Failed neck surgery syndrome

Tagged: difficulty swallowing, dysphagia, failed neck surgery syndrome

Viewing 4 posts - 1 through 4 (of 4 total)

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Ren24
Participant

April 16, 2015 at 5:26 am

Post count: 21

#19016

Hello doctor. I have several issues happening. The first is I was told by a rheumatogist I have failed neck surgery syndrome. I had a discectomy with allograft and sting at C5-6 last July 21. I have had nothing but problems ever since. Firstly and annoyingly I feel as if something is stuck in my throat or I am strangling all the time. I also have some difficulty swallowing which is even worse if I eat any thing hard or that doesn’t break up easily such as bread or hard candy or taffy which kind of goes down as a lump for exams. It seems like the muscle in my esophagus gets fatigued easy and then the sensation. Gets even worse. I also have visible cervical lymph nodes now on cat scan as well as a new autoimmune thyroid condition. I had low thyroglobulin levels and positive autoantibodies for thyroglobulin is there a chance I am reaction to the metal plate that was inserted? All this started after the surgery and keeps getting worse. Ive been tested many times for thyroid issues and always negative til this surgery. Also what can I do about this failed surgery syndrome. Anything ? I can’t get anyone to take this plate out now and it’s causing me a ton of issues. The constant pain and spasm alone in my neck and shoulders is annoying and my quality of life has gone way down. The other big issue I’m having is my lower back. I do have degenerative SI joints bilaterally with the right being worse with a bone spur in bottom end of right SI and at L5-S1 I have facet arthropathy changes. I have severe right hip pain and can barely lift my leg up for example to put a sock on. It is interfering with my walking also. There is also very annoyingly bilateral thigh pain. My feet and outer ankles also have severe pain and stiffness. The rheumatologist said she thinks I have osteoarthritis and my spondylitis blood marker was negative for the protein some people have who get ankylosing spondylitis I also have chronic tennis elbow to add to my misery Oh and let’s not forget the trigeminal neuralgia and Fibromyalgia Something is causing widespread inflammation for me and I swear I’ve had a major escalation in pain and inflammation since this surgery. At least before I could work and manage my life. Now it’s just a constant day to day battle with pain and trying to have enough energy and low pain level to get simple housework done. Can you please give me some idea of what you think is happening. I am very frustrated as I was very active and now am forced to sit or lay around to manage pain. I know u are limited as you havent seen me but any recommendations? Ideas what’s going on or what to do? I do think I should just have an Mri of whole spine to see what is happening Thank you…..lost

Donald Corenman, MD, DC
Moderator

April 16, 2015 at 11:39 am

Post count: 8660

#19023

You have a number of symptoms that are unrelated. First, the neck symptoms are due to two different disorders. Swallowing difficulties (dysphagia) can be related to the esophagus or possibly to the plate but that is unlikely.

The esophagus is a muscular tube that works somewhat like a snake swallowing a mouse. The muscles in the snake’s body in front of the mouse relax and the muscles behind the mouse constrict to propel the mouse down the snake’s body. This is the same as the bolus of food swallowed being propelled down the esophagus.

With retraction of the esophagus (necessary for exposure of the spine in the front of the neck), the muscular wall of the esophagus is compressed. If the retraction compression is too strong or too prolonged (or even if there is no significant retraction as happens occasionally), the muscular wall can develop some immobility. This prevents the smooth progression of the food bolus down the esophagus tube and food can get “stuck”. Normally, this feeling disappears after weeks but in your case, this appears to have continued.

A swallowing study seems to be in order in your case. A bolus of opaque dye is swallowed and an X-ray is taken. The “obstruction” can be identified and possibly corrected. It is rare but the plate or “hardware” still in your neck could be the cause and if so, can be removed.

Your “failed neck surgery syndrome” I imagine is due to a failure of the graft to fuse (pseudoarthrosis). The continued pain could be from that or from degeneration above or below that level.

Your other pains (lower back and legs) are mostly likely not related to the neck.

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.

Ren24
Participant

April 16, 2015 at 6:53 pm

Post count: 21

#19029

Hi doctor. Yes I ha e had a swallow test done. Twice. The barium swallow or esoohagram is completely normal I’m told. But the modifies barium swallow which is just of the upper part of my throat shows a slight narrowing right at the level of the plating. Nobody can seem to u det stand why such a “mild” indentation of my esophagus is causing me so much trouble. To me it feels huge and seem to get anyone to help me. I am not sure where to turn. Is there some place you know of I can go. I am running into the problem of the first surgeon who did this not giving a darn how bad I feel to the next surgeon saying I am fusing fine and I need to go to an ent. Who runs the esoohagram but says he can’t do anything as its out of his specialty. Gonna l to the surgeon. What do I do?? I am caught in a wove her back and forth battle. Take my money n shove me to the next dr. As for the lower spine issue. My pro is sending me for cat or fluoroscope guided injections into my so joint. Which I will give a shot but after reading your forum info I am not sure will help me. I also have the facet arthropathy changes at l5-s1 which quite possibly is causing the severe tailbone pain I was told by rheumatologist. Idk which way to turn as I have all this arthritic pain. I’m only going to be 43 this summer. Why am I having so much inflammation. Thank you for your time

Donald Corenman, MD, DC
Moderator

April 18, 2015 at 2:00 am

Post count: 8660

#19044

Tailbone pain can originate from the lumbar discs, the facets, the SI joint or the nerves in the canal (the end of the cauda equina called the pudendal nerves).

The plate could cause enough impingement to create swallowing difficulties but the only way to know if the plate is the cause is to remove the plate and see how you do. There are no guarantees.

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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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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