Donald Corenman, MD, DC
Moderator
Post count: 8660

You obviously needed this ACDF surgery at C4-5 due to the severe compression and cord injury (myelomalacia). However, you have pretty severe degenerative changes at C5-6 (“mild to moderate bilateral neural foraminal stenosis, worse on the left than right. Hypertrophic Luschka joint changes are preset”). You also have had the prior fusion at C6-7.

The C4-5 level needed to be surgically addressed but the C5-6 level houses the C6 nerve which radiates down to the hand on the thumb side. Your initial arm pain might have originated from this level as the C4-5 level (the C5 nerve) does not go down below the elbow. Your current pain could be from the C6 nerve. A selective nerve root block (while keeping a pain diary) will ascertain if this is the pain generator.

The fusion at C6-7 along with the new fusion at C4-5 places much greater stress on C5-6. Since this C5-6 level is already significantly degenerative and there will be much more stress due to the fusions above and below, you will probably wear C5-6 out faster and need to have this level addressed surgically.

Dr. Corenman

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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.