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Thank you for replying to my post Dr. Corenman. I wanted to update you and I had an additional question.
I ended up having shoulder surgery two weeks ago. The operative report noted “Adhesive capsulitis with chondral defect inferior glenoid, posteroinferior labrum tear and extensive subacromial bursitis, bursal side cuff, tendinosis and abrasion with an osteophytic spurring anteriorly, left shoulder.” The rotator cuff fraying was deemed too insignificant to stitch or anchor. The capsule was released through manipulation and they also did an arthroscopic labral debridement with chondroplasty of the glenoid, extensive bursectomy and limited acromioplasty.”
The surgery was successful in that I have more range of motion than before surgery, although I am still not 100% with hand behind the back and up the shoulder rotation. As part of the surgery, I received an interscalene block, which I understand blocks C4-C7. I have to say that for at least a week after surgery, my neck and scapula felt great, which I attribute to the effects of the block — I think even after the main effect wore off and my arm was no longer paralyzed, there was some residual effect. Now two weeks later, my neck and scapula pain is back, plus throbbing in my upper side arm, which had disappeared after surgery, is back.
So I guess I received a kind of nerve root block as part of my shoulder surgery, except it wasn’t selective because I believe it hit C4-C7. My question is if I now want to try a SNRB, given that I have problems really from C3-C7, do I somehow go for four separate blocks and how far apart are they spaced? I also have to add that I am reluctant to have a “therapeutic” block with steroid, as opposed to a diagnostic block with lidocaine only, because when I had a cortisone injection into my shoulder, I had a terrible reaction with a red burning face and the cortisone also ramped up my appetite, which caused me to gain weight. I was wondering how frequently you see cortisone flares and whether purely diagnostic blocks without cortisone are worth considering.
One small correction. The feeling of being “punched” that I am now experiencing is in the left deltoid, not in the shoulder, although I did not have that punched sensation until after the disastrous shoulder injection (although of course it could just be co-incidence).
The one consult pre-surgery who wanted to put an artificial disc at C4-C5 and fuse C5-C7 told me I had a very serious issue at C4-C5 and that if I didn’t let him put an ADR at that level, my left arm would become useless. In fact, his words have become prophetic, because the arm post-surgery has become fairly useless. My current MRI at C4-C5 reads: “There is loss of disk height and disk signal with a small osteophyte bridging the disk space, contributing to severe bilateral neural foraminal stenosis left greater than right as a result of marked facet disease. The cord signal is normal.”
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