[connect2maryk]

#13228

Dear Dr. Corenman,

I wanted to thank you for all the advice given to me in the past; unfortunately, I am not progressing as well as I would like to be in our university health plan.
Just a short review, 2008 I was diagnosed with a L2 intradural/ extramedullary schwannoma. I had a decompressive laminectomy and the tumor was removed. I had several follow ups and it seems there is no reoccurrence. The debilitating symptoms were gone, but two months into the aftermath I began having antolateral right thigh pain, paresthesia in my feet walking on glass, later anteromedial pain in both thighs, paracervical discomfort, posterior nuchal discomfort (all pains on right side of tumor). In 2013, the symptoms increased to unbearable. It was so difficult to walk. I no longer could sleep (still to this day) as I feel I am lying on broken glass.
I notified my surgeon concerning the neuropathy, electrical sensations (arm) and forearm pain, before he retired, and he suggested a full MRI. This has been a difficult task try to get my health plan to go along with full MRI. I finally was able (2 years later to have the cervical MRI) – Results below.
I was first sent for a CAT scan (neck pain) where I learned I that numerous small luciencies were noted throughout the vertebra body and posterior elements, particularly C7 and T1. I had testing for Multiple Myeloma and was told that it was negative. The MRI below is to confirm that the luciencies were not cancerous.
I desperately need advice concerning my right quadrant, I have such severe pain in my neck, right shoulder, clavicle area and right forearm.
I was at first told it was fibromyalgia, but after conversing with you I was able to go back and speak up and tell them it was only in my right quadrant it couldn’t be. I was then told fibromyalgia is just a blanket statement. They don’t know what it is. It could even be a virus of my nerves? I requested to see the shoulder expert (your advice) I received an xray. I was also given a cortisone injection in my shoulder (I requested).
The pain is still there if not worse. I wake up in the morning and I feel as if I have thousand pound weight on my right clavicle as well as dagger in this area. At times I could drop to my knees with the pain radiating from my neck, clavicle area, shoulder and right arm. I emailed the orthopedist asking if I should be see again and she told me that she believed it was neurological before the cortisone injection did not help the pain…. Go back to neurology.
I went to pain management this past Thursday and I was told the upper right quadrant pain could be from my surgery and the schwannoma. I asked about Arachnoiditis as my dura was cut as well as arachanoid bands and I was told they didn’t think so.
I am just hearing so many contradicting diagnoses.
I understand post surgery pain in my lower body especially with the added sacroiliac joint dysfunction and spondylothesis of the lumbosacral region (Hospital MRI states almost Grade II – The health plan MRI states Grade I), but the progressing pain in my upper right quadrant and the progressing weakness has me frightened. I have never experienced such pain (far surpassing childbirth).
Is it possible this upper quadrant pain can be from spinal surgery? Is it possible a pain so severe and debilitating can be neurological? I am so frightened.
MRI CERVICAL SPINE:

Vertebral body height and alignment are within normal limits. There is straightening of the normal cervical lordosis. Cervical cord is normal in caliber and signal intensity.

There are tiny T1 and T2 isointense or slightly hyperintense foci in the C2, T1, and T2 vertebral bodies, which do not demonstrate appreciable enhancement and most likely represent hemangiomas or lipomas.

Degenerative changes are again noted results in mild right neuroforaminal narrowing C3-4 and moderate left neuroforaminal narrowing at C6-7. No abnormal enhancement is seen.
Thank you so much in advance,
Mary

[Donald Corenman, MD, DC]

#13487

The removal of the schwannoma at L2 should have no bearing on your upper shoulder and neck pain. The feeling of “glass” in you foot could be from nerve injury secondary to the schwannoma removal but also could be from the spondylolisthesis.

Without significant compression of the nerves in you neck on the right side, the pain in your shoulder could be from Parsonage Turner syndrome (see website) or another type of nerve injury. You might consider an EMG from a good neurologist.

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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