7 months Posst ACDF c4-c7 Pain continues

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  • bethalbrec
    Participant
    Post count: 5
    #25538 |

    Hi. Well as the subject states I remain in pain since surgery. The Arms and shoulders burn, I have shooting pain down one of the two arms. Occasional finger ringing/numbness, and the most excruciating neck pain bilaterally down the side of my neck. My arms are heavy, and I can’t lift them to brush my hair, shop etc. Driving can also be a problem, and i have a weak grip in both hands. I was DX 4 months out of surgery with RSRM and my surgeon and pain doccor both thin that is the cause of my pain. My Neurologisst does not. I have since sought a second opinion of a neurosurgeon who has been working to peel the opinion away with me on this diilitating pain, that has me bedridden by 3:00 most days. This new neurosurgeon as been amazing, Ordering all sorts of X-rays and tests including a Scoleosis series and a new ENG (the surgeon who did my ACDF never did this). Turns out I have C5 C 6 nerve damage and two cervical ribs (one long left, and one short right). He now thinks I may be dealing with TOS – thoracic outlet syndrome. I also tested positive for Adsons, and he ordered a TOS MRI, which I am waiting the results of. My questions to you are: 1. If this is TOS, is it possible that my ACDF and Corpectomy created Trauma and caused the TOS to get worse? 2. With a 3 level fusion would they still be able remove the cervical Ribs/cause of the TOS without causing more issues. 3. Why wouldn’t my surgeon have seen these ribs on all the X-rays/marks he did before he had me gothough a 3 level fusion?

    My new doctor is amazing, and not looking to do surgery on me, just help me. He said depending on my MRI he will be sending me to a Thoracic surgeon at UCLA. Nice to have someone who really cares. My other surgeon just basically tells me I am fine, I have fused, and the pain is MS. Would love your thoughts.

    Dr. Corenman
    Moderator
    Post count: 5539

    I was thinking of thoracic outlet syndrome after your first four sentences however, since your surgery made the symptoms worse, I would think there might be some connection with the ACDF surgery too. I assume you had a CT scan and new MRI looking for fusion status and continued nerve compression and that these tests were negative.

    Thoracic outlet syndrome has certain symptoms that would lead to this diagnosis. See https://neckandback.com/conditions/thoracic-outlet-syndrome/.

    Having cervical ribs increases the likelihood of thoracic outlet syndrome. Only when compression is bad will you see EMG findings but it sounds like you have a significant case.

    I’m glad you found a good surgeon as this individual was exactly who you needed.

    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.
    If this forum has helped you, please let Dr. Corenman know!

    bethalbrec
    Participant
    Post count: 5

    Hi. Thanks for your quick response. The Mra showed I had arterial compression and two different neurosurgeons confirmed the TOS diagnosis. Here is my question. One referred me to a vascular surgeon who doesn’t seem to specialize in TOS but works at USC. The other referred me to a cardio-thoracic physician team that specializes in Thoracic outlet syndrome and works with sanford on training their fellows. Vascular vs thoracic. How do I choose?

    Ps. I saw the thoracic yesterday. Confirmed my case as open and shut bilateral tos requiring a minimally invasive cervical and possibly first rib resection.

    Dr. Corenman
    Moderator
    Post count: 5539

    Experience is what you need. Training programs however are a mixed bag. Even though the experience is there, you don’t necessarily want to be under surgery by a chief resident and not the attending surgeon. If this experienced surgeon will state he will be the primary surgeon and the assistant will be the chef resident, you should do OK.

    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.
    If this forum has helped you, please let Dr. Corenman know!

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