Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Rehabilitation after Cervical Fusion

Forum: Neurology Forum
Topic: Neurosurgery - General


In June of 1997 I was diagnosed with a disc herniation in the Cervical Spine
at the level of C6-C7. For the past two weeks I had been suffering neck
pain and then woke one morning with acute pain in the arm, shoulder etc.
Later MRI showed the disc with a right side herniation effecting the C7 Root.

Within two days after my initial pain, my strength in the right arm, mainly
in the triceps as much as 45% loss. I then saw a neurosurgeon in my city and
was given surgery, discetomy/fusion as my recommended action.

The following week I under went the surgery and was amazed by the time I was
in recovery I had regained most of the strength in my right arm. I asked at
the time about rehabilitation and wasn't given much of an answer.

I returned to work 4 weeks later and during the next 6 months had neck pain
on and off, all in the area of the c6-c7 disc. In Mid Sept, I began a formal
rehabilitation with a local group. I began to have more neck pain still in
the same area. This has caused me great concern.

I am interested in finding out more on accepted forms of rehabilitation for my
type of surgery and if pain should be part of the process. The pain I have been
having has not kept me from work or sleep, it just has gotten alittle more
persistant. The pain is mainly in the form of stiffness/tightness in the
immediate area of the C6-C7 Spinal process.

I should mention that in November I had another MRI done to evaluation the
fusion and was told that the C6-C7 fusion was solid or had taken.
____
____
Dear Paul,

Rest assured that things are going well. Patients often have some degree of pain after a fusion procedure. It is important, though, that your arm pain and weakness are improved or improving. The typical progression of improvement after this kind of surgery is that pain gets better first, usually right after surgery, followed by weakness, which can take months to a year or so, followed by numbness, which may not get better at all. This is simply the way nerves recover from such injury.

Physical therapy is often prescribed when a patient is weak. The specific form of physical therapy is best left to the therapists themselves. One would like to see patients do some mild strengthening exercises along with stretching and massage therapy, if necessary.

You state that your fusion is taking and that your strength is returning. Give the neck pain some time to recover. As long as things are getting better and your old pain is gone, you will do well.

Good luck.




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