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#11633

Thank you again; I will definitely keep you posted.

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#12070

Hi Dr. Corenman,

I wanted to update you on my situation.

On December 9th I had a laminotomy and foraminotomy performed at c5-7 on the right side only. The surgeon detected some motion from my prior ACDF so he fused my spine posteriorly using typical screws and rod and autografts using my own bone. No steroids were injected into the nerves during surgery, but I was on steroids for a few days after surgery. The surgery was not through tubes, but was open surgery. Two weeks after surgery, I developed a large golf ball size lump on the left side, which was the side opposite the surgery. An ultrasound showed it was not a hematoma, but a possible muscle spasm. It is still there and painful.

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#12072

After surgery, my right arm and right shoulderblade pain and numbness were completely gone. Three weeks after surgery, my right arm started getting numb again, and a week later spread to the hand. Prior to surgery, my right middle finger was numb and now it is the right thumb. The lump on the left is still there and painful. Six week X-rays showed no abnormalities. In the last week my right shoulderblade has once again become very numb and painful.

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#12073

Sorry for the multiple messages, but the website was rejecting my initial complete message.

In summary, I am now 7 weeks post revision surgery, and the right arm numbness and right shoulderblade pain and numbness that went away completely for the first three weeks after surgery have come back. The arm and hand numbness are worse now than before the second surgery, and the shoulderblade pain and numbness are now almost as bad as before the first surgery. The arm and shoulderblade are made worse by turning my neck even slightly. The arm numbness is also made much worse by laying down with my head elevated and bending my arm at the elbow to read.

I am taking nerve pain medicine, muscle relaxants, and pain medicine. I wear a collar as needed. Surgical pain has improved, but the pain that the surgery was meant to address has now become horrible, after resolving.

I am thinking that this second surgery has now failed, but am baffled as to how it worked completely for three weeks, and now things are getting rapidly and progressively worse. I have been very careful and have no clue what may be happening. I appreciate any insight that you might have.

Thanks

[Donald Corenman, MD, DC]

#12076

Posterior laminotomy is a good surgery for herniated discs (you can remove the offending fragment-see my video on the website). This procedure is not as good for foraminal stenosis (a spur off the uncovertebral joint causing foraminal compression from the front of the spine).

The reason is that the posterior decompression does not address the spur that develops off the front of the spine. The posterior foraminotomy opens the nerve canal from the back of the spine but the nerve still remains tented over the spur from the front of the spine. This tenting along with possible settling of the operated level can allow redevelopment of nerve compression after time (remember Peyton Manning).

A new MRI should be considered and if the above disorder is the case, it might be worth first trying a selective nerve root block to see if you can calm down the nerve. If no results and symptoms continue, an ACDF (fusion with bone graft) would be the solution.

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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#12080

Thanks again for your advice. I would like to ask a few follow up questions if that is ok:

1. Why would the posterior laminotomy/foraminotomy work completely for three weeks and then fail progressively?

2. Also, why would the pain and numbness now be worse than before the surgery, i.e., could the procedure actually make things worse instead of better, even though it was better for a few weeks? I would think that the surgery could perhaps not help, but how could it make things worse?

2. Is it too soon for an MRI? Would you do a CT scan as well?

3. Does the fact that the right side has now had instrumentation placed posteriorly make a potential ACDF more successful to fuse?

4. Did Peyton Manning’s surgery fail because he needed to be fused in front and not just because he had a disc problem that was attempted to be repaired from behind, or was it because of the anterior osteophytes?

Thanks again.

[Author]

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