burning pain in neck and other symptoms

[ms38]

I had ACDF surgery in 08/07.  I started experiencing burning pain on the right side of my neck approximately 6 weeks after surgery.. I have had several MRI's and the cervical ones indicated I have enlarged lymph nodes on the right side approximately 15millimeters in diameter. They were there presurgery as well. The surgeon says my bones are fused and evertything looks fine. My problem is this burning pain comes and goes on the right side of my neck and it has spread to under my breasts sometimes in the arms and now I have noticed my hands are turning red and they burn and sting as well.  It seems they turn red when the neck burns intensely. My sed rate on 2 different occasions was 27 and 35. My c reactive protein was normal. SOmething just doesnt feel right on the right side of my neck, it feels like a stretching pulling pain. I have seen 2 different neurologists and they have no answser for me. I havent had an EMG yet but think I should schedule one soon.  I am so worried about it and I want some answers. Are there any tests I can have done to get to the bottom of this."?  Could the titanium plate be causing this? I just need some answers and advice. I have an appt to see a Rheumatologist in late April. Please give me some guidance.
Thank you

[ms38]

bumping up

[Lee2263]

You might actually go to a Pain specialist that is knowledgable of CRPS, Complex Regional Pain Syndrome. The fact that it is moving and getting larger, smacks of this disease. I wouldn't have anymore surgeries for anything until you find out for sure. I don't mean to scare you, but this could be a pretty big problem.

[ms38]

Hello again.

I just had my EMG today done by a neurologist. IT was normal. Now my question to you is should I be concerned of possible infection? Since my lymph nodes were enlarged on the right side per MRI report. THis is where all my pain has been and it has been burning, stretching pulling ripping in nature. My sed rate on 2 different occasions was mildly elevated at 27 and 35.  My c reactive protein was normal. I am quite sore from having that EMG done. I would like your opinion. SHould I have a biopsy? Should I be concerned?  What should be my next step in your opinion.?? I have heard that cervical infections get misdiagnosed alot and doctors miss them alot in the early stages. My ACDF surgery was 8/07 and these symptoms started approximately 6 weeks after my surgery. Please help me understand.

[Prem Pillay, MD]

You do have a problem that does not fit well into any of our usual pigeon holes.
You do have to get a rheumatologist and a neuro specialist to go over you.
For neuralgic pains, medications like pergabalin and gabapentin are worth a try (under a doctors direction of course).

[ms38]

please respond. Bumping up

[ms38]

No I didnt have any of this burning pain prior to surgery. My symptoms prior to the surgery were left arm pain and left shoulder,scapula pain and left arm weakness.  The discs removed were C5-C6 and C6-C7. I started experiencing this intense burning pain approximately 6 weeks after the surgery. The pain also went into the back of my skull and down my right arm. For a while the pain was everyday nonstop for 3 months and then it began to taper where it was coming and going. The pain also was by my right ear. THen the burning began to spread to other parts of my body, for instance down my back and under my breasts and on my sides and so forth. I would like to give you my last MRI report if thats okay.  I have had a total of 6 MRI's since the surgery and no new herniations have shown up. My surgeon first said it could be the nerve root causing this pain but they still dont know as of yet. I have been undiagnosed still. I plan to have an EMG on Monday.  My question is what about the enlarged lymph nodes. The side of my neck that burns is on the right lateral side and also posterior as well.  I just want some answers thats all.  Here is the last MRI of my neck. I would like your advice.

MRI of the soft tissues of the neck without and with contrast:

Clinical information:right-sided neck pain and burning parethesias behind right ear. History of previous spinal fusion.
Technique: 1. Sagittal, axial, and coronal T1-weighted 5-mm images.
                  2. Axial and coronal T-2 weighted 4-mm images.
                 3.  Axial and coronal T-1 weighted 5-mm images after contrast admininstration with fat-saturation.
Comparison: There are no previous MR scans of the soft tissues of the neck available for comparison but there are outside MR scans of the soft tissues of the neck on 7/27/07 and 10/04/07. THis study was performed after the patient was premedicated for her gadolinium allergy with prednisone, zantac, and benadryl. There are postoperative changes of anterior cervical fusions as well as anterior plate and screw fixation from C-5 to C7. This causes some mild artifact. There are prominent level II nodes larger on the right side. THese show homogenous contrast enhancement and are no greater than 15mm in diameter, along their anterior superior axis. THese were also present on the outside MR scans of the cervical spine and have not significantly changed. I suspect that they represent benign reactive nodes. NO mass lesion is appreciated within the soft tissue of the neck.  THere is no evidence of a mass lesion in either lung apex.
Impression: 1. There are postoperative changes of anterior cervical fusion with instrumentation from C5 to C7. THis causes some minor artifact.
2.  THere are bilateral level II probable reactive nodes larger on the right side which in retrospect are unchanged from outside MR scans of the cervical spine on 7/07 and 10/07.
3. MR scan of the soft tissus of the neck is otherwise unremarkable.

So sorry it is so long. I also had an MRI of the thoracic spine but is was without contrast. It had no herniations. Please advise.