windee

Dear Dr. Corenman, Thanks so much for your reply and offer for advice. I really wish I could be seen by YOU, everyone I’ve talked to has recommended you as The Best surgeon in complex spine cases, but I appreciate your offer of consulting with me and getting your advice. I know this is long and you are a very busy man, but I feel I must be detailed in my history so you will know what advice to give me.
I am sorry I wasn’t clear on the topic of my trapezius muscle separating from my spine. You are correct about me having surgery before this occurred. I had 2 prior Posterior surgeries before this happened. The first was a posterior fusion with 2 rods, plates and 6 screws in October 2013, and the second was the removal of the posterior hardware 2 years later in October 2015, and it was after this my trap muscle separated. So the posterior fusion in 10/2013 was an attempt to correct 2 prior anterior fusions to c-6,7 in 5/2010 and c-5,6 in 10/2011. After the 2 fusions I actually was in worse pain than before the surgeries. I went through physical therapy of course, tried epidural injections and other therapies without success. I was referred to Dr. in Durango, CO who diagnosed zero fusion at 6,7 and only partial fusion at 5,6. He recommended a Posterior fusion to C-5-7 and performed this using my hip bone as graft. There was finally fusion at these levels but I continued every day with even more severe nerve pain than before along with radiculopathy in my right arm. Dr. said it could take up to a year or longer before nerves healed but after waiting 18 months in excruciating pain I knew there was a problem.
A new MRI and CT scan showed 2 of the pedicle screws at C 7 extending into my epidural space. When Dr. Youssef called about the CT he told me that I may be having an adverse reaction to the hardware and he would be glad to remove the hardware for me. When I asked him about the pedicle screws positioned in my epidural space and the excruciating pain I had been in while waiting for nerves to heal that were never going to because of the screws he referred me to the consent page I signed before surgery which states sometimes hardware is mal positioned but that is not the fault of the surgeon.
I found an orthopedic surgeon at Skyridge Medical Ctr. in Denver, CO to remove the posterior hardware right away, which he did in 10/2015. I had immediate relief when I woke up after the surgery and slowly over the next few months the nerve pain eased up dramatically. Unfortunately about 3 months after the hardware removal I began having a burning sensation and major pain in my neck muscles more so on the right along with my right shoulder popping in and out of place frequently, which was a new symptom and also super painful. I went back to Skyridge Medical in March 2016 and found that my trapezius muscle had separated about 2-3 inches apart from my spine. This was diagnosed by Dr, a collegaue of the surgeon who removed my hardware who works in the same office. He also looked at recent images and found moderate to severe instability at C-4,5 and recommended an anterior fusion there and during that surgery he would sew up the trap muscle.
In April 2016 I had the double surgery of the C-4,5 anterior fusion which he used what he called a cage – a semi circular piece about 3 inches long with 6 small screws that went from C-4 to C-6. I asked him if he could please remove the plates and screws from my first two fusions before he put the cage in, but he said he did not think it was necessary and part of that hardware was encased in the bone now. After the anterior fusion he turned me over and sewed the trap muscle back together. This was most excruciating and while recovering i felt the trapezius tear again! So only 3 months later in 7/2016 I was back in surgery having the trap muscle sewn back together, this time Dr. used non-absorbable Ethibond sutures. Since this surgery I have not had one day without burning hot pain not only inside along the area of my 6 inch incision but also a fever on the skin outside. I am not exaggerating when I say it feels like a volcano erupting with hot lava then these tiny pieces of suture spit out. I also have weird cyst like bumps that frequently come up around my neck and my neck muscles spasm constantly all day along with nerve pain also occuring near the C-6,7 area with weakness back in my right arm.
I had the anterior c-4-6 cage and screws removed in 4/2017 because of pain, difficulty swallowing and increased limited range of motion. I again asked if Dr. would please remove the other hardware from the first two surgeries since he had to be in there again anyway, but he still did not want to do it. After the cage was removed I had such immense and immediate relief I cannot even explain how much better I felt. My range of motion improved and swallowing was much better. I healed in less than 2 months and couldn’t believe how much relief that gave me.
However the back and core of my neck remain in excruciating pain and it is intolerable. A recent MRI shows possible movement of one of the screws of the anterior hardware. I really suffer as I am unable to take pain meds or muscle relaxers like normal people. I get little sleep, 2-4 hours tops, and that is interrupted every 15 minutes due to pain. With zero quality of life right now and in such excruciating pain I am desperate for answers and even desperate enough to go through another surgery to remove my remaining anterior hardware so I can at least be free of the metal plates and screws. Is there a possibility the remaining hardware is the culprit? Since I have such a huge feeling of relief when I have hardware removed maybe my system cannot tolerate the metal in there? Could a reaction to the stitches be similar in that my body wants to reject the sutures? I have recent MRI’s and a CT from 11/2017 but could ask my PCP for a new ct if needed. I will be anxious to hear what you think.