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  • jeo913
    Member
    Post count: 2

    I am a 41 female. I have had chronic neck pain for over 10 years. About 4 years ago my symptoms expaned down into my right arm. Deltoid weakness, muscle twitching in my forearm and having a tendency to drop things. The pain in my neck drives me crazy. I had the hemilaminectomy done in June of 2010 at the Mayo Clinic. After a lengthy recover, I am now experiencing the same symptoms again that I did prior to surgery. I believe the muscle twitching is worse and the neck pain is as bad or worse. At the same time, I have had chronic low back pain and this continues to worsen. If I carry an object over 10 lbs I experience weakness and warmth in my legs. I feel as though my legs will give out. I also have occassional “shock” feelings in my low back as well.
    I have been told that I have disc degeneration and that there’s nothing they can do. My daily life is becoming unbearable.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    Unfortunately, this appears to be a recurring theme this week.

    You more likely than not had foraminal stenosis of the C4-5 level. This is caused by a spur of the uncovertebral joint, the bony projection that forms the front of the tunnel that the cervical nerve exits from. It is quite common for this joint to develop a mushroom shaped spur and this spur will crowd out the nerve and cause nerve compression. Also, the disc itself collapses with these degenerative changes. The collapse causes further narrowing of the foramen (the nerve exit hole). The totality of narrowing compresses the nerve and causes pain, numbness, paresthesias (pins and needles) and weakness.

    The hemilaminectomy you underwent is also called a posterior foraminotomy. You will find much information on this website regarding this procedure including a surgical video if you are so inclined. This is a good procedure for certain disorders but has less success with bone spur compression.

    The problem with this procedure is that it is performed in the rear of the spine and the bone spur originates from the front of the spine. Removing this spur from the posterior approach is very difficult and requires nerve root manipulation. This manipulation can cause either increased nerve symptoms after surgery or can result in an incomplete decompression of the nerve and continued symptoms.

    Also, the hemilaminectomy does nothing to help relieve neck pain. It is strictly a surgery to relieve compression of the nerve. Continued neck pain is expected from this surgery.

    Muscle twitching can have many different sources but one is from denervation. When the muscle is disconnected from the nerve (such as by nerve compression), the muscle will start “twitching”.

    The chronic lower back pain is not directly related to your neck pain (except by the genetics of your degenerative disc disorder).

    You need another consultation by a thorough spine surgeon to give you the appropriate diagnosis and treatment program.

    Dr. Corenman

    jeo913
    Member
    Post count: 2

    I am planning to schedule an appointment very soon, as symptoms continue to increase. Is this something that most likely will require more surgery?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    This is hard to judge over the internet but if what I noted is true, surgery might still be in your future. You need to have a thorough evaluation and imaging to know that answer.

    Dr. Corenman

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