cervical fusion of c4-c6

[monkey3]

Six weeks ago i had a cervical fusion of C4-C6.  Prior to surgery there were no signs of neck pain but i had a horrible pain in the shoulder and upper arm.  When the doctor did a mri he discovered there was major compression on the spinal cord so he went in immediatly and fused C4-C6.  After coming out of surgery the pain was even worse in the shoulder and upper arm.  The doctor assumed that it was inflamation (inflammation) of the nerve and eventually it would go away.  He started me on steroids.  The second day of taking the medication my arm was unable to lift due to major weekness and pain.  the pain has settled but through physical theropy the weekness still has not gotten any better.  I had an EMG taken and it showed radiopathy of the C5 root.  What does this mean?  I thought that was the purpose of the surgery.  Will this get better or will I need another surgery to the spinal cord?  Please help me in some direction.  Not being able to have full use of your arm is frustrating and makes you wonder how before surgery I had no weekness and one week later I was unable to function my left arm properly.

[Abhijeet Deshmukh, MD]

Hello.

It is unfortunate that you have not benefited from the surgery. Was there any artificial disc implanted? Did they use metal plates?

IF these devices are implanted, the spine becomes stable. And the adjacent discs may have a chance of bulging due to the extra pressure they have to bear.

It is possible that the C5 nerve root is getting pressed at the intervertebral foramen.

Regards

[monkey3]

So what kind of treatment would need to be done to cure this problem or is it something that just needs to heal over time.  Would physical theropy help at all?  Or would you need another surgery to fix the pressure on the nerve root that is getting pressed on?

[Abhijeet Deshmukh, MD]

Hello.

There can be a revision surgery. You should not leave it to heal by itself. It may not heal. Please discuss the option of a revision surgery with your spine surgeon.

There have been instances where people with a failed surgery have benefited from a revision surgery.

Regards

[monkey3]

The real question may be the fact the theropy is actually helping with being able to raise my arm. The strength is not yet back but as I begin to get the extension of my arm to raise the pain starts back again in the shoulder and arm. Not as bad as it used to be but the question is if the strength comes back without surgery but there still is pain would it be to my best interest not to have a revision surgery.  I would prefer not to be opened up again if not needed.  This is really one of those situations that you dont know which way is the best way to go.  I know the doctor will say if its getting better it just needs time and patience.  Do you really feel that this is the right or wrong answer?  The surgeon is very stubborn and Im not wanting to **** him off but in the same way I would truly like answers.  As a doctor what would you do if you had a patient in this situation?  Would revision surgery be the answer or would you wait a couple more weeks to see how the patient was doing?