@mkrylowski Welcome to Connect. It was my physical therapist who noticed it. Muscle loss was on the back of my shoulders and upper arm. It was probably about 6 months before surgery and I was feeling more pain symptoms in my neck and arms. I did have pain all over my body and even pain in my legs and feet that was coming from spinal cord compression in my neck. I am 10 years post op now and doing well. No other issues, and I have had PT to maintain strength. I also own a horse and riding helps me with core strength that supports my spine.