[Jellyhall]

#27707

I am looking for your advice Dr Corenman.

I had an ACDF of C3/4 and C4/5 done 5 years ago. The two levels below that are now very degenerated, but there is still just enough room for my CSF to flow around the cord.
My actual neck is more painful now than it was before my surgery. I also suffer with nerve type pain in both arms and especially my hands.

I have noticed over the last couple of months, that when I am sitting without my head being supported, it slowly falls forward and slightly over to the right. In about a minute it will fall into quite an abnormal position. I was told that my neck had lost its normal curve before my ACDF. I am worried that it could be starting to actually curve forward now.

* Is that likely to happen, and is there anything I can do to stop the progression?
* What is likely to happen long term?

[Donald Corenman, MD, DC]

#27718

The “falling forward” symptoms could be from degenerative kyphosis (https://neckandback.com/conditions/cervical-degenerative-kyphosis/) or from antalgia due to cervical radiculopathy “I also suffer with nerve type pain in both arms and especially my hands”. (see https://neckandback.com/conditions/radiculopathy-pinched-nerve-in-neck/).

You now note that your neck is more painful than it was prior to your surgery 5 years ago. Was there a period after that surgery where you felt great and then slowly developed this neck pain?

The two studies that will answer the questions are an X-ray with flexion/extension views and a new MRI.

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.

[Jellyhall]

#27728

Thank you for your reply Dr Corenman.

I suspect, having read about degenerative kyphosis, that it is my very degenerated neck that is causing the problem. The two levels below my fused levels, are very degenerated with loss of disc height and the scan report states ‘broad based bulged disc and bilateralhypertrophy of the Luschka joints with bilateral foraminal stenosis. Am I correct in thinking that I need to try to strengthen my muscles to that my head is lifted into a more normal position to slow down further degeneration? My surgeon, after my ACDF, told me that these lower levels either had or would fuse themselves. I am concerned that they might fuse themselves in a forward bending position.

There wasn’t a period after my surgery where I felt great. The only benefit really was reduced headaches. My surgeon had warned me though, that the surgery might not help my symptoms. He said he was doing surgery to get the compression off my cord that was being damaged. He also said I might need further surgery from the back later. When I asked which levels of my neck that would be on, he said all of it. He saw me a year ago and is happy that there is still room for the spinal fluid to flow around the cord, so no surgery is planned.

I have been referred to see another neurosurgeon, but am in the UK, so am likely to have to wait for a few months. I will tell him about the way my head slow falls forward when I am sitting and relaxing. Is there something that I can do to help while I am waiting to see him? Would sitting with my head supported in a high backed chair help?

Thank you for your advice.

[Donald Corenman, MD, DC]

#27732

Strengthening extensor muscles (that bend the neck backwards) would help with kyphosis pain. Your pain may be kyphosis pain or simple degenerative disc and facet pain.It is unlikely that these bottom discs will fuse themselves but it is possible. You want to strengthen your neck but rest it when it is complaining to you.

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.

[Jellyhall]

#27756

Thank you Dr Corenman,
Are there any exercises on your website that would be suitable for me to do to strengthen my neck?

I would say that my MRI scan looks most like the 5th x-ray, with loss of the straight sides to the vertebrae and with almost a ‘skirt’ to the front surface of them. (I hope you know what I mean!) I think these are all the osteophytes that have grown on the vertebrae. My neck looks very ‘untidy’!

[Donald Corenman, MD, DC]

#27764

See https://neckandback.com/pre-and-post-op/neck-situp-exercises/. Be careful not to do too many or you will “curse” my name.

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.

[Author]

Posts