C56 Fusion 1999. New cervical stenosis

[BigSkyy]

I a had successful spinal fusion at level C56, in 1999. I did a year of physical therapy after my procedure and I have done very well. In Feb of 2010, pain in my left shoulder and neck started and in July, I went to orthopedic doc and he diagnosed me with rotator cuff impingement. Before I could even be treated for the rotator cuff problem, I experienced the worst muscle spams in my right arm that radiated into my right shoulder. I went to the emergency room and the doc ordered a MRI of my neck and sure enough much to my dismay, I had three compressed discs in my cervical spine. C34, C45 and C67. I contacted my neurosurgeon that conducted my prior fusion (we had relocated from where my original surgery transpired) and learned my doc had passed away. He was a fantastic doc that was young and dynamic and his passing left me feeling hopeless. I did speak with the doc that acquired the medical practice and the doc reviewed my new MRI over and agreed to do a two level fusion, C56. C67, without having a EMG conducted. We moved to a area of the US that is very isolated and since I had not met this new neurosurgeon, nor had this doctor examined me, I felt compelled to get another opinion. In the area I lived we are also limited to advanced medical care or docs that are specialized. I researched docs that specialized in cervical spine disorders and found a doc at a leading university, whom teaches, researches and practices neurosurgery and orthopedic surgery. I flew out over the holiday season to meet this doc and a doc that practices in the university's fellowship medical program. I made sure to bring my new MRI on a cd to my appointment. Upon viewing my MRI the fellowship doc went right in and got the doctor whom is the director of the spine surgery fellowship. Both of the docs explained to me that my symptoms and the MRI lead them to be concerned of the stability of my spine. Also, the director of the program explained I could be a candidate of a procedure called, Cervical Laminoplasty, instead of another ACDF. However, I would need to undergo a EMG (I had an EMG administrated prior to my last fusion) and also a MRI of my brain. I flew right home and had both procedures done, ASAP. Two weeks later I heard back from the university's doctors office and I was told that the brain scan was fine and the EMG did not show any problems with the exception of carpal tunnel in my right hand. There was nothing for this department at the university to do for me but to recommend a good doctor for the carpel tunnel. I asked what was causing my symptoms on the left side of my body; shoulder pain, pain in my forearms, numbness, severe weakness, my hands shake at times, especially my little finger. Plus, I have symptoms in both of my feet. I understand right side arm and hand problems are symptoms from the carpel tunnel but that can't be what is happening on the left side of my body? I asked the university's doctor representative if the EMG could be inaccurate. The answer was no. I then asked if the doc could just go off of reading the MRI of my neck that showed the discs pressing into my spinal cord. Again I was told the answer was, no, the EMG was the test that would indicate nerve irritation/damage. Since the EMG was negative for anything wrong with the nerve conduction there was nothing the university spine center could offer me. I have something else wrong with me and the cause is not my cervical spine. Now what? I am always in pain and I drop things constantly. I am also very clumsy. Where do I go from here and what on earth should I look at as a possible problem. I have personally ruled MS out since I have had two MRI's and nothing was mentioned of MS being a possibility. As I mentioned earlier, I live in a remote area and it's not easy to get other docs opinions. Any help is appreciated.

[TerisDad]

Hi there, I am so sorry to hear about your continued problems! I am trying to help my father-in-law, who is having some similar issues. He has now had 4 cervical fusions, and is still in the same condition! The pain in his neck is so bad sometimes that causes vomiting. He has been through every form of physical therapy, is on opiate pain meds that rarely help at all, has constant headaches that are so severe, he has had to retire from his job, and numbness down his arm. His hands also shake uncontrollably.
At this point, he is getting nerve blocks every so often, which help, but for just a few days at best. His current doctor, the latest of several drs seen, is suggesting a "peripheral nerve stimulator." He is scheduled to have this done 2 months from now. Needless to say, he is not optimistic, as after so much treatment, he is just not seeing any improvement!
His current findings show: Symptomatic Cervical Disc Disease, Bony Hypertrophy With Flattening Of The Ventral Cord, Bony Prominence Of The Occipital Bone, Subtle Cord Volume Loss, and most significant, Right C3-4 Uncovertebral Disc Spur Complex Resulting In Moderate Right Foraminal Narrowing With Right C4 Nerve Encroachment. (Whew!)
So now that I've given you tons of info, (sorry) I was just wondering if you wouldn't mind letting me know what you find out about your condition, so that it might hopefully give us some insight to his condition or possible treatments! Hopefully something that actually helps! Thank you so much for your time and attention!
This thank you also applies to anyone else who may read this and have any insight for me!

[Jrsygrl109]

yeah - it sounds like they just don't want to treat you.  I've had EMGs done 1 year apart with different results - the first said carpal tunnel, the second said ulnar nerve. Personally I think it is from my (failed)  neck surgery. By the time an EMG picks up something wrong I have found that it is too late to do anything but everyone's body heals differently. Pre-ACDF C4-6 my emg showed chronic nerve root irritation c5-6 and the pain never went away. AND the ony way I was able to show the doc that my neck pain was 'real' was that I forced him to order a sitting mri which showed severe instability. If I try to do something like use a blower for leaves or use a weedwacker for more than a couple of minutes afterwards my hands shake so much I can't hold a cup of coffee - this has been constant since before the surgery which was done in 2007. I'm not an advocate of un-necessary surgery but if the first doc said he would help you and you have conflicting opinions I would try and meet with the first doc.  Obtain your office notes from the Univ. doc, get all test results, and present them to the first doc and see what he says. Good Luck.