Re Neck, Sholder and Arm pain

[sgtpep57]

I've written a question before about the almost unbearable pain in my neck, sholder,and arm pain and got a great response from Dr Sharma. I had 2 seperate cervical disc surgeries with a fusion done about 25 years ago and another about 4 years ago.Recently I had terrible pain and they put me in hospital did MRI and said that the disc were degenterive and Broken down.I did not really understand the results but I just did what they said and followed up with my primary doc. Well he put me on stronger pain meds and wrote me a referral for what I thought was a neurology  consult but as it turns out my appt is with a spine clinic. The pain in my neck, sholders and arms are so bad that I can't sleep and the meds only seem to ease it a little. Is a spine doctor gonna be able to help me? Also what questions should I ask this doctor? I'm so worried that I will have to get another referreal and now wait some more I already feel like I'm gonna lose my mind because of the pain.

[sgtpep57]

I've been thru hell with the pain in my neck arms and sholders. Lower back pain never even dicussed. Doctors did not do mri with contrast because they did not realize I had had surgery before. I've lost my job still have unbearable pain and there does not seem to be any doctors that care.I'm lost and don't know what to do now except pray.

[sgtpep57]

Thank you so much for this information it has been so helpful. I have my appt with the neurosurgeon and your info will help me to ask the right questions!
Jenny

[Dr Sharma]

Hi there. I can understand your anxiety and concerns. You have undergone 2 discectomies and a fusion. Fusion is done since the space between the bony vertebrae is empty after the disc removal. This is filled with a bone graft and often immobilized with metal plates and screws and bone graft joins the vertebrae above and below to form one solid piece with the new bone growth. This can limit the range of motion if more than one level is operated on. New motion preserving artificial disc replacements are the new alternatives to fusion. This preserves the range of motion better. There could be various causes for these symptoms postoperative. Vertebrae failing to fuse due to smoking, osteoporosis, obesity etc.  There may be a hardware fracture, which means the metal screws, rods etc may move or break before your vertebrae are completely fused. this needs to be investigated and a second surgery may be required. Adjacent segment disease occurs when the vertebrae above or below the fusion take on extra stress and lead to degeneration of adjacent vertebrae. Some disc herniations may permanently damage a nerve making it unresponsive to decompressive surgery. In such cases you could get relief from spinal cord stimulation. you must have realistic expectations about your pain after discussing with your neurosurgeon. You need to meet a neurosurgeon for these problems. He would examine you clinically and with an MRI spine to check the postoperative status of spine and new developments. The further course of action needs to be discussed in detail and must have your consent after realistic goals. Hope this helps. Take care.