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Neurology (Expert Forum)
cronic pain six months after anterior cervical disc surgery
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cronic pain six months after anterior cervical disc surgery
by ea5cng, Jul 07, 2005 12:00AM
After a car accident in September 2004 I had to have anterior cervical surgery in February. I had two affected discs, one between C5-C6 to the left in contact with C6 nerve and another in C6-C7 compressing the spine which was causing a right paralysis. The neurosurgeon assured that the problem and pain would be solved by C6-C7 discectomy replaced with a titanium disc (wing cage method) and bone graft taken from my own vertebra. Right after the op all symptoms and pain disappeared but one week after I started having cervicobrachialgia and chronic pain. 2 months after cervicobrachialgia and lumbar brachialgia got worse. 6 months after I continue having chronic pain, cervicobrachialgia, lumbar brachialgia. Some days I can't even walk and I am completely unstable standing and doing normal activities. At present, I am taking 650mg paracetamol 1-1-1, 400mg ibuprofen twice a day ,valium 1-1-1, Amitriptyline 1-0-1 to reduce the symptoms of chronic pain and 25mg of Aremis (sertraline) (anti-depressant to cope with the chronic pain crisis when they occur)
I go to physiotherapy but I don't seem to improve. When I get a bit better and reduce medication the pain crisis get worse and last longer. I have been in and out of hosp 8 times to receive intravenous pain treatment. I have been told that I should have had both discs replaced because now the hernia right above the artrodesis is taking all the strain and causing the pain which results in muscle contractures which increase the pain and irradiate. Should I have surgery again to replace the other disc or will these symptoms disappear?
I go to physiotherapy but I don't seem to improve. When I get a bit better and reduce medication the pain crisis get worse and last longer. I have been in and out of hosp 8 times to receive intravenous pain treatment. I have been told that I should have had both discs replaced because now the hernia right above the artrodesis is taking all the strain and causing the pain which results in muscle contractures which increase the pain and irradiate. Should I have surgery again to replace the other disc or will these symptoms disappear?
Doctor's Answer
by CCF-Neuro-M.D.-PW, Jul 12, 2005 12:00AM
I cannot recommend surgey for you over the internet
Without knowing you, your examination, or your scan, it is impossible for me to do so
If you did have C5-6 nerve compression, then this could still be causing pain in teh neck and upper arm , and possible weakness o f lifting the arm or externally rotating it.
The chronic pain sounds like it is an issue in and of itself, and you are correct in that soft tissue strain and muscle spasm is probably now contricuting. It sounds like you need a seconds opinion on further surgery, and a good pain management physician. A postop MRI scan if not doen already can sometimes reveal a persistent disc or disc fragment that might be causing problems.
Goo dluck
Without knowing you, your examination, or your scan, it is impossible for me to do so
If you did have C5-6 nerve compression, then this could still be causing pain in teh neck and upper arm , and possible weakness o f lifting the arm or externally rotating it.
The chronic pain sounds like it is an issue in and of itself, and you are correct in that soft tissue strain and muscle spasm is probably now contricuting. It sounds like you need a seconds opinion on further surgery, and a good pain management physician. A postop MRI scan if not doen already can sometimes reveal a persistent disc or disc fragment that might be causing problems.
Goo dluck
I have just been diagnosed with Spasmodic Torticollis (Cervical Dystonia). These symptoms began immediately following a neck fusion and have increasingly worsened. My head is at a20 degree tilt to the right (going toward my shoulder) and my shoulder is elevated 20 degrees. The pain that I am in is actually much worse than before I had the neck fusion. Is it possible that the surgery caused this dystonia?
I just received Botox injections, as all other medications have failed, but still take Vicodin twice daily and Valium 3 times per day.
I can only hope that these help, but have been told that I will have to have them every three months for the rest of my life. Is anyone familiar with this happening?
Please help.
Thank you,
Yana
I am keeping the pain under control at the moment. I was sent to a pain unit were they are used to people that have had this kind of op and they know the symptoms and sometimes the cause, they are the best managing pain. If your pain continues, you should seriously consider being treated in a pain unit. Acupuncture has also helped a lot in my case. In the pain unit I am treated with cervical epidural injections (once a month). In an epidural injection they place anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots to reduce the pain in the neck, shoulders and arms. It can help the injury to heal by reducing inflammation an it relieves pain even for several months while the injury/cause of pain is healing.
I have also been prescribed LYRYCA (PREGABALIN) for Neuropathic pain and so far so good. In the mean time I am awating results but if I can manage pain this way I will not have surgery again.
Good luck and I hope you get better soon,
ea5cng