ak31153MemberApril 25, 2013 at 11:03 pmPost count: 6
Thank you again for this service, it has been very helpful for me, both leading up to and after surgery. Long story short, I had my procedure (C7 microscopic laminoforaminotomy) on March 14, 2013, to relieve symptoms caused by a herniated disc, which included left thumb, index finger, and middle finger numbness, as well as left tricep, rhomboid, and lat weakness. MRI impression was:
C6-7: normal disc height with left uncovertebral joint disc osteophyte/extrusion. There is impingement of the left C7 nerve root. Vertebral canal and right neural foremen are patent.
C5-6: small anterior traction osteophyte. Normal disc height without stenosis.
Immediately after surgery, my numbness and weakness increased, which lasted about two weeks. At that point, the numbness started to dissipate, and the weakness started to improve, and today, 6 weeks post-op, the numbness is only noticeable in the tip of my left index finger, and I feel weakness is slowly improving. However, I have noticed that I still get some electrical “shock” sensations in my left hand, where the numbness used to be if I position my neck certain ways. For example, if I pull my head back like I’m trying to make a double-chin, or if I tilt my head back too far to drink water. This doesn’t hurt, but it feels like a sharp zap. My concern is that the nerve root is still being impinged, despite the fact that I had surgery. I am curious to get your thoughts, as I don’t have an appointment with my NS for another two months. Thanks!Donald Corenman, MD, DCModeratorMay 1, 2013 at 8:33 pmPost count: 8455
As I have noted before, the posterior laminoforaminotomy decompresses the nerve root entrapped by the bone spur in the foramen. This procedure accomplishes this by unroofing the bony canal from the back. The spur is generally still present as this spur originates from the front of the canal (the uncovertebral joint- see cervical radiculopathy on the website).
The nerve is decompressed (hopefully) but still has to take a more circuitous path to exit the foramen. This elongated path still stretches the nerve somewhat. Both neck maneuvers you indicate that produce the electrical sensation does induce a narrowing of the foramen. If the nerve is not fully decompressed or is still somewhat swollen, these symptoms will persist.
Patience is required to wait until the nerve root is no longer swollen to determine if the decompression was successful. About three to four months is required to see if the symptoms abate. Continued symptoms might be reduced by a selective nerve root block of the surgical level.
Further symptoms that are disagreeable after that period would require a new MRI to determine the status of the nerve root.
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