Post op ACDF problems

Viewing 3 posts - 1 through 3 (of 3 total)

Author

Posts
alliesdad
Member

October 29, 2013 at 4:32 am

Post count: 2

#9718

Hello Dr. Coleman and thank you for your time.

I am 41 yr old male with no neck problems prior to November 2012.
I was involved in a MVA November 2012, side impact low speed. Right before impact I reached into the back seat to brace my 2 yr old daughter for impact. Didn’t feel anything right after the accident but went to the hospital to have daughter checked out. While there and adrenaline wore off started to experience a stiff neck. So I got checked out,x-rays showed no fracture. Was sent home with muscle relaxer script and follow up with my GP.
In December GP ordered MRI an the results were:(don’t know what all this stuff means just typing it as it was written)
c6/7 Broad based disc herniation with approx 3 mm of central disc herniation. The anterior spinal canal displaced the cord posteriorly. AP diameter of the canal at this level measures 9 mm. No abnormal signal intensity within the cord, No significant foraminal narrowing.
C7/T1 Very minor right paracentral disc herniation. No significant central canal or foraminal narrowing.
Did PT for 3 months, did the epidural injections and nothing helped.The pain spread down my both arms, mostly left one, hands would become numb and then shooting pain in the palms near the middle and ring finger.
Was then referred to an orthopedic spine surgeon. He requested another MRI in August of 2013
The results were the same for c6/7 and C&/T1
C5/6 Minor right lateral recess herniation new since the previous exam.
Orthopedic recommended surgery ACDF of c6/7 due to symptoms not getting any better with conservative treatment and had new symptoms. When I would bend my neck down I would have a weird electric shock feeling go down my left inside leg.

Had ACDF surgery on October 22nd 2013 of C6/7. After waking up and not feeling to bad I drank some juice and ate pudding at the hospital. I then began to vomit, which was unbelievable and painful. Had not more shooting pain down the arms, nor numbness which was great. I left the hospital the next day, with only painful swallowing and a little neck pain. Had a soft collar given to me for comfort.
3 days later pain in back of neck became worse,swallowing was horrible and started having problems breathing.I also felt pressure near my incision site. Saturday the painful swallowing went away, but the breathing problem continued and I am sleeping only 2 hrs a night. Last night at 1 am I woke up sweating,heart racing and difficulty breathing. My wife drove me to the ER. The ER doc sent me through a CT scan and said I had a post op hematoma that was pushing on my trachea but was not compromising my airway. He sent me home and told me to consult my surgeon,today which I did. The PA from the Surgeons office told me the hematomas are common and he will see me November 7th for the follow up. I also told him I had right arm tremors,which I never had before, and every time I lay down on my back I feel like I can’t breath and my heart races. He didn’t seemed to concerned.

So my question is how long does it take for the hematoma to go away?
What would be the best way to sleep without feeling I can’t breath?
Will the right arm tremors go away after the hematoma goes away?
Should I continue to walk the mile and half I’ve been doing since getting out of surgery?

Thank you for any advice

Donald Corenman, MD, DC
Moderator

October 29, 2013 at 6:17 pm

Post count: 8660

#9723

A small hematoma in front of the surgery site (where the esophagus is located) is not uncommon but is not surprising.

Vomiting after surgery is much more uncommon nowadays with the newer anesthetic agents but still does occur. The pain medications (typically opioids) can also create nausea in some patients.

It is true that these hematomas will eventually absorb away.

Your quote “1 am I woke up sweating,heart racing and difficulty breathing” could be from anxiety but medication reaction and even infection can cause those symptoms. It would be distinctly unusual to have an infection in the neck. The hematoma can give you anxiety if you feel like you cannot get enough air when you lie down.

Hematomas can take as much as six weeks to absorb.

Right arm tremors generally are not related to nerve compression as a tremor is a contraction/relaxation of a muscle and the nerves of the neck are not capable of producing those tremors.

Sleeping in a recliner would give you comfort until the hematoma absorbs away.

By all means, continue to walk.

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.

alliesdad
Member

October 29, 2013 at 7:42 pm

Post count: 2

#9724

Thank you so much Dr. Corenman, I appreciate the info. BTW keep doing what your are doing, you are what every Doctor should be. Your brief explanation put my mind at ease.
Author

Posts

Viewing 3 posts - 1 through 3 (of 3 total)

You must be logged in to reply to this topic.

Donald Corenman, MD, DC

Average rating:

81 reviews

Eric S

Sep 25, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 10, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 8, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

Submit your review
First Name, Last Initial:
Email:
Review Title:
Rating:	1 2 3 4 5
Review:

Check this box to confirm you are human.
Submit Cancel