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ACDF Surgery Done. Headache, Pain And Numbness On Arm With Stiff Neck. Any Solution?
Question: I am 3 months post op from ADCF of 4/5 5/6 6/7. My neck has healed well and i have less headaches and the pain I had on left arm to thumb and first finger is gone and numbing of thumb is leaving. The problem is I now have stiffness of my neck and numbing of neck left side. In addition I now have pain on right shoulder into upper arm. Doesn't go to fingers. My neck in back has pain and the left side of neck has pain going straight down back. Upper back is hurting to neck and stiff. My doctor has had me have MRI and it shows posterior osteophytes at the same levels I had the fusion. From everything I have read, these should have been removed during the fusion and they can cause pain, all three are indenting the thecal sac, and C4/5 is also and C5/6 result in mild narrowing of the canal, there also is narrowing of the right neural foramin at C5/6 level.
I am having more pain now than before my surgery and I wondered if there is any solution for this problem????
I am having more pain now than before my surgery and I wondered if there is any solution for this problem????
Hi,
Thank you for posting your query.
I can understand your discomfort on account of pain and stiffness.
Many times, surgeons to reduce the morbidity after surgery, limit the extent of surgery so that the duration of surgery & anaesthesia is less, resulting in faster recovery after surgery. That could be the reason for surgeons not to remove the osteophytes.
As of now, what could help you most is good physical therapy. This would consist of passive and active neck extension exercises, pain relief measures such as IFT, ultrasound, etc. This can be done twice daily- mornings and evenings.
In addition, medications such as pregabalin or gabapentin would help in reducing the neuropathic pain.
I am sure that with these measures, you would get better over time.
I hope it helps. Please get back if you have any more queries.
Wishing you good health,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Thank you for posting your query.
I can understand your discomfort on account of pain and stiffness.
Many times, surgeons to reduce the morbidity after surgery, limit the extent of surgery so that the duration of surgery & anaesthesia is less, resulting in faster recovery after surgery. That could be the reason for surgeons not to remove the osteophytes.
As of now, what could help you most is good physical therapy. This would consist of passive and active neck extension exercises, pain relief measures such as IFT, ultrasound, etc. This can be done twice daily- mornings and evenings.
In addition, medications such as pregabalin or gabapentin would help in reducing the neuropathic pain.
I am sure that with these measures, you would get better over time.
I hope it helps. Please get back if you have any more queries.
Wishing you good health,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I already have had physical therapy. I have gotten worse in last four weeks. Very bad stiffness and pain into upper back to neck and left neck. Not normal. Cannot tolerate neurotin. Have had ultrasound and massage also.
Would a minimally invasive posterior surgery be possible to remove them now? Or could he go in from front again? I am sick. This is awful. The surgical site healed perfect and the left arm pain went away.
Would a minimally invasive posterior surgery be possible to remove them now? Or could he go in from front again? I am sick. This is awful. The surgical site healed perfect and the left arm pain went away.
Thank you for getting back and providing additional information.
Another surgery may not be preferred now, as minimally invasive surgery would technically be difficult after having had one surgery, and also, the chances of success in second surgery is lesser, unless done by very experienced surgeons.
If you could not tolerate neurontin, you could give a try to pregabalin (lyrica) or duloxetine (cymbalta).
Another option is epidural injections. This can be given in consultation with pain specialist/neurosurgeon.
Best wishes,
Dr Sudhir Kumar MD (Internal Medicine) DM (Neurology)
Another surgery may not be preferred now, as minimally invasive surgery would technically be difficult after having had one surgery, and also, the chances of success in second surgery is lesser, unless done by very experienced surgeons.
If you could not tolerate neurontin, you could give a try to pregabalin (lyrica) or duloxetine (cymbalta).
Another option is epidural injections. This can be given in consultation with pain specialist/neurosurgeon.
Best wishes,
Dr Sudhir Kumar MD (Internal Medicine) DM (Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have seen the surgery report. It shows the doctor looked at the osteoophytes but did not attempt to remove them. He also said everything went remarkably well and the surgery was a succss and I should be pain free.
I have read every attempt should be made to remove posterior osteophytes during nterior surgery as they ae a problem that will not go away. This was in a government report.
I have read every attempt should be made to remove posterior osteophytes during nterior surgery as they ae a problem that will not go away. This was in a government report.
Thank you for getting back and providing more information.
Removal of osteophytes is not part of the standard surgery. It also depends on the surgeon's assessment at the time of surgery (intra-operative assessment). It seems from his report that he felt removal of osteophytes was not necessary, probably there was no compression of the nerves with them. In retrospect, I agree with you that probably that was not the best decision.
Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)
Removal of osteophytes is not part of the standard surgery. It also depends on the surgeon's assessment at the time of surgery (intra-operative assessment). It seems from his report that he felt removal of osteophytes was not necessary, probably there was no compression of the nerves with them. In retrospect, I agree with you that probably that was not the best decision.
Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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