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Dear Dr. Corenman,
Thank you for your time.Previously had a fusion c4-c7 back in 6/04. New cervical symptoms 9/11. Ended up in ER end of march 2012 with spinal cord injury c3/4 herniated disc and stenosis. On call Dr. did an ACDF. I was grateful to be walking. He was afraid of instability – did not have a big enough spacer. Was sent home with pneumonia, no antibiotic. Ended up back in hospital for 12 days with pneumonia. I had words with him, after that he refused to speak to me or treat me. Went back to original surgeon (was misinformed he does take my insurance out of network) New MRI shows posterior indentation on cord c3/4 level & cord signal. Surgeon thinks thinks there is instability, took an X-Ray,no signs of fusion. Wants to perform a laminectomy. Symptoms are electric current type feeling in both arms when putting head down, constant burning in both arms,numbness mostly right hand, some in left. Heavy head, neck, shoulder upper back, right elbow pain.Don’t know if I am at risk by not having or putting off this surgery. No promises that arm pain or nerve damage will improve. I’m just scared of getting worse. Can send recent MRI & CT scan. Much appreciation.
Be Well,
LynnYou had a fusion of C4-7 some time ago. Apparently you fell or were injured and developed a disc hernation and stenosis at C3-4 which probably caused a central cord syndrome, hence the emergency surgery.
I am not sure what you mean that the surgeon “did not have a big enough spacer”. Even though I don’t use spacers for neck fusions, the availability of multiple spacers for various types of anterior cervical surgery during surgery is common.
Unfortunately, you developed pneumonia and had to be readmitted. I cannot tell you why the operating surgeon refused to see you after that but that is unusual.
You now have a protrusion of the spacer and cord impingement. It may be that the cord was already injured from the original herniation and you are now seeing in a follow-up MRI what the injury looks like. However, if the cord is still impinged, more likely than not, this will have to be addressed.
If there is no sign of fusion, a laminectomy by itself will further destabilize the area. There are two potential fixes, a posterior laminectomy and fusion or a removal of the loose cage and re-fusion in front along with a posterior fusion without laminectomy.
Your symptoms are consistent with cord injury. I would get another opinion as to what to do.
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.Dear Dr. Corenman,
Thank you once again for your kindness and expertise. Would it be too much trouble for you to take a look at MRI & CT scan?
Take Care,
LynnCall my nurses at (970) 476-1100 and let them know we have talked. They will give you the Fed-Ex info.
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.Once again, thank you in advance. I will call on Monday.
Once again, many thanks for explaining everything so thoroughly. Just one more question – my arms go numb (fall asleep) when putting my head down (chin to chest) Is this cause for concern or another symptom of failed fusion? Sorry for being such a worrier!
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