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  • dotari
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    Dr. Corenman,

    I am grateful to have found your forum. 14 years ago as a National Product Mgr w/ a fortune 25 company, I was diagnosed w/ Chiari which was highly symptomatic. I have always been a motivated, productive and fitness oriented person. I had a decompression w/ large craniotomy which looks good on MRI in 1998 meaning the Chiari part. I have had severe muscle pain, neck pain and occipital neuralgia since the surgery but could initially do light activities, volunteer, etc. However, 8 years ago, I had a herniated disc and I have been plagued by severe disabling pain ever since.
    My husband and I have done everything possible to keep moving forward despite tremendous disabling neck pain and now radiculopathy of right arm which actually improved 8 years ago after the EMG/nerve test but the neck pain by c5/6 did not. (I believe my old MRIs also had a c6/7 herniation which seems to have resolved itself) I have literally done every therapy available some with complications and most providing temporary relief at best. The therapies I have tried include acupuncture, massage, PT, purchasing a swimming pool /a $3000 pilates machine as I am dizzy as well so I can keep legs strong, formal aqua therapy, trigger points, botox injection, Epidural Steroid injection, many medications, high dose prednisone and care at one of the best Headache centers in the country due to the pain/occipital neuralgia and chronic migraine.
    I have been unable to work or ever do the activities I enjoy. I have been so afraid of any further surgeries since the Chiari surgery. I have had periods of relative stability, however, they never include things like going to the grocery store as I cannot load and unload and put away groceries without being highly symptomatic. Just doing personal daily care is a true struggle. We have tried to be satisfied that I am here and have a beautiful 19 year old daughter in college. I did fall one year ago and broke my foot from imbalance.
    This summer things have gone from severely limited and in pain (hard to aqua job w/ arms weights as arms / wrist weak) to unable to do anything without excruciated neck pain and the right shoulder and arm, hand are now involved including pain in deltoid shoulder and weakness. The neck pain is so bad that I have to talk myself into getting into a daily shower and the arm pain is very bothersome. I had a new MRI in August which reveals foraminal cervical stenosis indenting the thecal sac from a posterior right osteophyte complex. I also think I did something after the MRI as about 2 weeks after, the pain is so searing that we are contemplating what to do. I haven’t had a surgery consult since 2004 when I was told since the arm pain improved I was not a candidate and there was only herniated disc at the time no stenoisis and not much in the way of minimally invasive here in Upstate NY and they advised against a fusion due to risks, etc.
    My primary gave me a cortisone shot a few weeks ago and no relief and my neurologist is recommending traction for which I am scheduled for next week. I know there are no easy answers but am wondering because I already have a craniotomy or plate if I am even a candidate for any kind of neck surgery. I read through your boards but do not know if the stenosis is from the facet or uncovertebral joint. I am used to having limited my life to avoid pain but I see so many people from dancers to football players keep moving I keep thinking maybe just maybe there is something out there to help relieve the pain and help me increase my participation in life. I feel I have so much to give and am only 50 years old and I would love not to center my entire life around what I cannot do. Grateful for any advice.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8468

    For those who do not know, a Chiari malformation is a condition where the base of the brain “settles” and a portion of the brain protrudes through the foramen magnum, the large hole at the base of the skull. This crowding of the brainstem causes compression and symptoms that are difficult to live with.

    The treatment is to enlarge the hole and decompress the brain stem. This typically involves removal of a portion of the first vertebra and occasional fusion of the upper vertebra.

    You apparently did reasonably well after this decompression but note a herniated disc some years after the Chiari decompression.

    Your current symptoms could be from foraminal stenosis, a disc hernation, some advancement of the Chiari malformation or cervical stenosis. You do need a new MRI, CT scan and a consult with a spine surgeon who specializes in base of the skull surgery. You can call my 888 number and talk to Margaret for a recommendation of which surgeons might be able to help you (I do not perform Chiari surgery).

    Dr. Corenman

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