Thoracic / Shoulder Blade pain after ACDF

Tagged: Shoulder supraprinitus tear after ACDF and increasing thoractic pain

Viewing 6 posts - 7 through 12 (of 14 total)

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shirley j
Member

March 20, 2014 at 1:44 pm

Post count: 4

#10583

Scoliotic spines can become unbalanced after acdf- espcially multiple level fusions. I have this unfortunate complication after 4 level acdf. I have not found a fully effective treatment. Chiropractic is helpful on unfused areas along with adunctive therapies like electrostim, ultra sound, massage. The t-spine pain after the surgery was extremely intense. This could be contributing to your pain.

Donald Corenman, MD, DC
Moderator

March 21, 2014 at 4:59 am

Post count: 8660

#10588

It is true that balancing a scoliotic spine with a fusion above the scoliosis can be difficult and if fused in an unbalance position, can cause pain.

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.

blakedfw5050
Member

February 11, 2015 at 1:38 am

Post count: 2

#12188

Hello – This post is very similar to my conditions.

ACDF c7-t1 Dec 2014, 3 weeks after surgery, I sat up and within 15-30 mins and my left should, rib cage, neck, jaw tightned up, its like it shifted. I thought I was having a heart attack and went to ER, still in neck brace.

Let surgeon know asap and I have seen numerous docs since then, nobody can help. Surgeon says fusion okay, get checked out for TOS and Pain Mgmt. – I am waiting on appts for that.

With that said, still today, I have spasms in back, the left shoulder is elevated, pectorial tight, shoulder blade pain, in my neck, jaw and even feel TMJ setting in. I get headaches too. Sometimes the anxiety is incredible. Also, cold and and burning sensations in hand.

It feels as the fusion has significantly changed the mechanics of my shoulder and back and neck – but I cant get answers where or how to try to manage.

Ive had one MRI since surgery and just says okay, but one doc says it was a poor quality MRI.

Any thoughts on how to figure out why so much discomfort?

Donald Corenman, MD, DC
Moderator

February 11, 2015 at 11:31 am

Post count: 8660

#12191

You have symptoms that could originate from any number of problems. The C3 or C4 nerves could cause these symptoms. There is a disorder called “cervical angina” which is a C4 nerve involvement that “feels” like a heart attack.

Unusual but TOS can cause this too.

A new better quality MRI with attention to the foramen at C3-4 and C4-5 would be called for in my opinion.

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.

blakedfw5050
Member

February 16, 2015 at 2:29 am

Post count: 2

#12241

Dr. Corenman,
Thank you for the quick reply.

I may have some minor issues the the other c levels, but what is very concerning is the tightness of my left pectorial, the elevated left shoulder and the spasms in the back of my neck on each side of the t1 area. My shoulders now have the pointed side of the collar bone sticking out – I did not have any shoulder issues prior to surgery and they sometimes hurt pretty bad, both sides.

I may have some should tendinitis, but again, I never injured shoulders and it would be bc of the shift of my body when I sat up. I made a big mistake by obviously pushing up too hard when sitting and that has damaged something in the surgical area of my back to cause pain, spasms and now un-alignment of my shoulders. Other interesting note is that when I lengthen my neck my head shifts to the right, and the left scalene muscle is much tighter than the right.

Also, the MRI does say the fusion is sublexed, which is concerning – but don’t understand what that means.

Would your practice try to help me understand, as I live in Texas, so a trip for a week would be possible in the future.

Next week I see sports med DR at UCSD and a Physiatrist for answers. The doctor at UCSD for TOS said he can tell something is wrong, but its “Fuzzy.”

I do test positive for the Adson’s sign, left side only.

Do you know if the original “poster” of the question get her answers? I seem to read a lot about should pain after ACDF, but not much on answers.

Many thanks,
blake

Donald Corenman, MD, DC
Moderator

February 16, 2015 at 11:41 pm

Post count: 8660

#12253

A good physical examination might help to ahead some light on these symptoms. You might find an orthopedist who can examine your shoulders to see if there are internal disorders that might mimic these symptoms. There is a disorder called Polymyalgia Rheumatica that can also mimic your symptoms. I have not written about this yet but you can Google this disorder to see if it fits your symptoms.

This forum is anonymous so I cannot track any participants to find out what has happened to them.

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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Donald Corenman, MD, DC

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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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Thoracic / Shoulder Blade pain after ACDF – 6 months post op