post-cervical discectomy

[caynetina]

Hi,I had a C5-6&C6-7 microdiscectomy and instrumented fusion on Feb.21/03 for a large C6-7 disc herniation with C7 rad. and C5-6 a similar disc.Symptoms were there about 1 year prior to sx. Previous symptoms included severe L arm pain,pain between shoulder blades& into the thumb,index & middle finger& muscle spasms/numbness. At sx. a sequestrated disc fragment was found around the posterior annulus &longitudinal ligament&was excised which was not seen on MRI.I saw my surgeon briefly before D/C from hospital& told him I was still having pain in the arm almost like before.He told me it would take a little while to heal because the neuroforamen was extremely filled with debris which he cleaned out. I also developed a UTI in hospital (I wasn't catheterized though)&never had a UTI before. My questions are, I'm still in an extreme amt of pain sometimes more severe than before& numbness, is this normal? I was told to increase activities slowly but I cannot even sit in a car for more than 10-15 minutes without developing extreme pain like before.I also can't sit at the computer for longer than 10 minutes.I'm taking even more pain killers now.  My fam doc sent me for a sed rate & it was normal. I'm so worried that I'm not going to get pain relief.When I lie down I feel less pain &pain is there most time.I was not bad for the first week after sx. but it seems worst now like before.Does this get worst before it gets better?if so could you give me an estimate when I may see some improvement?I see my surgeon on April 9th for a F/U with x-ray.Also,do UTI's happen after neck sx? Thank you

[CCF-Neuro-M.D.-JT]

In my experience, it's quite variable.  I've had some patients tell me they were better immediately, while a few unfortunately did not experience any significant pain relief, but did not deteriorate in terms of function post-op.  I would give it another week or two to give everything time to settle down.  There may be a little inflammation in the area of the surgery (won'[t be picked up by a sed rate) that will probably resolve on its own over time. Also keep in mind that the surgery sounds pretty extensive.  Having said that, it's a little unusual for you to feel worse than before.  Give your surgeon a call before your followup appointment (maybe in the next week or two and let them know that you're in more pain than pre-op).  They may want to bump up your appointment and evaluate you sooner with an exam and films.

As for the UTI, that's actually not uncommon in the setting of surgery and hospital stay.  Could be from urinary retention during the surgery or you may have been cath'ed during the surgery and then it was removed.  At any rate, as long as it was treated wouldn't worry too much about it. Good luck.

[caynetina]

I just wanted to mention that my pain tends to get much worst when I'm upright.  When I lie down I do get relief in my arm and my numbness is much better too, any suggestions why this might be happening?  Many thanks again!