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  • aprokop
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    Post count: 22

    Dr. Corenman,

    I had an ACDF on my C5/C6 January of 2018. Since then I still have muscle soreness and pain in my traps and neck. My ROM isn’t great and my thumb is numb. Arm pain is better but stiff and sore. I don’t have any shooting nerve pain. I recently had an MRI and this is what they said:

    The C3-4 interspace demonstrates mild central canal, moderate to marked left neural foraminal, and marked right neural foraminal narrowing secondary to minimal broad-based disc bulge with hypertrophic changes. Interspace otherwise negative.

    The C5-6 interspace demonstrates mild central canal, mild left neural foraminal, and moderate to marked right neural foraminal narrowing secondary to a significant spurt involving the right uncovertebral joint. Interspace otherwise negative.

    I’m so lost on what my next step should be? I really hoped my ACDF would help and I feel a worse. Another surgery scares me because I don’t want to be worse off than I am now.

    Thanks for your advice,
    Andy

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    After an ACDF at C5-6, you note; “I still have muscle soreness and pain in my traps and neck. My ROM isn’t great and my thumb is numb”. I assume this is your right thumb you mention.

    Your radiological report notes at C3-4 “moderate to marked left neural foraminal, and marked right neural foraminal narrowing”. This level can cause upper shoulder (trapezius) pain but will not cause arm pain or numbness. However, your surgical level at C5-6 still has some narrowing; “moderate to marked right neural foraminal narrowing” which could explain hand numbness and arm soreness.

    It appears that there was an incomplete decompression at the right C5-6 level. This can happen if the spur is quite large initially or the vertebral disc height cannot be restored adequately. If you do not have a solid fusion, which would explain why you “feel worse”, a revision ACDF could be considered. If you have a solid fusion, a posterior foraminotomy could be considered.

    Before all that however, a diagnostic injection (selective nerve root block at C5-6 right) that yields relief is needed to prove the pain generator. See https://neckandback.com/treatments/epidural-injections-and-selective-nerve-root-blocks-diagnostic-and-therapeutic-neck/ and https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections-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.
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