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Still having issues 4 months post op ACDF C4-C6
Spine Health | Last Active: Jun 20 4:32pm | Replies (26)Comment receiving replies
@amywood20 I'm sorry you are having issues. I understand your concern with that image. The screws do seem kind of long like they could be breaking through to the spinal canal. What I am not sure about is what kind of artifacts could be caused by the hardware itself on the imaging, so I don't know if the screw is pushing into the spinal canal or right up to it. If you don't get a satisfactory answer from your doctors, you may want to see a neurologist for another opinion who is not associated with the medical centers of your current doctors. If a doctor misses something, others associated with that facility don't want to challenge the current opinion. I had run into that myself before I had surgery when the various surgeons who evaluated me didn't understand my symptoms. I had found the answer myself in medical literature and asked for help in bringing that to the attention of the surgeon, and none of the doctors would help with that even though I had been their patients for several years before I saw the spine surgeon. The only thing they would say is to get another opinion, and I did at Mayo which is where I did get help.
If you see a neurologist who specializes in spine issues or thoracic outlet syndrome, that would be best. You could have thoracic outlet syndrome in addition to the other issues you mentioned and it causes arm and hand pain, and TOS is more common with spine injury patients. You also have surgical scar tissue in an adjacent area if you had a frontal approach in your surgery. I do have TOS in addition to my spine issue which was at C5/C6, and after my ACDF, my TOS got worse and everything tightened up, and doing myofascial release helped me loosen that up. I do have extra tightness on one side of my neck and shoulder that pulls into my rib cage. I keep working on this with myofascial release which I was also doing for several years before my spine surgery. I think it helped surgery go easier because the tissues were looser which made it easier to retract. You might want to look at our MFR discussion for information. Mostly, this is hands on stretching by the therapist while you lie on the table. I have not been seeing my PT because of COVID-19, but I continue on my own as best I can.
You are also at 4 months spine surgery post op and when I was at that stage, that is when my muscles really tightened up. I had no hardware and had to be really careful not to do anything until I fused, but it was at the 4 month mark that I was beginning to fuse and was cleared to begin PT and myofascial release again. MFR might be able to help you even if you don't exactly know the source of the pain. If your PT is not trained in MFR, there is a provider finder on the MFR website. If you do have TOS, it causes compression of nerves in the brachial plexus and blood vessels where they pass between the ribs and collar bone. It is usually missed and misunderstood by doctors, so look for a neurologist at a facility that treats TOS as a condition. I have had some shoulder issues too, a SLAP tear in the capsule in one, and a frozen shoulder in the other caused by the contrast that they injected during an MRI for shoulder instability. Neither of the shoulder issues was the source of my ongoing pain, it was caused by my spine (cervical stenosis) and TOS. My spine has been corrected, and I'm still working on the TOS and making progress.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988
https://trainingandrehabilitation.com/how-truly-treat-thoracic-outlet-syndrome/
Replies to "@amywood20 I'm sorry you are having issues. I understand your concern with that image. The screws..."
Jennifer, I am at the end of week 7 post-op. My biggest concern was being unable to swallow satisfactorily after surgery. At 6 weeks post-op I saw a speech therapist for dysphagia, and she noticed how tight the right side (same side as my incision) of my throat was compared to the left side, and ordered a barium swallow test. She thought my swallowing problem may be due to either swelling of my throat or to scar tissue from incision. Anyway, the swallow test had to be postponed this week because she was out of town and wanted to be with me during the testing. In the meantime, I began to very gently massage the really tight muscles that began up closer to my chin (not the ones farther down below where my new disks had been implanted), and then two days ago I noticed that the right side of my neck had become much softer and for the first time I was able to take my pills without any major problems, and I even got down a larger nutritional supplement, which I hadn't taken since my surgery. I have concluded that my swallowing problem was the result of swelling after surgery, which brings me to another issue. The night after my surgery, I had a nurse who was wonderful about making my pills into a smaller or in some cases even a powdery form, which she mixed up with chocolate pudding. Then the next morning, she was replaced by another nurse who while I was too groggy to really know what was going on, put all of my pills into one cup of chocolate pudding and fed it to me. I, not understanding what was happening, bit down on one medication that not to be broken apart, and just the liquid from it got down my throat and caused me to violently throw up. Needless to say, when I finished throwing up, I asked the nurse why in the world she gave me the pills like that and she told me that was how she always her patients their pills, even ones right after ACDF surgery. Then she told me that, albeit unconscious at the time, I shouldn't be having any problem taking the pills because I was able to take all of them with just water when I first arrived in my room, which implied my problem was just an emotional one, not anatomical one. Now that I have figured out that my problem swallowing, that I have had until recently, was related to swelling in my throat, causing my muscles to be too tight. Therefore, I am guessing that the reason I was able to take them when I was first out of surgery was because my throat had not swollen yet. Anyway, that was the only bad experience I had while at Mayo. Everything else was wonderful!
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@jenniferhunter thanks for your insight. My physical therapist started doing manual work on Thursday instead of the ASTYM she was doing on my arm. She is now working the pec area and the arm. I don't know if it's technically MFR though. If I don't get satisfactory answers with the neurosurgeon I am either going to go back to the shoulder doc ("if" the surgeon thinks it's a shoulder issue) or make an appointment with Mayo. I did the bouncing back and forth between these two specialists prior to surgery and don't want to do it again. Both of them, along with two physical therapists, said my issues were cervical spine which is why I had surgery. I tend to think that is what I have going on again. Even the hubby said I might just need to go to Mayo. We'll see how Monday goes. Thanks again for your response!