Complex Neck and Shoulder Issue

///Complex Neck and Shoulder Issue
Complex Neck and Shoulder Issue

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  • Avataradvrider
    Participant
    Post count: 5

    Thank you Dr. Corenman for the prompt reply.

    The spine surgeon I saw most recently also mentioned that the foraminal compression could in fact be worse than depicted in the MRI and he noted that the quality of the axial images was poor.

    Neither he nor the other surgeons I’d seen previously noted any loss of disc height or shifting of the disc. I was leaning more towards an ADR and thinking about going ahead with the surgery at this point having exhausted all other avenues. The surgeon I am seeing has been involved in trials with artificial discs since 2005, although for an one level surgery he doesn’t believe there is enough evidence to suggest they offer any significant benefits over an ACDF.

    My only concern is that at one point I did have some facet pain. It came on about 6 months after my initial injury in September 2017 and I then had an RFA in June 2018, I haven’t had to repeat it and haven’t had facet pain since. I’ve seen elsewhere where you stated that facet pain can be a contradiction for an ADR.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6759

    Previous facet pain from the level in question that resolved with an RFA worries me regarding an ADR implant. ADRs tend to allow or even increase motion of the segment when implanted. This motion can re-trigger facet pain. However, most pain docs ablate multiple levels so this is not a conclusive statement. There is probably a small risk for facet pain flair-up. You have to decide if an ADR is the right move with the understanding of the risks. ADRs in the cervical spine can always be revised to a fusion if necessary.

    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.
    Avataradvrider
    Participant
    Post count: 5

    Dr. Corenman,

    Thank you again for all the information you provide on this forum. I think I’m going to go forward with surgery at this point after trying PT, multiple ESIs, the RFA, the suprascapular nerve release surgery and still having intractable neck pain and arm weakness and pins and needles in my arm. Definitely have concerns about having surgery at 33, but at this point I’m already forced to change careers from the military and have had to stop pursuing nearly all my hobbies. Will discuss my concerns about facet pain with the doctor when I see him next week and discuss the ADR vs ACDF again.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6759

    Please keep us informed of your progress.

    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.
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