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  • ecomeau
    Post count: 1

    Hi Doctor,

    Thank you for having this forum.

    I have been suffering from neck and lower back pain since 2005 but I will only talk about my neck issues now. I was told that I have degenerative disk disease back in 2005. In 2006 I had an ACDF on C5/6 and C6/7. In 2007 I had what I believe was called a C7 Framinotomy where the Doctor basically made the opening for the nerves wider at that level. In 2011 I had an ACDF on C4/5. Finally in 2012 I had a morphine pump installed to combat the pain that I constantly stay in. I have noticeable muscle atrophy on my right pectoral muscle up to the top of the right shoulder and between the right shoulder blade and spine itself. The pain has always been on my right side, right side of the neck, shoulder down the right arm and finally to my right hand and finger tips of my thumb, pointer and middle finger until now. Now 6 months later I have the same type of ache on my left side that I did at first like I did on the right, I don’t know if I should say dull but I do not have any shooting pain. I do feel that I have some strength loss on my left side from time to time. The pain seems to come and go on the left side only. The following are some questions I have are:
    1. Is it possible to somehow replace the disks from C4-7 and take out the fusions?

    2. Is it possible to replace at one level only?

    3. Why are my issues so one sided?

    Thank you again for taking my questions.

    Donald Corenman, MD, DC
    Post count: 8652

    You note degenerative disc disease and then a surgical fusion for this disorder in 2006 (ACDF C5-7). Were your symptoms strictly neck pain or did you have shoulder and arm pain also? What was the work-up to determine which levels to operate on? What were the results? Did you have relief of neck and or arm pain and if so, what percentage (full relief would be 100%)?

    One year later you had a foraminotomy of C6-7 on the left. This was at a level that was already fused. Did you have recurrence of arm pain or did the original arm or shoulder pain continue after the original surgery? I can conceive that an incomplete decompression after the ACDF might have occurred requiring the posterior decompression but how was the source of pain diagnosed? Did the surgeon use a selective nerve block to diagnose the nerve pain? What did the second surgery do to your pain?

    You then had another ACDF of C4-5 in 2011. Why was that surgery performed? Did this level break down, develop a hernation or develop instability? How did the surgeon decide that this level needed a fusion? Was there a selective nerve root block performed? An epidural? Discograms? What did this new surgery do for your symptoms? Any change? Any new symptoms? Any worsening of symptoms?

    Finally, you had a morphine pump implanted. This is for end stage pain control. Did this pump help or change the symptoms?

    If you have pain into your shoulders, has anyone looked at your shoulders to see if there are any potential disorders here to cause pain?

    Regarding the fusions, you cannot change them into artificial discs. The fusions cause fibrosis of the facets and reversal to allow motion won’t work.

    You need a thorough history, physical examination, imaging work-up and diagnostic work-up to determine where your pain is originating from.

    Dr. Corenman

    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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