[Donald Corenman, MD, DC]

#32432

I assume you were fused when you had your instrumented posterior cervical surgery. You might have been fused in kyphosis unless you were not fused or developed a pseudoarthrosis. That is why it is so important to have a pain generator work-up to determine your pain source. If the C3-4 level foraminal stenosis is causing your pain and you have a solid anterior fusion as you noted earlier, then the posterior foraminotomy is the procedure of choice.

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.

[westie California]

#32436

Your the best! thank you very much

[Donald Corenman, MD, DC]

#32444

My pleasure!

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.

[westie California]

#32615

Good evening Dr Corenman,

I have a question again, over the past couple of years I’ve been having at times severe base of neck pain, and muscle spasms, etc. We spoke about this in the past. Last month I meet with my neurologist and he wasn’t too happy with my issues and referred me to an orthopedic spine surgeon. After 90 minutes of going over my history, physical assessment, surgical notes and scans he mentioned that my surgery from 2017 never healed, said there’s movement.

My 2017 procedure extended posterior fusion from C7 to T2, Revision of cervical laminectomy with foraminctomies, medial facetecomies C5-C7 and segmental instrumentations C4-T2. I was shocked and asked how was this possible since my neurosurgeon stated in 2018 that my fusion was solid when he removed hardware. The orthopedic spine surgeon said looking at CT scan from April 2020 you have movement, and psuedorthosis, and that he has over 25 years looking at this stuff and he’s 100% percent sure. So he referred me to another surgeon since this area may need to be broken and reset. I have an appointment in a couple of weeks, any suggestions on the complexity of a C7 , T1 and T2 none union correction and is this an issue that an orthopedic surgeon is better equipped to address? Thanks in advance

[westie California]

#32618

I forgot to ask during my previous post, for pseudarthrosis at T1/T2 would medial branch blocks be the best option to diagnose if this level is causing pain, and dynamic MRI or flexion/extension x rays at this level is worth trying? Thanks again

[Donald Corenman, MD, DC]

#32619

a pseudoarthrosis certainly can cause base of the neck pain. The best way to diagnose this is with a fine-cut CT scan and flexion/extension x-rays. The best way to prove it is one of the pain generators is with a small-volume epidural at this level with good diagnostic pain relief. If this level was already attempted to be fused posteriorly, medial branch blocks would be useless as these fine nerve-fibrils would be already ablated and bound in scar if they even exist.

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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