Post Cervical Foraminotomy

[Christine1214]

Dear Doctor, Approximately 2 weeks ago my husband underwent the above listed procedure to relieve pressure on a compressed nerve. The procedure was performed at the C6/C7 level. Prior to this he had a cervical disc fustion at the same level two years ago. The fusion did take although we recently found out through plain film x-rays and a MRI that the fusion took almost one and a half years to fuse! Now, the problem is...post operatively from the foraminotomy his original complaint of hand pain into his fingers subsided. Then about one and a half weeks later the pain came back. He currently feels (in relation to hand pain) the way he felt pre-op. His incision site is still considerably swollen but has gone down dramaticly since the procedure. Is it normal for the pain to reoccur? I'm assuming the nerve is swollen, we've been placing cold packs at the incision site and he is still on his medications for pain and muscle relaxers. Would a medication such as an anti-inflamatory be beneficial at this point as well? PLEASE HELP!

[CCFNeuroMD JT, MD]

Dear Christine,

Thank you very much for your question. I am happy to address the issues that you pose, although it is important that you recognize that my impression is based entirely on the information you have provided in your posting and is by no means a replacement for an office visit with a neurologist.  Diagnosis is contingent on detailed history and physical exam and as such, the following information should be considered solely for educational purposes.

I understand your concern given the return of your husband's preoperative symptoms.  Indeed, my best advice to you would be to make sure that the surgeon who performed the procedure is made aware of your husband's current circumstances.  Although I cannot make a diagnosis without having examined your husband and performed necessary testing, my inclination is that his current symptoms are likely related to post-operative swelling.  A trial of an anti-inflammatory medication such as motrin of naproxen may be of help in aleviation of symptoms.  However, prolonged swelling may result in compressive damage to the nerves in the arm and may have permanent sequelae.  It is for this reason that I urge you to contact your husband's surgeon.  Additionally, it is important to make sure that he hasn't developed a collection of blood (hematoma) or infection (abscess) at the surgical site.

I hope this information has been helpful to you.

Sincerely,
JBT, MD