Post op cervical pain

Tagged: Post op cervical pain

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kaparker65
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September 20, 2018 at 10:29 am

Post count: 14

#29393

I am 3 months post op for ACDF C4-7. I had impacted disc protrusion left c4-5 with severe foraminal stenosis, substantial anterolisthesis c5-6 with ostophyte complex on the right, and pseudoarthrosis c6-7 after ACDF in 2010 and 2013. The post op report did not mention surgeon correcting the pseudoarthosis at c6-7 but the vertebrae has been reduced posteriorly. I had a severe hump there before surgery. I also woke up with 2 right anterior incisions, one new at C4-5 and one repeat at C6-7. I also had a drain at C6-7. The C6-7 repeat incision and subsequent drain was not mentioned on the report. My cervical ROM is quite limited. Forward flexion causes pain at the junction of my neck/shoulders down between shoulder blades. Extension is slight causing a sharp painful catch at the junctions of neck/shoulders on the right, left, and posteriorly which also causes a painful pull between shoulder blades. Right and left ear to shoulder causes a very sharp painful catch at the junction neck/shoulders and a painful catch into my rotator cuffs. The C7-T1 area vertebrae is sore to palpation and movement. I feel these catches in my neck 20 or more times a day. On a pain scale of 1-10, I avg a dull ache increasing increasing in intensity with any exertion. I no longer have any numbness or tingling in my arms, hands, or fingers bilaterally since the surgery. I have not seen or spoken to the surgeon since morning before my surgery on June 14, 2018. I saw the NP on July 27, 2018. I expressed my concern about the continued pain and non-existent ROM. I was informed that this was normal as a triple level fusion and to give it time. The muscle spasms into my shoulders bilaterally is excruciating with movement.

Question: Why am I feeling the painful catches and bone soreness?

kaparker65
Participant

September 20, 2018 at 10:34 am

Post count: 14

#29394

I forgot to add my pain avg a 6 at rest and 8-9 with movement. I am not had any pain meds or muscle relaxers in 3 weeks. I avg maybe 2 hrs of sleep at night and as early as last night, I had been up since 0800 the previous morning and pass out from sheer exhaustion. I do not know how much more my psyche or body can take at this point.

Donald Corenman, MD, DC
Moderator

September 21, 2018 at 7:04 am

Post count: 8660

#29397

It is distinctly unusual for the operative report not to mention 2 separate incisions and to discuss what was found at the twice operated pseudoarthrosis site at C6-7. I am worried about the C6-7 level and if there is any significant degeneration of the C7-T1 level that has been magnified by the three level fusion above. A new set of X-rays with flexion/extension view should be your first start in this work-up.

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.

kaparker65
Participant

September 21, 2018 at 8:24 am

Post count: 14

#29400

I can’t do flexion, extension, or bilateral ear to shoulder at all. I can to head left to right some with considerable pain I. The c6 region if I turn too much or fast. I can lift my arms bilaterally beyond shoulder level. I cannot lift more than 3 lbs without dropping it. My hand strength is normal bilaterally though.

I am seeing my chiropractor today. He is going to help me determine mechanically what the issue is and measure my ROM. I have been to 2 ortho rehab med doctors in the last 2 weeks without assistance. I am
Grasping at straws at this point. I know something is wrong. I am not giving up until I figure it out.

Can you take a consult and order tests long distance?

Donald Corenman, MD, DC
Moderator

September 23, 2018 at 9:07 am

Post count: 8660

#29410

Do not get a manipulation from your Chiropractor at this point until you understand what your mechanics are in your neck.

Yes, I do long-distance consults. I review all images and discuss with you the new patient forms that you fill out. We have a telephone discussion for 20-30 minutes and i recommend potentially new tests. Since there is no doctor-patient relationship, I can only make suggestions. You need to have a physician who would be comfortable in employing my suggestions.

Call the office at 888 888-5310 and talk to my office manager Lori if you are interested.

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.

kaparker65
Participant

September 23, 2018 at 9:50 am

Post count: 14

#29411

No manipulations. He took cervical X-rays and he assessed my ROM. He showed me the hardware C4-7. Some fusion c4-5, none C5-6, some questionable C6-7. Plates and screws intact anteriorly on C4-6 and laterally on C6-7. The hardware on C6-7 was considerably larger. I’m not certain but I feel that the placement of the hardware on C6-7 is what is causing that area to be sore. It feels like it is cutting into me when I move my head. He also said that I had disc protrusions T2-4 from reading my April 2018 MRI. The area is also sore when upon palpation. My shoulder muscles are holding my neck tight and he said I was having symptoms of occipital neuralgia. I don’t have history of headaches. The C6-7 hardware is new and place laterally instead of anteriorly as was the case when I reviewed my April 2018 films. Not noted on post-surgical report dated June 14, 2018.

Danica sent me an email on Friday to set up consultation with you.

Kim
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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 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 11, 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 9, 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.

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