[Donald Corenman, MD, DC]

#8536

Your symptoms are exactly as you suspected. Extension of the neck (bending backwards) or neck retraction (“if I pull my head back like I’m trying to make a double-chin”) will narrow the foramen (the exit hole of the nerve). If there still is some narrowing from the surgical posterior foraminotomy, the nerve will still be affected by compression.

This is the dilemma of the posterior foraminotomy surgery. If the nerve is compressed by an anterior spur off the uncovertebral joint which is typically the case (see anatomy and cervical radiculopathy on the website) the posterior surgery can only decompress so much. Too much removal of the facet in the back of the neck will cause instability and subsequent neck pain. Too little removal can leave residual narrowing of the foramen.

You have to give this surgery some time to determine if your symptoms will abate. I would say that three months would be enough time. If you continue to have these symptoms, you might have to consider an ACDF.

Dr. Corenman

[ak31153]

#8547

Dr. Corenman,
As always, thank you for the quick response. So, even though the numbness in my fingers has almost completely resolved, and I no longer have a positive Spurlings, the described symptoms suggest that the nerve may still be entrapped? Is it possible that there is still nerve root inflammation nearly 7 weeks post-op, and that this will potentially dissipate given ample time? Thank you again for your time – it is much appreciated.

[Donald Corenman, MD, DC]

#8548

Yes-give the symptoms some time to abate. Your description sounds like the symptoms are not dangerous. The surgeon might consider giving you an oral steroid to shorten the time for improvement. Epidurals and SNRBs (see website) also can produce improvement in a short period of time.

Dr. Corenman

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