[westie California]

#27254

Happy New Year Dr Corenman,

I had a second opinion with an endoscopic spine surgeon and was told that the risk reward is bad. The normal anotomy of the spine is gone, and an endoscopic procedure can’t be done because the instruments would not have space to navigate.

The surgeon also noted “there is a boat load of scar tissue”, and did not feel a diagnostic SNRB-selective nerve root block would work because the medication would not reach the nerves (would follow the path of scar tissues). In addition he mentioned that there is no disc space at C5 and C6. I was told the best of luck and he is sorry. My question to you is I understand endoscopic spine surgery is out however:

I have continued nerve pain after cervical fusion, foraminotomies,laminectomy, and medial facetectomies. My CT scan demonstrates solid fusion, My MRI and EMG confirms continued foraminal stenosis.I’m told I have kyphosis of cervical thoracic spine.The recent X-rays show Lordosis between C2 and T2 with a measurement of 4.

How does one proceed? It appears the foramina stenosis and the lack of disc space is the root of my problems? Any help would be appreciated. Thanks

[Donald Corenman, MD, DC]

#27255

I am confused as you initially reported that you had a fusion of C4-7 and then there were some discussions of an artificial disc replacement. You then note “there is no disc space at C5 and C6” which means to me degeneration but obviously if involved with a fusion, there would not be a disc space.

I disagree with the last surgeon. I still think you need a shoulder block and then a selective nerve root block.

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.

[westie California]

#27256

Dr Corenman the following are the surgeries performed with dates:

October 2012

ACDF – C4-C5, C5- C6

Diagnosis:herniated disc, nerve root compression, spinal cord compression, cervical radiculopathy, cervical spondylosis

Symptoms : neck pain, arm pain, headaches, dizziness

August 2013 —two procedures

ACDF C3-C4, C6-C7

Bilateral decompressive laminectomy with fusion C3, C4, C5, C6, C7 – right dural tear

Diagnosis : degenerative disc disease, cervical spondylosis, herniated disc, cervical nerve root compression, radiculogpthy

Symptoms : neck pain, arm pain, headaches, dizziness

November 2014

left C6-C7 foraminotomy

Diagnosis: left radiculopathy

Symptoms : neck pain, arm pain, headaches, dizziness

August 2015

ACDF C7-T1-placement of cage

diagnosis cervical radiculathypathy and anterior subluxation

Symptoms : neck pain, arm pain, headaches, dizziness

January 2017

Posterior cervical laminectomy with foraminctomies, medial facetectomies at C5-C6, C6-C7, and C7-T1
posterior segmental instrumentation C5, C6, C7, T1 and T2

Diagnosis :evidence of residual foramina stenosis and kyphosis at C7-T1 and psuedoarthrosis C7-T1

Thank you

[Donald Corenman, MD, DC]

#27259

How did you do, good or bad from each surgery? Another way to ask is did the surgery do what it was proposed to do?

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.

[westie California]

#27260

1)2012 surgery I noticed improvement in both biceps pain upon awakening, however the neck pain was severe. After a couple of months the arm pain came back. The neck pain kept progressing.

2)2013 two procedure’s – The first surgery left arm pain went away and right stayed. The second procedure was the worst, left hospital after 10 days in an ambulance, went to subacute facility for seven weeks. I was unable to ambulate. The doctor mentioned a dura tear and after patching it started to leak again. My headaches worsened and i was in a wheel chair for 4 weeks, then transitioned to walker, then cane. Physical therapy was performed five days a week for a couple of hours a day. Started to have base of the neck pain – neck meets shoulders and radiation of pain into the top of my shoulders. Also having cracking and popping noises from the base of my neck.

3)2014 procedure – neck pain worsening starting to get more severe muscle spasms, left arm pain improves with rest, right side no improvement. Started to notice pain in fingers, forearms, tingling sensation.

4)2015 procedure- neck pain improves with rest, worst when sitting and standing. Both biceps pain becomes unbearable when going for walks.

5)2017 procedure -symptoms every time I go for walks and sitting causes my pain level at the base of my neck, arms, and shoulder blades to become unbearable, headaches, arm pain, dizziness, fingers tingling both hands, triceps hurt, forearms, numbness weakness in arms, I also noticed my gait has worsen. I awaken during nights like i slept on my arms, feels like they went to sleep. looking up causes base of skull both side extreme pain. The base of neck is by far the worst.

Hope this helps.

[Donald Corenman, MD, DC]

#27327

It appears that you have had a cord injury after your 2013 surgery (“The second procedure was the worst, left hospital after 10 days in an ambulance, went to subacute facility for seven weeks. I was unable to ambulate”).

I would assume that after the August 2015 procedure (ACDF C7-T1-placement of cage) that this was also unsuccessful as placing a cage in an ACDF under a 4 level fusion probably did not fuse. You indicate that in your reply.

You finally had a posterior fusion down to T2 which I hope made all the bottom levels fuse. Do you know your status for fusion now as your complaints indicate a non-fusion (“2017 procedure -symptoms every time I go for walks and sitting causes my pain level at the base of my neck, arms, and shoulder blades to become unbearable”)?

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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