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Hello Dr. Corenman:
When you mention “forward flexion”/ kyphosis are you referring to the cervical spine bending forward (anteriorly) in an exaggeration of the normal lordosis curve?
My x ray had shown just the opposite, whereby the cervical spine was curved backwards (posteriorly)
in what was referred to in patient notes as an “erosion of the normal lordosis curve” as opposed to an exaggeration of it. The physical therapists gave me exercises to get my neck to bend backwards to reverse the erosion and thereby get my cervical spine to bend forward again. I’ve made progress with this as I can now drink from a glass or jug with my head extending back and can stand with normal posture, the head level.
I was told at the time of surgery that I was born with a tight canal and had disc degeneration, but I never had any issues with arm/hand strength and/or numbness before the accident.
According to what I read, if the canal was compromised/narrowed due to degenerative changes (bone spurs) and/or was too narrow congenitally, such that swelling from the accident would cause cause secondary damage, that would call for the laminectomy of the C3-C6; but the procedure would need to be done within 24hrs. of the injury to have any benefit. I wasn’t treated until 4 days later thus it seems logical that the C3-C6 laminectomy wouldn’t have been done, but only a removal of the broken spinous process fragments of C3-C6. Again, the only real indicated laminectomy would have been at C7 as it had the bilateral fracture of the lamina and the C1 and C2 fusion as the pivot bone was shattered.
If any lamina work was needed for C3-C6 it would best be a laminoplasty not laminectomy, which I read is best to avoid kyphosis. I hope they didn’t do a C3=C6 laminectomy as it wouldn’t have achieve anything given when it was performed in relation to the time of the accident and would cause kyphosis.
I hope this clarifies things as much as we can without more imaging and thanks for your info. It’s much valued.
Best Regards, Steve T.Lordosis is a backwards curve of the neck and kyphosis is the loss of the normal curve. It is extremely rare to have a hyperlordotic curve and especially rare if you have had a laminectomy. The spinous processes and the inter/supraspinous ligaments are gone and these structures act as a tension band (tether) to prevent forward movement.Your statement “the physical therapists gave me exercises to get my neck to bend backwards” is exactly what is needed with a kyphotic neck.
Removing the “broken spinous processes” makes no sense to me if there was no other injury to the spinal canal. To remove a posterior tether without need makes the neck more susceptible to “falling forward” (kyphosis). These spinous processes could eventually heal or at least develop a fibrous union which would help keep the tether effect.
A laminoplasty to enlarge the canal is generally not performed in a trauma situation.
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.Hello Dr. Corenman:
Thanks again!
Just so we have this right, when you say lordosis is the “backward curve”, post surgically my head was abnormally tilted downward and forward with the cervical spine itself bent backwards. What is normal is the head level with the cervical spine bowed forward. The latter is what I have better achieved with exercises.
Does this sound like I had kyphosis?
Would anyone perform laminectomy to enlarge the canal in a trauma situation, but not laminoplasty?
If so, would it only make sense to be done within hours of the trauma, not four days later?
I’m trying to figure out what and the rationale for what was done here?
Best Regards, Steve T.Lordosis causes the head to located directly over the shoulders. If you were facing to the left, the curve would be a normal “C” when viewed from the side. A head that is “abnormally tilted downward and forward” has lost the “C” curve which is why it is pointed down. It makes no sense that the neck then could be “cervical spine itself bent backwards”. I think you are confusing terminology.
Laminectomy can be used to open the canal in a trauma situation but normally, a fusion accompanies this decompression (but not always). It depends upon the surgeon’s preference. I cannot give you better understanding of this surgeon’s plan. Maybe you can get the pre surgery report of X-rays, MRI and/or CT scan and print them here.
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.Hello Dr. Corenman:
Thanks for your interest and attention.
What I’d meant in saying the cervical spine “bent backwards” was that if someone is facing left and looked at laterally the normal lordosis curve would be, just as you say, the normal “C” shape, the curve being to the left or forward with respect to the subject. In my case the “C” is/was reversed when I’m observed in such position, the curve pointing to the back; like the letter “D” without the straight piece, hence my saying “bent backwards”.
It would be a bit of a job to get pre-surgical imaging and post them. I’ll put that one on hold for a bit. As mentioned, I do have the post surgical x-ray on the disc, which could be pasted here if the computer permits it.
Thanks again.
Best Regards, Steve T.Hello Dr. Corenman:
Thanks for your interest and attention.
What I’d meant in saying the cervical spine “bent backwards” was that if someone is facing left and looked at laterally the normal lordosis curve would be, just as you say, the normal “C” shape, the curve being to the left or forward with respect to the subject. In my case the “C” is/was reversed when I’m observed in such position, the curve pointing to the back; like the letter “D” without the straight piece, hence my saying “bent backwards”.
It would be a bit of a job to get pre-surgical imaging and post them. I’ll put that one on hold for a bit. As mentioned, I do have the post surgical x-ray on the disc, which could be pasted here if the computer permits it.
Thanks again.
Best Regards, Steve T. -
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