Had Cervical Radiculopathy For 9 Years, Will Surgery Still Help?

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NPainSufferer
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September 9, 2014 at 11:51 pm

Post count: 4

#11406

Hi All,
As you can tell I’m new to the forum. Gee whiz I don’t know where to start.. I guess I’ll state my injury first and foremost:

I’m 31 years old but since I was 22 I had disc degeneration/disc bulges in both the C3-C4 and C4-C5 areas along with narrowing in both spaces etc etc…And this leads to my left trapezius muscle in constant spasms..jaw pain along with pain down my left arm and hand. (More details on my sob backstory after the main question)

My main question is I’ve done a lot of research and surgery has a high success rate of relieving those suffering from Cervical Radiculopathy. BUT I heard that since it’s been so long it might not help…
I was wondering what are the facts on this and if there’s any truth to it? has it been too long for hope of full recovery? Or time isn’t a factor?
(Because I would think once the pressure is taken off from pinching / irritating the nerve the pain will stop..unless there’s some things about prolonged nerve irritation I don’t know about.)
Every doctor / PT / Chiropractor I talked to said ‘I have to learn how to live with the pain’..eff that! I was hoping someone can shed some light on this question as I’m at my wits end and will do anything to fix the pain! And I’m praying that just because it’s been so long there’s still HOPE of living a pain free life…Thanks in advance!

(P.S. I’m living in Thailand now and I have dual citizenship from the U.S. and Thailand so I’m under Thailand’s Universal Healthcare which covers surgeries)

Backstory:
The reason why it’s been 9 years with no recovery is because I have the worst luck with doctors,I always seem to encounter INCOMPETENT doctors that kept misdiagnosing me and it took a physical therapist to FINALLY find the root cause after 4 years of agony and frustration of doctors that were incompetent or just didn’t care. Of course people thought I was just making this up to get pity or something (Um, yeah I want to be in a life of neverending pain, sounds hunky dory!)
I’m not sure how the injury happened in 2005 but when it did of course it hurt like ****!…Even when I was finally seeing a ‘Spine Specialist’ in 2009 they were just milking the system and after a year of just getting pain meds, nothing. I read reviews of the clinic and a lot of people had the same nightmarish experiences; 2 hour wait for 5 minutes of ‘face’ time. And in the end the head doctor said ‘there’s nothing wrong’ even though the MRI and my pain says otherwise…

Symptoms:
Pain going from my neck down my left trapezius down my left arm and hand. The left trapezius has constant spasms that NEVER go away..one very painful spasm the size of a golfball between the neck and shoulder and I tried everything: (massage,PT,chiropractor,acupuncture,cortisone shots, epidural steroid injection etc..I don’t know WHY surgery was never brought up) and all of the typical areas hurt: jaw, parts of head, etc. The pinched nerves have also sped up my metabolism which makes it hard for me to gain weight. I used to be athletic and built but now I’m seriously underweight. I saw this one chart where it showed that one area can lead to weight loss which is what I’m experiencing. Not to mention all the other unpleasantness that comes with pinched nerves.

Donald Corenman, MD, DC
Moderator

September 14, 2014 at 5:08 am

Post count: 8660

#11418

There is some truth to longevity of pain due to nerve compression being more difficult to treat but the percentages are not too high. I have had patients with 3-4 years of nerve pain have improvement with surgery. It really depends upon the amount of damage and potential healing of the damaged nerve. Motor strength defect is the most important condition to address surgically in the least amount of time.

You do not have to live in pain if you are a surgical candidate. That means a work-up needs to be completed to determine if you are a candidate. This might be as simple as a history, physical examination and evaluation of images. Work-up might also include nerve blocks, facet blocks or even discograms (see website).

See the section regarding “symptoms of cervical nerve injuries” to understand what nerves go to what areas and the symptoms these compressed nerve manifest.

Keep us posted.

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.

NPainSufferer
Member

October 17, 2014 at 11:55 pm

Post count: 4

#11551

moved to below

NPainSufferer
Member

October 18, 2014 at 1:04 am

Post count: 4

#11552

Thank you for the reply Dr. Corenman! Sorry for my late reply. Thank you for the ray of hope. I’ve done tons of research on cervical radicualopathy. I’m scheduled for a new MRI/check up with blood work on Nov 12 and then speaking to a surgeon or specialist on Nov 20. I sure hope I’ll be a candidate for surgery and have my quality of life improve greatly!

Despite all my research I do have several questions…(Sorry for the length, I’m just trying to be as accurate and clear as possible)

First off, how do I share pictures? I can’t share links that have pictures that show all the areas that hurt which would be much easier..but I digress.

1) I was wondering if it’s possible for spasms to make noise? If I move my affected area in certain ways I can feel popping from my trapezius down my arm (especially the elbow which pops). When I put my hand over spasms and tender areas I can feel popping,although when I press on them they don’t pop. Physical therapists and one doctor have said the noise was coming from muscles that have tightened up and in spasm caused by a compressed nerve in C5/C6.
The space b/w my neck and shoulder is the most tender area and has a stretch of spasms that go down my upper back a few inches. There’s plenty of pictures that show tender/trigger points when certain discs are affected which I wanted to share. So I hope you know what I’m talking about.It feels like someone is stabbing me with an ice pick at the top of the spasms b/w the neck and shoulder. And it feels like the entire left trapezius is in spasms.
Although when I lay on a tennis ball and put it on the bottom of my trapezius right under the bottom of the scapula the spasms loosen up and no loud noises occur..I wonder what’s going on there? It seems as if I got trigger points and I’ve had many trigger point injections to no relief. Right now I’m also really confused on trigger points..Can having Cervical Radiculapthy cause trigger points or are they a whole different thing? When I search for “cervical radiculopathy” and “trapezius spasms’ the pictures that show my area of pain come from myofascial trigger point websites..oh I’m so confused!! I wish I was back in the states so I could ask a spine
Dr..
In conclusion, I bring this up because…
Since these areas are where the spasms,tightness,and pain are.. I hear popping and crackling noises all over these areas from top to bottom. Can big tight spasms make these popping and crackling noises?

Because I just stumbled upon “snapping scapula” / Scapulothoracic crepitus-bursitis (which I read can be confused for cervical Radiculopathy) and I’m the paranoid type…because the areas I told you about are around the scapula and trapezius and I saw a video of someone who had snapping scapula and it made me scared that I might have that although none of my physicians of any kind brought it up.
And as I said, knowledgeable physical therapists and an old dr have said all the pain, popping and crackling are from the spasms on the upper left portion and is coming from cervical radicuopathy…but some reassurance would be nice..How do you tell the the difference between the two?
(I’m asking here because I’m in Thailand and sometimes there’s a language barrier even though I can speak Thai)

2) I forgot to mention that I had 2 MRIs done but they had different results
(All results said there was mild to moderate narrowing, nothing about disc bulges and I heard sometimes a little compression can cause a lot of pain and other people may have full on disc herniations but not feel anything)

When I had one done in the U.S. it showed nerve compression in 2 areas : C3/C4 and C5/C6 but when I did one out here in Thailand it only showed C5/C6, I looked online and found different answers and was wondering what’s your take? because I do feel tightness in my neck, behind the ear and jaw area.

(BTW: I read your page on ‘When to Have Surgery’ and although my MRI’s both said mild to moderate narrowing I’ve heard from a good therapist and your page confirms that even though there’s only slight compression (not a herniation or disc protrustion) it can still cause a lot of pain since the nerve is sensitive which seems to be my case..I mean I go through periods where I just get tired and can’t take the pain anymore despite medication and I find regular tasks hard to do and just stay in bed.. which is WHY I want this to be gone for good!)

Thank you for directing me to see what nerves go where..believe me I’ve done a lot of research and I’ve been coming up with different results and pictures but the majority tend to say the same thing but I wanted to hear from you Doctor and others…

Thanks!
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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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