7Weeks Post-op 3 level ACDF - severe neck pain, arm weakness

Tagged: Pain after a three level ACDF

Viewing 6 posts - 1 through 6 (of 6 total)

Author

Posts
bethalbrec
Participant

January 11, 2017 at 5:49 pm

Post count: 5

#24102

HI Dr. Corenman,

First of all let me start by saying you did fantastic job on your website. As a a marketing person in the health insurance world, I appreciate a site that is organized well and provides just the right amount of information. I know a few doctors who can take a lesson or two from the work you have done here!

That aside, here is my story/question.

1. Surgery C4-C7 November 21st after 2 years of unrelenting neck, shoulder & arm pain/weakness (significant loss of ability to hold things in left hand). I had 3 herniated discs, and severe stenosis, degenerative, not caused by an accident, and slight scoliosis. (Besides low back and neck issues, a benign thyroid nodule, and vitaman D, B 12 deficiency – which I am taking supplements for – I am an otherwise healthy, petite 49 year old with a family history of back issues)

2. In surgery for 2 hours, in hospital 4 days. Was told there was significant work done to remove the bone spurs. Aspen collar for 6 weeks, then soft collar (which I am currently wearing. Bone simulator 30 nin/day

3. Some initial relief from arm pain and weakness, and started to turn a corner with neck/shoulder pain when fainted and fell in the shower at 2 weeks post op. I feel on my neck shoulder. CT Scan and xray revealed all instrumentation in tact….and perhaps soft tissue damage (the pain went through the roof).

4. 3 weeks post op visit, MRI revealed only mild stenosis remaining..and nothing else (my doctor uses his own mri company so while I want to trust him, i hope he is not filtering the results in the report). Pain was still bad — told me to continue muscle relaxers and pain meds.

5. Went back to work from home last week full time. Arm and neck burning became excruciating — doctor felt from over use and put me on a 6 day steroid pack. That helped with the burn. But neck shoulder pain is still awful. In fact, by 2 in the afternoon I literally feel like I am being strangled around the neck – muscle spasms? Doctor is puzzled. I am off pain meds except at night to help sleep. And during the day I take Soma — but it doesn’t seem to help. Heat doesn’t help, but Ice does for a little while. My arms (bilateral) are excessively weak by 3 or 4…and I just end up spending the rest of my day working from my bed, or not working at all.

Could this be an early sign of fusion troubles? My doctor seems to be throwing up his hands…although he feels bad for me…he just doesn’t seem to know what is going on. I am an executive and professionally I can’t afford to stay in the state. Any isnights you have would be much appreciated.

Donald Corenman, MD, DC
Moderator

January 14, 2017 at 8:03 pm

Post count: 8660

#24116

Thanks for the compliments.

I must say that your surgeon has speedy fingers! A three level fusion would take me 3-3 1/2 hours (if I used autograft). I also would feel better if your surgeon showed you the films (as I always do). You could request and read the radiological report as a radiologist is required to read these films.

You can also request the CT scan report as it will also be read and the radiologist will comment on remaining foraminal stenosis.

It is possible that you have chronic radiculopathy, Parsonage Turner Syndrome or some other brachial plexopathy but more likely than not, there is some trouble with your surgery. Review your films and reports. A second opinion will not hurt.

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.

bethalbrec
Participant

February 2, 2017 at 6:00 pm

Post count: 5

#24263

Thank you for this. Interestingly, I just got the surgeon’s report – (from my Pain Mgmt Doctor). Coming out of surgery he told me he did some major work. What I didn’t realize is how “major” he really meant until seeing the report. In addition to my 3 level ACDF he did a 3 level bilateral foraminotomy and a 3 level partial (50%) corpectomy. Maybe I am making to much out of this, but the strikes as really excessive. Could that be why I am having such a hard recovery? Is this normal?

Donald Corenman, MD, DC
Moderator

February 5, 2017 at 8:33 am

Post count: 8660

#24277

His full surgical time becomes even more impressive if he did a three level partial corpectomy! I am unclear why you needed a partial corpectomy (partial removal of the entire vertebral body) as I need to do this only about once every 40 ACDFs. Every ACDF should include bilateral foraminotomies so that does not add to the surgical complexities.

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.

bethalbrec
Participant

May 7, 2017 at 8:17 am

Post count: 5

#24740

Hi — according to the surgery report, i had signficant bone spurs he had to remove, and used some of the materials as an autograft (in combination witht he allograft). That said, 6 weeks ago I landed back in the hospital with left side facial numbness and burning. (this was in addition to continued left side shoulder and arm burning from the surgery, and arm/hand numbness). Bottom line, they diagnosed me with MS, something my neurologist suspected 2 years, but there wasn’t enough evidence to diagnose. Now I am almost 6 months post op, in excrutiating neck, shoulder and arm pain (which now is starting on the right side too) – but my spinal surgion refuses to believe it has anything to do with the extensive surgery he did on my neck. I am not completely fused, but he said “the spaces have filled in nicely”. He believes it is all the MS. My Neurologist on the other hand, says he doesn’t agree. He thinks some of my pain, neuropathy etc are coming from the spine/spine surgery. How do I reconcile the source of the issues? My MS is the Relapsing – Remitting form. Should I get a second opinion from a Spine surgeon. This pain has started to interfere with my ability to perform my job and my social life and marriage. I can’t lift my arms to type for more than 2 hours. And by 1 in the afternoon, I am desperate to lay down and support my neck/arms with pillows. I am on lyrica during the day, and only take percocet at night after work to calm the pain down….but I am not sure how much longer I can last this way. Appreciate your advice.

Donald Corenman, MD, DC
Moderator

May 7, 2017 at 9:48 am

Post count: 8660

#24741

This is not hard to figure out. If you have remaining pain after surgery and it appears to be radiculopathy, you can simply undergo a SNRB (selective nerve root block) of the nerve or nerves suspected of radiculopathy pain. If you get no or minimal relief, it is probably MS. If you get substantial temporary relief (see pain diary), then this is radiculopathy.

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.
Author

Posts

Viewing 6 posts - 1 through 6 (of 6 total)

You must be logged in to reply to this topic.

Donald Corenman, MD, DC

Average rating:

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.

Submit your review
First Name, Last Initial:
Email:
Review Title:
Rating:	1 2 3 4 5
Review:

Check this box to confirm you are human.
Submit Cancel

7Weeks Post-op 3 level ACDF – severe neck pain, arm weakness