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  • mnjody
    Participant
    Post count: 19

    I had two ACDF procedures in December of 2019. First one was c6-T2, second was 4 days later to address c5-6 (orginal surgery was off one level). I have been to PT, currently taking Lyrica for nerve pain. I have shoulder pain, but the thing that is most concerning to me is a burning stabbing pain in the mid line of my lower neck, between shoulder blades – probably a little higher. This pain feels like someone is taking a screwdriver and stabbing me repeatedly. I am going to pain management – he tried trigger point injections and a occipical nerve block for my headaches. My headaches did get better for almost a week, but now have returned, it didn’t help with that midline pain. I have some numbness and still the shooting pain in my left arm – which I have come down to dealing with. The pain in my midline neck is so bad, it affects everything I do.

    My most recent visit to my surgeon, he mentioned it may still be healing, or facet joints, and maybe even fibromyalgia. Pain Dr is going to try thoracic facet joint injections (t2-4?), thinking it may be the facet joints below the 4-level fusion causing this horrible pain.

    I did get xrays done at 7 months, and all three of them looked good surgeon said. No other imaging done.

    Any suggestions or ideas of what this is? Or any pain relief that you have come across with your patients that could help me?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    The first situation I think about in this circumstance is a non-union (lack of fusion) at one or more levels. The second is adjacent segment degeneration (problems with the non-surgical levels). It is unlikely to be upper thoracic facet or disc generated pain. The first test I would consider (after flexion-extension X-rays and a thorough physical examination) should be a CT scan (1mm fine cut) to look for fusion status.

    Dr. Corenman

    mnjody
    Participant
    Post count: 19

    So do I ask the surgeon to do this? I feel like I’m insulting his intelligence by bringing these issues up, since he clearly has not. I do need to find answers soon though.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    If you gently ask him if a pseudoarthrosis (lack of fusion) could be one of the reasons you have “stalled” in your recovery, then he might be amenable to a CT scan. Maybe, tell him you heard it here but remember that some surgeons don’t want outside opinions and might be somewhat negative on this line of questioning. You can always get a second opinion if you choose.

    Dr. Corenman

    mnjody
    Participant
    Post count: 19

    Thank you, I will need to build up my courage!

    Have a great night!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    Please keep us informed.

    Dr. Corenman

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