Pain following C5-C6 Fusion with allograft 3 yrs ago

[karyrn]

I have been an RN since 1982. I have worked in ICU, CCU, Neuro ICU, Open Heart, Out patient Surg. and Research. In 1985 iwas diagnosed with scoliosis and had Harrington Rods placed (2) T1 throughout my entire t-spine. In 1998 I fell forward into a bookcase and fractured my neck. I also had a closed head injury. At that time they did a C5-C6 Discectomy. I did not have rehab after either surgery. As time went on I had more and more crepitus in my neck and started having decreased sensation in my fingers and strength in my arms. I eventually consulted a orthopedic surgeon. In Oct of 2005 I had a C5-C6 Fusion with Allograft. I had the drain removed the next day and went home with the McGill Collar. I wore that for 6 weeks. I did not have physical therapy after the surgery. I did have the usual inscional  pain and muscle spasms. I had difficulty eating and lost a lot of weight. I was taking Demerol for pain and Valium for muscle spasm. To this day I still have pain that radiates down my right arm. My trapezoid muscles are always tight. I have been to pain Dr's, I can't take many of the medications. I am not a candidate for a stim unit. I have only had MRI's and 1 X-ray. They say everything is patent and the hardware is in place. I can literally palpate at C-5 (and it is now noticeable a bump) that when pushed too hard causes pain to radiate down the backside of my right arm to my right pinky and ring finger. I had migraines before the surgery but they are much, much worse since the surgery. I have not been able to return to work. I am trying to figure out what is causing this.  

[karyrn]

Thank you for your comments. Yes I did apply for S.S.D. an am on it. My pain MD thinks I can return to work????? I have been able to pin point the pain. I actually  have an area at C-5 that is now developing that is the size of a nickel. When palpated it causes pain and neuro changes up my neck to my right ear and down across my right shoulder all the way to my right pinky and right ring finger. This is new. This is at the level of the fusion. I also had a Rhizotomy done about 2 1/2 months ago at C-3.4.5 bilaterally. The left side worked well. They want to do it again on the C level and also lumbar level. I have also had a micro L4-L5 laminec. foraminotomy due to a injury sustained while working. Other than that I just keep praying and keep the faith.

[kittyluv1]

I am sorry to hear of your continued health problems.  It sounds as if you have experienced more than your fair share of problems!
You do present with a complex history and determining the source of your pain apparently has stumped the physicians you have consulted to date.
My initial thought was whether the current symptoms (arm pain, trapezoid muscle spasms) have been present since your fusion or are a new development.
Some nerve damage could potentially result in permanent residuals that fusion surgery was unable to remedy.
I had anterior cervical discectomy and fusion C4-C7 done eight weeks ago and had a very good outcome.  The potential for further disc degeneration at other levels exists and the need for additional surgery is a possibility.  I am hoping that won't happen for some time --- but who knows?
Absent any definite pathology on MRI or x-ray makes identifying the source of your pain much more difficult.  Is there any possibility that the pain generator might be more localized to the facet joint?  I do not know how visible the facet joints are on MRI post fusion.  I have heard that the hardware can obscure some details.
There is a problem that pain unresolved over a length of time contributes to a chronic pain syndrome and treatment options are less successful.  Are there any methods currently being suggested by the pain specialists?  It is physically and emotionally tiring and frustrating to cope with constant pain.  
I can only encourage you to keep targeting specific areas of possible pain generators until all options have been exhausted.  Since you are not a candidate for e-stim and most pain medications not tolerated, the available options are more limited in scope.
The inability to return to work is a definite contributing factor as, based on your work history, your professional career remains in limbo.  Have you considered filing for permanent disability?
Please keep us updated on your status.  My thoughts and best wishes to you for added strength as you cope with your pain.