Continual Pain

[Kalvin]

A couple of years ago, I had an ACDF, due to intractable pain. I had severe neck, chest, scapular, shoulder and arm pain in addition to a numb thumb, index and middle finger. All on the left side. Prior to surgery I tried traction, which didn’t help and my surgeon decided on an ACDF @ C6/7.

It took several months to feel better, the shocking pain in my arm was gone, however I was still having a lot of neck, scapular and shoulder pain.  My post- op x-rays looked good and my surgeon basically told me that there was nothing else he could do for me and referred me to PT,after that I saw an Osteopath and a Physiatrist, all of which were no help. I’ve been in constant pain  since and over time my pain has actually increased. Doctor, I would really appreciate your thoughts on my MRI report.  

The axial images at C6-7 show that the broad-based disc protrusion superimposed upon spondylosis is associated with slight flattening of the ventral aspect of the spinal cord, and mild right and moderate left C7 foraminal stenosis.

At C5-6, the spondylosis partially effaces the CFS ventral to the cord, but there is no cord compression or foraminal stenosis evident.

At C4-5 broad based disc protrusion extends into the neural foramina on the left which is moderately stenotic. The right neural foramen appears mildly stenotic.

At C3-4, broad-based disc bulging/protrusion extends below the interspace level on the right producing mild right foraminal stenosis. The cord is mildly flattened in the midline by the disc protrusion.

My current symptoms are numbness in my face and fingers, severe scapular pain, constant chest tightness, shoulder and elbow pain and muscle spasm, and pain in the axilla. I also experience pins and needles sensations in these areas and have lost the ability to move my arm backwards. All this is occurring on my left side.

Any thoughts would be greatly appreciated

[Dr_Nassim]

if no plans for a 2nd surgery, the cure is 1 tab of gabapentin each evening and 1 tab of venlafaxine 75 each morning for 2 years. Progressive dosing !

[Dr_Nassim]

if you still in pain let me know (please notify me in a new letter )

[Kalvin]

Doctor, thank you very much for answering my question. I should have made my question clearer. Those MRI results were pre-surgery. I also had a MRI after surgery. The only difference as was;

At C6-7 Status post anterior cervical diskectomy and fusion at C6-7, with plate and screw fixation hardware, and residual osteophyte.

My question is do my symptoms correlate with left sided moderate foraminal stenosis at C4-5? Do you think a diskectomy and fusion there would help me?

I had a Neurologist run an EMG on me a year or so ago, and he said my symptoms were consistent with chronic C6 radiculopathy, I don’t understand, because my MRI shows minimal changes at C5-6.

I tried gabapentin quite awhile ago, I think I got up to 1200 mg/day it didn’t help, but I will try the Venlavaxine.

Thank you very much Doctor, for your help