[aprokop]

#31395

Dr. Corenman,

My surgeon recommended that I get a C3/C4 Posterior Foraminotomy procedure. I had an ACDF on my C5/C6 about two years ago that he believes was successful. However I’m still have pain in my upper neck and trap area on my right side. My upper shoulder also is painful whenever I use it. The surgeon suggested that I try a nerve injection which I did into my C4 nerve root. I immediately felt better and for the first few hours I was almost pain free. The steroid into the nerve seemed some long term as well.(maybe 40% better).

I’m curious if you like this option over another fusion? Are Foraminotomy surgery successful? Do you recommend them to your patients? Do they lead to other surgeries in the future. I’m just 41. Are they more painful than an 1 level ACDF? I’m scared to have an fusion but the thought of a second surgery also has me nervous.

Thanks,
Andrew

[Donald Corenman, MD, DC]

#31414

The C3-4 level houses the C4 nerve root which radiates into the upper shoulder region. Compression of this root can very well cause neck and top of the shoulder pain. The best way to diagnose this disorder is with a selective nerve root block (SNRB) at C3-4 which you had and was diagnostic. Foraminotomies are generally successful surgeries if performed for the right reasons and performed correctly. It sounds like you have the appropriate reasons for this procedure. They don’t stabled the operated level but since you already have an ACDF two levels below, this would be an appropriate use of this procedure.

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.

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