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  • riclach
    Participant
    Post count: 20

    Dear Dr. Corenman, I had my C4 to C6 ACDF surgery one week ago. The neurosurgeon placed a peek cage filled with the remains of my bone spurs. He also placed a titanium plate. The surgery went well, but the pain I am feeling it’s unbearable. I have incredible trapezius and arm spasms with twitching. I also experience nerve pain and dizziness and I have not been able to sit up since 4 days. I have a catheter. I have tried Flexeril, Valium, Percocet to no avail. 25 hours ago the doctor gave me a 12 mcg Fentanyl patch and it has made no difference. I have now applied another patch upon his recommendation. Would Gabapentin or Lyrica help? I have a IFC unit. Would it help if I placed it on my arms?
    Thank you so very much!!!
    Claudia

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    I am unclear why you have your severe symptoms after the ACDF at C4-6. If the disc spaces were distracted, typically you would note posterior neck and some trap pain. I cannot explain the arm spasms. After surgery when you developed these symptoms, did you have a thorough physical examination and if so, were all your upper extremity muscles groups tested and if so, were they all strong? Do you have some new onset weakness? Did the symptoms occur immediately after you woke up or did they develop some time afterwards?

    Did you have new X-rays to look at the surgical construct?

    What does your surgeon have to say about these symptoms?

    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.
    riclach
    Participant
    Post count: 20

    Yes, all the tests were performed and came back normal, x-rays included.
    I don’t have new onset weakness but have pain and spasms in my left bicep which I didn’t have before.
    The symptoms got worse after 2 days. Prior to surgery, I only had arm pain on my right bicep but it’s now worsen. I also get twitches on my right side but not the left.
    Massaging the biceps makes it feel better.
    On a good note, my right hand grip is a lot stronger than it was before my surgery.
    Also, the itching on the bottom of my scalp has gone away.
    After writing you my initial post I was able to sit up in bed.
    I got extremely dizzy but forced myself to sit for 5 minutes.
    Within the next hour, I forced myself to sit up again and this time I was able to stand up and even walk and finally wash my hair after a week. Of course this was all done with the help of my husband.
    I am now sitting in the recliner and I don’t have any dizziness.

    When should posterior neck and trap pain be expected to subside?
    Do you think it’s okay for me to use my tens/IFC unit on my arms?
    It’s best I don’t use that on my traps though, right?

    Thank you as always. You are an amazing doctor to take your valuable time to write to us.

    riclach
    Participant
    Post count: 20

    Just wanted to correct that the pain is in my biceps and triceps.

    riclach
    Participant
    Post count: 20

    I was able to pull the x-ray reports. My surgery was on July 31.

    July 31, 2018
    XR C Spine Routine Series
    Cervical spine, AP, bilateral oblique and lateral views:
    HISTORY: Post op follow up
    FINDINGS:
    Anterior fusion of the cervical spine from C4 through C6. Plate hardware and interbody position. A drain is identified.
    There is normal alignment of the cervical vertebral bodies. Vertebral body height is maintained and no fracture or suspicious bony lesion is seen.
    The atlantoaxial joint is normal. IMPRESSION:
    Fusion of the cervical spine.

    August 2, 2018
    XR C Spine Routine Series
    XR C Spine Routine Series COMPARISON: 7/31/2018 radiographs Views: 6
    IMPRESSION:
    C4-C6 ACDF. A surgical drain is in place. The left posterior oblique view demonstrates mild C3-C4, mild C4-C5, severe C5-C6, and moderate C6-C7 right neural foraminal narrowing.
    The right posterior oblique demonstrates mild C4-C5, moderate C5-C6, and moderate C6-C7 left neural foraminal narrowing.
    The ACDF hardware is engaged and intact. No acute fracture or subluxation.

    riclach
    Participant
    Post count: 20

    Oh, and I still have numbness in my right thumb and index finger.

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