[Donald Corenman, MD, DC]

#28925

Your comments; “have pain and spasms in my left bicep which I didn’t have before. Prior to surgery, I only had arm pain on my right bicep but it’s now worse” might be related to irritation of the C6 nerve at the C5-6 level where you had the fusion surgery. There isn’t much to go on regarding imaging but this comment from the radiologist has me somewhat concerned; “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”. He or she notes that you still have significant foraminal narrowing. Hopefully this is an over-read and this problem has been corrected.

“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?” This discomfort should fade away over the next couple of weeks. Don’t use your TENS for this.

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]

#28939

Hi Dr. Corenman,

I talked to my surgeon on the phone and he said that the radiologist’s comments were definitely an over-read. He confirmed once again that the surgery went as expected.
My neck spasms have calmed down some and I am able to take care of myself now.

What has me confused is the right arm and shoulder pain. It is still worse than before the surgery.
I thought that arm pain was the first to be eliminated after surgery…

When I told the surgeon I had numbness in my right thumb and index fingers he thought that we were right on track. Huh?
The conversation was quick and I didn’t have time to clarify this with him. I will see him on the 24th.
Any thoughts?

Thank you so much!!!

[Donald Corenman, MD, DC]

#28944

I am concerned that you still might have some root compression. I would ask your surgeon if you could get a new MRI or CT scan to look at the foramen to see if there still might be some compression present. He might not want to but with increased nerve pain, I think this would be the right thing 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.

[riclach]

#28957

Thank you so much for answering me.
What would need to be done if I do still have some compression on C4-C5 C5-C6?

My MRI had shown that I had foraminal narrowing on C3-C4 and C6-C7 as well.
Should the surgeon have performed a 4-level surgery instead of just targeting C4 to C6?
What now?
THANK YOU!!!

**********************************************

C3-C4 Normal disc. Mild narrowing of the central spinal canal with an AP sac diameter of 9.5 mm. Uncovertebral hypertrophy contributes to moderate to severe right and mild left neurforaminal narrowing

C4-C5 Small to moderate sized diffuse disc osteophyte complex contacts and moderately contours the ventral spinal cord and causes moderate narrowing of the central spinal canal with an AP sac diameter of 7.5 mm. Uncovertebral hypertrophy contributes to moderate to severe bilateral neural foramina narrowing.

C5-C6 Small diffuse disc osteophyte complex contacts and mildly to moderately contours the central spinal cord and causes moderate to severe central canal stenosis with an AP sac diameter of 7 mm. Unconvertebral hypertrophy contributes to severe right and moderate to severe left neuroforaminal narrowing

C6-C7 Normal disc. Mild narrowing of the central spinal canal with an AP sac diameter of 10.4 mm. Uncovertebral hypertrophy contributes to moderate to severe bilateral neural foramina narrowing

[Donald Corenman, MD, DC]

#28959

I can’t say what the appropriate surgery could have been as it would depend upon not only the imaging studies but what your symptoms were, what your physical examination demonstrated and what (if any) diagnostic injection results yielded as well as your own expectations for results from surgery.

If there is residual compression noted that is symptomatic, there are essentially three things that can be done; therapeutic injections, revision of the symptomatic level from the front or a posterior foraminotomy.

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]

#30841

Dear Dr. Corenman:

I had previously mentioned that I had been having shoulder pain while sleeping. I finally had a shoulder MRI done and on May 15 of this year I had a right shoulder arthroscopy with arthroscopic:
1. Rotator cuff repair (Subscapularis)
2. Bicep tenodesis
3. Subacromial decompression
4. Distal clavicle excision
5. Extensive debriment

I wore a sling for 6 weeks and had very little pain.
Once I started doing physical therapy, I started experiencing pain, not only to my shoulder and trapezius, which is normal, but also what feels like ‘nerve pain’ shooting down my right arm, forearm, hand and fingers (mainly middle). I also experience some numbness and tingling.
The nerve pain is not there all the time but the inside of my forearm gets a lot of painful knots and so do my bicep and trapezius and up my neck.
My physical therapists have no answers for me.
I asked my shoulder surgeon and was told that shoulder problems never radiate past the upper arm and thought I should ask my neck surgeon.

I never did get another MRI or CT scan to see if there still might be some foraminal compression present or to see if I had a successful fusion.
Now that I had the shoulder surgery I think it’s time to follow up with my neck condition.

In my case, would it be best to get an MRI or a CT scan?
I also wonder if the Brachial Plexus could have been irritated during shoulder surgery…

Thank you so much!!!

Claudia

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