Having myelopathy goes hand-in-hand with central spinal stenosis. The fact that you woke up with new onset arm pain might fit with your remaining foraminal stenosis (“results in moderate spinal canal stenosis. Uncovertebral joint hypertrophy contributes to severe left greater than right neuroforaminal stenosis”). Why after an ACDF, your nerve root would be more painful than before could be from root manipulation due to surgery but this is unusual.
You can address all these problems from a posterior approach (posterior central and foraminal decompression with a posterior fusion) but this does not address the problem as well as a revision anterior approach and revision ACDF or even a front and back approach (360).
The nerve root compression is causes by enlargement of an anterior structure (the uncovertebral joint) and the canal compromise is usually caused by an anterior spur so it makes sense to address this at least from the front of the spine. Excision of the graft that did not heal (pseudoarthrosis) can also be addressed from the front.
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.
