier fusion with the plate caused my problems above c5,and if my laminectomy caused this recent tingling problem which I suspect is above c3. Yes, I do have cervical stenosis, but I had assumed that the screws and pins were to spread the vertebra to relieve the stenosis. I knew that I had had two posterior fusions, but didn’t associate all the hardware to the fusions. My earlier fusions were anterior which I assume must be an entirely different procedure.

    I don’t know how to approach this latest problem because more surgery might put me on a ventilator for the rest of my time on earth. Would you feel that an anterior surgery would be less likely to cause Phrenic nerve damage, which could effect my remaining working diaphragm, if my problem is now at the c2-3 level?

    I have made an appointment with a Neurosurgeon in another area, but it seems most doctors don’t want to get involved with someone else’s work. It seems it’s all a crap shoot to find the right doctor, but I guess that’s true of most of life’s situations.

    PS: I did purchase and use an expensive neck device that was supposed to aid in bone fusion during recovery. It reminded me of the voodoo gimmicks on TV, but perhaps I’m just being cynical. ;)

    Thanks again for any further comments!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Fusion below can increase stress on levels above but generally, there is little motion of the surgical levels so the difference is much smaller.

    You still continue with issues. I will assume that the levels at C3-5 are fused posteriorly (but that is a dangerous assumption). If C2-3 is causing difficulty, it can be addressed from the front (an ACDF-generally a safe surgery). You must first make sure that this level is causing you enough symptoms to require surgery. This can generally be done with a TFESI (see website) and a pain diary. I would make sure that these symptoms are not generated by the levels below.

    It seems you have adapted to the phrenic nerve injury. Sleeping is more difficult as the lungs when you sit up are “stretched” by gravity making them more compliant (easier to fill up). When you lie down, gravity is not as helpful and there is more work required to expand the lungs (breathe).

    Good luck.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    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.
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