[kborg75]

#8004

Hi Doctor,

On 8/5/2009 I fell and began to have middle back pain. I was treated for a year with injections, chiropractics, physical therapy, accupuncture and pain management medications. After a year, I went to a neurosurgeon who did an MRI of my neck and said I needed a fusion at C5-6. I had that done on 11/30/2010, felt remarkedly better, but slowly began to have pain agin. Started physical therapy, finally after 4 months an xray showed a crooked screw. So 3/30/2011 I had another surgery to remove the screw. I was feeling better, but again 6 months later I began to have nerve pain down my arms. Dr. diagnosed as compressed nerve. Another surgery 3/20/12, he opened the canal and again I was feeling better. Again the pain begain again as acute spasms across chest and back and all around the neck. Diagnosis? Another fusion needed above and below the fusion already done. So, 12/19/2012 4th surgery and did double fusion. 2 months later, I still have much neck pain, especially up the back of the neck into the skull, also the spasm pain around the neck and back and chest. I have been on pain meds since day 1 and now they don’t seem to be helping, even though I am now taking dilaudid. Waiting for an xray to be done next week.
In your opinion, should I be looking for another neurosurgeon? After each surgery he tells me this one will fix me, but it doesn’t. Please, I need your advice. Thank you

[Donald Corenman, MD, DC]

#8006

Your current pain could be from multiple sources. Pain free intervals after surgery with onset of the same pain after some months could indicate a pseudoarthrosis (lack of fusion). It sounds like you now have a three level fusion. A new MRI and/or a CT scan would be quite helpful to start the determination of the origin of your current symptoms (of course with a thorough physical examination and X-rays).

I cannot comment as to the need for another neurosurgeon but it never hurts to gain another opinion.

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.

[Donald Corenman, MD, DC]

#8007

Your current pain could be from multiple sources. Pain free intervals after surgery with onset of the same pain after some months could indicate a pseudoarthrosis (lack of fusion). It sounds like you now have a three level fusion. A new MRI and/or a CT scan would be quite helpful to start the determination of the origin of your current symptoms (of course with a thorough physical examination and X-rays).

I cannot comment as to the need for another neurosurgeon but it never hurts to gain another opinion.

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.

[kborg75]

#8014

pseudoarthrosis – is it something that can be fixed? If it is a crooked screw again that’s causing the spasms, it would be the 2nd one, is this a normal occurrence when doing a fusion?

[Donald Corenman, MD, DC]

#8034

A pseudoarthrosis can be repaired and is commonly repaired if it causes symptoms. A “crooked screw” by itself should not cause symptoms. Now, if the screw was “straight” when it was put in and bent under abnormal forces, this would also give more evidence to indicate a pseudoarthoses.

Depending upon the technique for fusion and number of levels, a pseudoarthoses can occur anywhere from 3% to 30% of the time.

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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