[Auric]

#4996

Firstly, thanks to Dr. Corenman for the helpful, prompt assistance in my decision regarding ACDF.

Two and a half weeks after surgery, the right hand. arm, back and shoulder symptoms that lead to my ACDF for C6/C7 are essentially gone. I am grateful.

Post-op, I am experiencing a left forearm numbness which I cannot recall before surgery. This can extend (infrequently) to the little finger. It would seem to be a C8 issue, but this is a puzzle to me, as the MRI indicated that C7/T1 was normal.

There is no pain in the upper left arm. And the numbness in the inner part of the lower arm seems linked to flexion, for example, as I type this note sitting at a keyboard. Strength and dexterity seem intact, though this shortly after surgery, I can’t really test them.

A similar numbness can be experienced on the right forearm, but to a far less degree.

I am trying not to let the matter concern me. I am still in a collar and have not begun therapy. But I would welcome any insights as to why and how this would express itself after an ACDF for C6/C7.

[Donald Corenman, MD, DC]

#5001

The symptoms you discuss after the C6-7 ACDF surgery could be from two separate sources. First is the decompression of the nerve. When a nerve is compressed, pain is the predominant symptom noticed. There is most likely numbness also present but that numbness is not noted as it is overshadowed by pain. When the nerve pain is reduced after surgical decompression, the numbness is finally recognized. Numbness takes months to resolve and resolves very slowly.

You are correct that forearm numbness that radiates into the little finger is typically the distribution of the C8 nerve and the nerve that was operated on was the C7 nerve. There are two possibilities with pinky finger involvement. The first, which is rare is that you are wired differently than most people and C8 covers the inside of the hand. However, the most likely problem is that you have ulnar neuropathy.

The ulnar nerve sits in the cubital tunnel at the elbow (the “funny bone”). This nerve becomes stretched when you bend your elbow and will radiate numbness into the small finger and inside of the hand. Since this condition can be bilateral, you notice some of the numbness on the right hand.

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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