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  • OswaldOtte
    Participant
    May 14, 2020 at 2:02 am
    Post count: 10
    #32542

    Hello doc

    On Febr 7th 2020 I was diagnosed with
    c3/4 hernia
    c5/6 hernia + facet degeneration
    c6/7 hernia with spinal cord compression

    On Febr 20th 2020 I got ACDF – self retaining PEEK cage with self tapping screws for c6/7

    On May 7th I was diagnosed with
    c7/t1 facet degeneration (not seen before ACDF)

    What I feel mostly now is pain when extending my neck. Also on and off burning of the C7/t1 facet joint.

    What plan of attack would you advise to decrease pain, increase mobility, increase strength and avoid future surgery?

    I’m hoping to get back into running, swimming and mountainbiking. I would like to hear your thoughts on these sports?

    Thanks in advance
    Oswald

    Donald Corenman, MD, DC
    Moderator
    May 14, 2020 at 8:43 am
    Post count: 8459
    #32543

    First, I would consider a good course of physical therapy. If you fail that, diagnostic blocks to determine the pain generators. Make sure that you have a solid fusion at C6-7. Facet blocks at C7-T1 would be suggested.

    Dr. Corenman

    OswaldOtte
    Participant
    May 19, 2020 at 12:25 am
    Post count: 10
    #32560

    I take Leflunomide for RA. My rheumatologist says this won’t effect the fusion. I have little faith in her as she also claims NSAIDS won’t effect fusion. I refuse to take any NSAIDS now, but what about Leflunomide?

    Also, I found a PT that uses the David Spine Concept. Would this be a good course?

    Donald Corenman, MD, DC
    Moderator
    May 19, 2020 at 5:02 am
    Post count: 8459
    #32561

    This is what I found investigating the medication; “Leflunomide is a pyrimidine synthesis inhibitor belonging to the disease-modifying anti-rheumatic class of drugs (DMARD)”. This medication is not like a NSAID which will inhibit bone healing for the first 2-3 months after fusion. I am unclear if this medication could inhibit fusion so I cannot make a statement on its use.

    I also did research on the “David Spine Concept”. This is a functional program (the treatment is based upon your functional deficits, how much you can bend for example, and not your diagnosis). I would be careful with functional programs as in general.They don’t take into consideration post-operative healing times and limitations that need to be considered when the spine has been altered surgically and needs time to heal.

    Find a therapist who can follow your surgeon’s directions and will not “overtrain” you especially in the earliest post-operative period.

    Dr. Corenman

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