[westie California]

#33088

Good Evening Dr. Corenman,

I spoke earlier to spine surgeon that found my T1-T2 Pseudarthrosis and went over preoperative paperwork and planned procedure. He decided to include T3 and would add hardware from T1. So T1 thru T3 would have a rod on each side. When I mentioned should we include rods from C5 thru T3, he said it was unnecessary due to the fact that 1. your already fused at C5, C6 and C7, why would you add hardware, just to add? it’s a waste of time and money 2. there’s no added benefit 3. adding hardware to fused levels, can increase likelihood of chronic pain from hardware. He would not recommend this at all.

He discussed that a posterior foraminotomy can’t address moderate/severe C3-C4 foraminal stenosis or any other levels at C4-5, C5-C6, and C6-C7 because Spondylitic ridging and uncovertebral spurring are in ACDF fusion, they were never removed during ACDF procedure’s. He’s very confident that addressing Pseudarthrosis will provide a great deal of pain relief and reduction of muscle spasms.

Is there a way to know how much of someone’s pain, and muscle spasms, are caused by uncovertebral spurring verse Pseudarthrosis or there’s overlap? Thanks

[Donald Corenman, MD, DC]

#33098

Uncovertebral spurring is another way to say foraminal stenosis. See https://neckandback.com/conditions/radiculopathy-pinched-nerve-in-neck/.

Nerve root pain typically causes referral pain into the shoulder and down the arm if the level is C4-5 or lower. Pseudoarthrosis pain will typically cause neck pain (that can radiate out but the majority of pain is centered in the neck).

Your surgeon is correct in that; “a posterior foraminotomy can’t address moderate/severe C3-C4 foraminal stenosis or any other levels…because Spondylitic ridging and uncovertebral spurring are” typically removed “in ACDF fusion”. However, a posterior foraminotomy can make more room for the nerve so can be helpful in your circumstance if you still have nerve root pain residual from your last surgery.

If your surgeon is fusing T1-3 posteriorly, I would probably agree that you don’t need hardware above into C5-7 but hardware into the fused levels does make the construct more stout which is not a bad problem to have (better chance of fusion).

The best way to differentiate pain origins is to use selective nerve root blocks to determine the painful levels. See https://neckandback.com/treatments/epidural-injections-and-selective-nerve-root-blocks-diagnostic-and-therapeutic-neck/ and https://neckandback.com/treatments/diagnostic-therapeutic-neck/

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]

#33101

Dr. Corenman,

Thank you so much! It is greatly appreciated, stay safe and healthy.

[Donald Corenman, MD, DC]

#33102

Thank you

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]

#33118

Good Afternoon Dr. Corenman,

Thanks for your continued support, just have a quick question please. My surgeon stated that he can open up nerve channel’s in cervical spine for those levels that are tight. Is this a foraminotomy or something else? Thanks

[Donald Corenman, MD, DC]

#33128

That would be a foraminotomy.

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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