-
AuthorPosts
-
I Had neck pain for 10+ years. I have done Chiropractic care, etc. I am 30 years old.
August 2013 – Had MRI & X-Ray done. Had herniated disc and bulged disc at another level that was compressing a nerve. My problem was mostly my neck pain. I had some weakness in my left arm but it did not bother me that much. I did drop a few trays things like that but my main concern was to get out of neck pain. Had two different surgeons recommended an ACDF. I did not do any conservative treatment before surgery. They both said would only be temporary. Wish I had tried conservative treatment.
September 20, 2013 – Had ACDF surgery C4-C6 by Dr. X at the South Eastern Spine Institute.
November 10, 2013 – Started PT. After PT session developed excruciating pain in scapula area down arm. Had nerve root block which helped.
January 2014 – Doing well for 2 months since nerve block. Banged my head & neck hard from fall. Neck hurt deep in my neck. Neck stiff.
February 2014 – Had nerve root block epidural injection for pain. Helped a lot. Left arm strength was stronger but got to a point where no improvement could be made. My arm strength stayed at a certain level. I was still in a lot of pain. I had EMG test done. EMG test reported no problems
May – June 2014 – Still in a lot of pain. Had epidural injections C5 & C6. They did not help much. Still weak in left arm.
June 23, 2014 – I was concerned that I may have pseudarthrosis because my pain was not getting any better. Dr. X ordered me a CT scan. Based on the CT scan he said that my neck was not completely fused but was in the process of fusing and that it sometimes takes longer for some people. On my CT scan report it says There is reversal of the normal lordosis. There is an anterior fusion with screws and with discectomies at C4-C5 and C5-C6. There is no compression fracture. There is no jumped facet. There is normal height and alignment from C1-C7. There is no obvious epidural mass. There are artifacts from the hardware. There is no abnormality C2-C3 or C3-C4. At C4-C5 there is a left paracentral osteophyte, canal stenosis and a moderate left foraminal stenosis. The right foramen is slightly narrowed. C5-C6 there is a small osteophyte. There is mild left foraminal stenosis. The right foramen is patent. At C6-C7 there is no abnormality. At C7-T1 there is no abnormality. I am concerned that those bone spurs may be causing problems.
September 5, 2014 – Had Facet Joint Injections above and below surgery levels and on both sides. These injections seem to help the most for my pain. It made my neck very stiff and I seem to hurt bad for two weeks after injection. But after that it helped a lot. I still had this deep ache in my neck that does not ever ease off. The September 5 facet joint injection lasted about 1.5 months. My pain was slowly getting worse after 1.5 months.
December 15, 2014 – I was in excruciating pain. The pain had been getting worse and worse up to this point. I could not sit up or stand without being in awful pain. The pain was shooting down my left arm to about my elbow. The only little relief I could get is if I pressed on a point in my neck or shoulder and I had to lie down. I rushed down to the SSI to be seen and have another facet joint injection. It seem to ease off my shooting arm pain and eased my neck pain on the left side. But for days after my right side of my neck was in much pain where it hadn’t been before.
Currently as of Today – My pain seems to be better since the December 15 facet joint injection. I would give my pain a 5 on a scale from 1-10. There still is a deep ache in my neck. I am in 24/7 pain. I can’t sit on hard surfaces very long or it increases my pain. I can not ride in a car very long or it increases my pain. I can’t do much activity with out it increasing my pain. My left arm weakness has gotten worse and worse. It feels like I have dead weight for an arm. I can not lift more than 3 lbs. I am really concerned about my arm weakness. I’m concerned there may be a bone spur pressing on a nerve somewhere. It has been 1year and 6mths since my surgery and I am no better. My pain is much worse since my surgery. I would not have had the surgery if I knew the outcome would have been this. Shouldn’t I be fused by now? What do you think is the root of my pain and arm weakness? I think there is something wrong in my neck. HELP! Thank you so much for your time!
To summarize, you had nerve compression and underwent an ACDF of C4-6. You don’t report arm weakness prior to the surgery. Can I assume that this weakness was present prior to the surgery and then improved after surgery but did not fully recover? Can I assume this pain and weakness was primarily in the left arm?
You started PT three weeks after your surgery. This is a somewhat unusual order as the grafts have not “set up” at this point. Could the PT have performed range of motion exercises that then could have caused graft migration? There is no comment regarding this possibility.
Was there any discussion by your surgeon about this possibility? Was this pain the same pain that occurred prior to your surgery or was it in a different location?
Arm strength still lessened post-surgery but an EMG was normal-this does not make sense. See the section on EMG/NCV to understand how an EMG works. There could have been misinterpretation of this test.
Almost a year after the fusion, a CT scan was ordered and the surgeon states that “my neck was not completely fused but was in the process of fusing”. After a year of recovery, the neck should be fused and I would have you get another opinion as it is unlikely that your neck will go on to fuse at this level.
Also remember that a CT scan will indicate bone involvement but not nerve compression from a herniated disc or cartilage (the so-called “soft disc”) involvement.
You need another opinion from a spine surgeon who will take the time to evaluate you and give you some valid answers.
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.Yes, pain and weakness is primarily in left arm. My arm weakness has gotten worse after surgery. I had no arm pain prior to surgery just weakness only and a lot of neck pain. I was wrong on the dates that I told you before about when I started PT. I started PT 3 months after surgery. I had left arm pain after I started physical therapy. My arm weakness has gotten worse since surgery. My bicep muscle is highly affected post surgery and this is where most of my weakness is. I currently cannot curl more than 3 lbs. Starting 2 weeks ago, weakness in my left arm and hand has majorly concerned me because it is getting worse to the point of dropping things out of my hand. The pain in my neck is debilitating without the facet joint injections.
Yes, my pain is different since surgery. I had no pain in my arm prior to surgery. My neck pain post surgery is slightly different. I have the same pain as before and have pain that is more extreme in my neck. It feels to be a deeper pain, throbbing & shooting pain. In my neck it feels like a broken bone or an extreme migraine headache while having a taser gun shooting in my left arm. Do you think I have a failed fusion? Do you think I have something compressing a nerve or are my problems facet joint related? What in your opinion is the source of my issues?
Thank you so much Dr. Corenman for your time!
-
AuthorPosts
- You must be logged in to reply to this topic.