Persistent pain post-anterior cervical fusion C4-C7?

I had posterior rods and screws at different levels, cervical, thoracic, and lumbar. I also had anterior plates and screws in the cervical area. The rods and screws placed from c2 to t2 causes pain in my trapezius muscle. The surgery was 14 months ago and muscles feel larger than they used to be. Pain is constant and gets some relief from trigger point injections. One thought I have is that the hardware is pushing out on the muscles causing the discomfort. I asked my surgeon about removing the hardware and he is avoiding it. I had a small screw and hardware in my thoracic area for a year with similar pain. Cleveland Clinic removed it and the pain was resolved. I will try to see if I can find a surgeon to remove the C2-T2 hardware.

@jgandee - Welcome to Mayo Connect. I haven't given any thought to having my hardware removed but I imagine this is as big a decision for you as deciding to have the hardware installed in the first place.

Find the best equipment to assist in the diagnosis, the best facility where their protocols are top notch, and the best surgeons to analyze the input and provide your diagnosis. You may be right about needing the hardware to be removed...but second and even third opinions are useful for you.

It was your post and the posts that have followed that have led me to my response. I am 63yo and had surgery 1/15/2024. My MRI showed moderate to severe nerve pinching at C5, C6.C7 to T1. I tried to avoid surgery with chiropractic therapy, physical therapy, neurosamatic message therapy, and injections but without relief. Post surgery I was given PT for 17 sessions. I continue to be in pain; sometimes hitting 8 or 9. The pain radiates up to my left ear and in my throat; it feels like I’m being choked. There remains a stabbing behind my shoulder blade. The surgeon did another MRI and doesn’t understand why I’m still in such pain 4 months post surgery. My GP thinks PT should have solved my issues and my office wants me back at work. I was a hiker, jogged races, 5k, 10k and 2 half’s. Now I’m useless. I’ve been prescribed Gabapentin and Baclofin but I’m at my limit of understanding why I’m not progressing.
Any help or advice would be greatly appreciated.

Hi. I’m also 63. I’ve had cervical pain for 30 years. Have tried all kinds of conservative treatment. Now they’re telling me I will become paralyzed if I don’t have posterior laminectomy and fusion. This will not relieve my pain but will assure I don’t lose the use of my arms and legs. You may have throat and ear problems because they went in from the front. This is concerning. I would suggest you get a second opinion from a neurosurgeon. I’m going for a second opinion before I decide whether or not to have surgery. Best of luck

@desertoasis Welcome to Connect. My thoughts are that it may be your surgical scar tissue that is causing pain. Standard PT may not address this. Your surgical scar tissue can link to other tightness or scar tissue in muscles and cause a lot of pressure and tightness. My PT did myofascial release before and after my cervical spine surgery and it made a big difference. MFR is a specialized technique to stretch overly tight tissue and the therapists waits for it to release and loosen. Here is our discussion where you can learn about it. The first pages have links to information. I continue to do stretches to maintain muscle function and movement in my neck.

Neuropathy - "Myofascial Release Therapy (MFR) for treating compression and pain"
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Thanks for responding. I lost a good deal of my left hand function and had constant stingers that felt like I stuck my finger in a socket. I felt like surgery was my last option but I was certainly hoping for more relief not just deferent pain.
The did do the surgery posterior. And I am definitely considering a second opinion on my post surgery issues and recovery expectations.
Thanks again.

@karen1103 Welcome to Connect. Have you had spine surgery before? 30 years is a long time to be in pain, and if your doctors are talking about possible paralysis, it sounds like they may be talking about spinal cord compression. How soon will you have a consultation for a second opinion? What are your concerns about your spine condition and possible surgery?

Yes it is spinal cord compression. She cannot even do an epidural as there is no space to put the needle. The pain would ebb and flow. I treated with all types of treatment. Physical therapy, traction, aqua therapy, biofeedback. Hypnosis. Was advised against chiropractic. But it never affected my ability to function. Many years ago a neurosurgeon told me not to have surgery because all levels were involved and would never be pain free. He did say if I noticed any change in my gait I would have to be seen. I’m now having a problem walking due to leg pain and weakness. It’s not sciatica it’s coming from cord compression in my cervical spine. I’m terrified of spine surgery. I worked for orthopedic surgeons for 20 years so I know what bad outcomes look like. I will have a second opinion on June 7 with another neurosurgeon. I would never go to an orthopedic surgeon for spine surgery

Have you been evaluated for Glossopharyngeal neuralgia (throat and ear pain)

@desertoasis - To have spinal surgery or not is such a huge decision - made complicated by the fact it's literally impossible for any doctor to tell you with 100% certainty what your particular outcome will be. (I've come to believe that any doc who claims to know exactly what will happen to you is not to be believed...).

What exact surgery did you have? Regardless - I have several thoughts. (1) I was told to expect a recovery period of 9-12 months. That prediction has been correct. As you are well under six months post - patience is still required. (2) I always suggest to spine surgery patients that "no more pain" is not necessarily the expected outcome. More important is eliminating the nerve pressure which can permanently injure a nerve leading to possible permanent injury. (3) I would be very cautious about chiropractic treatments. Severe spine twisting and manipulations may not help in your recovery and can actually produce new and unwanted spinal damage. (4) I changed PT providers and was happy I did. After several months, the first PT provider's approach had my recovery stalled. The change I made was very helpful for me.

Lastly, maintain a positive attitude! That can be so important in recovery. True - you may have to find new hobbies (I still hike but gave up running to reduce spinal jarring). I've discovered some new things I like as well - or even more...

A bunch of soap box "wind" above. Sorry about that. Just hoping to give you useful perspectives from an old spinal surgery vet.