Post surgery burning pain

@solom174 I am a spine surgery patient, and I see neurosurgery as an elegant specialty requiring exceptional skill, and I say that because spine surgery gave me my life back. I do not have pain, and decompressing my spinal cord gave me back the coordination in my arms. That being said, I didn't wait many years to do this and expect a miracle. I paid attention and kept notes about how my condition was progressing and I knew that nerve damage could become permanent if it went on too long. I worked with a physical therapist who did her best to keep my spine supported before my surgery. While I waited for surgery, I watched as many online spine conference videos as I could, so I learned about spine conditions and various surgical techniques and what may apply to my case, and I read journals about spine cases online. There are many different ways that surgeons solve problems and nothing is "one size fits all". My recommendation is to be an informed patient, ask a lot of questions and advocate for your care and share in decision making with your surgeon. Reputation also matters, and find the best surgeon that you can who has an interest in the problem that you have.

Research is going on at Mayo Clinic in spinal cord regeneration from traumatic injuries, but there is a lot of other research going on in the field and at the government clinic trials website you can find many clinical trials related to the spine, artificial disks, and various implants to address spine issues. Some spine issues are age related as the spinal discs dry out a bit and that is normal, but that can act on previous injuries and exacerbate a condition. Dr. Bydon, who is researching spine regeneration at Mayo, has had success with a spine trauma case and a man can now walk again who had been somewhat paralyzed. Not everyone will have this degree of recovery, but it shows the promise of what may be possible going forward. As a patient, you must learn all you can and choose wisely. You don't know what you don't know about the field of spine surgery, and that takes some investigation and asking questions. Every case is different, and surgeons cannot guarantee to fix pain. They address function, and consider surgery successful if spine function is improved or stabilized from an unstable situation. There are compromises when you choose surgery, and you make that informed choice because the benefit of surgery hopes to improve the situation and the benefit is greater than the risk. The patient also influences the success of their outcome in many ways.

Hi @jenniferhunter, thanks for your comment. It may be a bit presumptuous to assume I did not do as much or more research than you but that is irrelevant, as the surgeon has the duty to advise of the best course of action and what the realistic results will be, not me. I do not believe realistic results were imparted to me, and if you have not had a fusion then you do not understand how that feels and the disabling nature of it. I went in with no pain and post-surgery my spine is messed up because the forces are not distributed in the same way as they naturally are when you have a fully flexible spine. That is an enormous change that cannot just be glossed over, and indeed a signficant functional impairment of the spine. In any event, I am glad for you that your problem was solved, however mine has just begun, albeit I did not engage a "compromise" with surgery, there was no real choice. I do think fusion is a crude solution and there should be a focus on innovation in surgical technique so that a healthy spine is not hacked up and fused as normal course.

@solom174 Yes, I understand that you are recovering from surgery now. I do hope that it gets better for you in time. Please also understand that my comments are for the entire community. I didn't make assumptions about your experience and my comments are based on my surgical experience and observations. I don't know what surgery you had, but I do know that in general, spine surgery recovery is more difficult at the lower end of the spine than it is for a cervical surgery as told to me by my doctor because a patient is bearing most of their body weight on the lumbar spine. I had a cervical fusion of C5/C6 and my head turning ability is the same as it was before the fusion. I cannot touch my chin to my chest as before, but it is close. That is the compromise I spoke about because after surgery something will be different. I had one good choice I could make in having a fusion because I had bone spurs pressing into my spinal cord that were beginning to cause disability. I could have chosen an artificial disc, but I wasn't a great candidate for that and it had other risks I worried about. I could have chosen no surgery and my disability and pain would get worse.

Prior to surgery, I had pain all over my body from spinal cord compression, and that was all gone when I woke up from decompression surgery. The pain I experienced after surgery was related to the surgical path, and muscle spasms that are very common with spine patients as well as rehabbing from weakness after wearing a neck brace. Healing after invasive surgery is exhausting. Surgery also creates scar tissue that gets tight that causes pain, and I have worked with my physical therapist on this doing myofascial release to loosen this after the appropriate amount of healing. I periodically loosen it to prevent tightness that leads to muscle spasms. I remember that the tightness from scar tissue began at about 9 weeks and were annoying me a lot at the 3 month mark and I wasn't allowed to do any physical therapy on my neck at that point. I asked for a fusion without hardware, and the choice I made was to stay in a neck brace until fused which was just beginning at the 3 month mark. It was probably a month later when my therapist could start working on me again and I had a lot of pain pulling on my neck and headaches from neck spasms.

I asked my surgeon how I could try to avoid further spine surgery in the future and his answer was to maintain core strength and I do that. A strong core supports the spine and helps hold it with "proper" alignment or what is the best that I can do. A cervical fusion causes the spine to "dump forward" a bit because the bone disc spacer doesn't flex like a disc does so that affects the optimal neck curvature a little bit. Cervical vertebrae are pretty small, so a single level fusion wasn't very different for me than before the surgery. It has also been several years since my surgery, and generally it may take a year or longer after spine surgery for a full recovery. Every patent is different in what their surgery is and how they recover from it and how much pain they experience. The work I did with my physical therapist added to the success of the surgery because muscles were more pliable and easier to retract so it was less tension applied to my body during surgery which helped in healing. I also applied relaxation techniques to help manage pain and stopped taking pain medication that made me feel yucky. I saw it as healing pain at that point as a bridge to my recovery. I do think this helped.

I wrote this response before I found another of your posts, and I now see that you had a thoracic fusion of couple levels. From personal experience, I know an injury can change everything. My spine issues came from a whiplash injury years earlier and more recently, I was sidelined by a significant ankle fracture, and even though that has healed, and I've had the fixation hardware removed, I still have pain from the tendons and ligaments and cannot walk as far as I want. When my ankle gives out, I'm done and have to sit down. That of course comes with a realization that my physical abilities have changed, and I won't be able to hike as I thought I would be able to do after recovery. It's a personal loss and it takes a bit of time to adjust to that. I'm sorry your surgeon didn't set the right expectations for you.

Jennifer

Hi Jennifer, thanks for your further elaboration. I appreciate your empathy and I am sorry that you cannot engage in the same degree of physical activity as before either. It seems to me that the time is ripe to move forward with surgial technique for this very reason, we should not have people have to "compromise" by taking on new disability that they did not have in the first place - the surgeon views these things as "trade-offs" but I do not think it is appropriate to aspire to this kind of trade-off and think we can do better if there is a will to figure this out like they have for traumatic spial cord injury. I know this surgical intervention technique is old because I read about its history in Dr. Edward Benzel's book on spine biomechanics. There have been developments around the surgical intervention techniques in imaging (with advent of MRI, CT scan, microscope, etc.) that facilitate surgery but the fundamental surgical procedures in spine are quite staid and need innovation to also prevent disabling the patient post-surgery yet proclaiming the surgery is technically a success.

Just curious, what side effects did you have with Gabapentin?
I just started taking it.
Thank you

I hope we both get the help we need for the pain is unbearable

Hi all,

I have had cervical issues for the last 13 months with C6, C7 nerve compression.

At the beginning wasn't too bad, but after 11 months of physio, osteo, cortisone and nerve blocks I wasn't getting anywhere therefore I decided to go to the Deukspine Institute in Florida. The neurosurgeon there performed:

Left C5-C6, C6-C7 disc decompression using the Deuk Laser and the following ryzothomies:
Bilateral C5-C6, C6-C7, C7-T1

L4-L5, L5-S1 and Sacroiliac joints.

As soon as I woke up from the surgeries I noticed that I had a drop head and excruciating pain in my neck with lots of referred pain.

I got back to Australia on 09/06/23.
In the last month I got really worse despite self care. I went to ED this Wednesday because the pain in the neck was unbearable despite Gabapentin 300kg and Oxycodone 10mg.

I feel twisted inside the neck.
I have unbearable pain in the left side with very stiff neck. There are sore swollen lumps where the are ablated facet joint are located. You can see them with naked eye.

There is a lot of strong pain referral, burning, extreme tightness, stiffness, pins and needles, numbness in the neck, traps, shoulders, arms, hands, fingers, burning kegs, tight feet, painful toes. Also get headaches, pain in andvbehind the ears, jaw, cheekbone pain from time to time.

The hospital just gave me more Oxycodone which still didn't resolve the extreme pain and sent me home.

I feel that I have been butchered by the surgeon inside. The ryzothomies caused burning of the paraspinal muscles of the neck also.

I am going through hell since a week ago and I am unable to sleep, stand and sit.

There is something terribly wrong because the pain management is not working.
My neck is sore to the touch.
I have no neurological deficits since my arm, hands and legs still function despite the pain.

I don't know what to do because the hospital is sending me home and not investigating my issues and if I have to book a neurosurgeon I have to wait 2 months even if I pay.

What's next? I am worried.

@solom174 I disagree with you regarding surgical techniques and instrumentation. I had stainless steel implanted in spine in 1990. At the time it was gold standard. That changed with the advent of titanium which is stronger. And they now have artificial discs to replace bad ones which were not available back then. It’s unfortunate your outcome was not ideal, in your eyes but it might also be diagnostic for the surgeon. A less invasive and potentially less traumatic procedure was not successful. You then move onto the procedure that would typically fall in line. Surgeons are all different and the more experienced they are the better outcome you’ll have.

As I said there have been improvements around the surgical techniques, the implant material also being one of them but the material's improvement is not a surgical technique. The issue is fusion as a surgical technique is very old and not ideal. Also FYI my neurosurgeon is one of the most experienced currently and is a sought after authority among neuro and ortho spine surgeons. That did not of itself guarantee me a better outcome. I think it is incumbent on spine surgeons to push the envelope not only of research on spinal cord injury and regeneration which seems to be the focus, but also on surgical techniques that innovate and minimize impact on patient - the body does not like heavy interventions and they should be minimized.

Hi Everyone,

I am back with another moan, but I have been in excruciating pain since I got back from Florida on 6 Sep 23 after neck surgery and rhizotomies.

I decided to get laser surgery because I did not want a fusion.

I left Australia on 26 Aug to go to the DeukSpine Institute in Melbourne Florida to be operated by Dr Deuk on the following:

Deuk Laser Disc Repair C5-C6, C6-C7
Deuk Plasma Rhizotomy
Bilateral C5-C6, C6-C7, C7-T1; RT L4-L5, L5-S1; BL SI Joints

When I woke up from the surgery, I developed a dropped head that I did not have before. I also had extensive severe pain all over my neck and back.

I told the neurosurgeon about it, but he stated that there was nothing in the surgery that could have caused the dropped head. I find it hard to believe.

There is so much deep seeded pain in my paraspinal, trapezius muscles that I struggle to lift head because it feels very heavy

I went back to Melbourne Australia and have been suffering with severe burning pain till now. Chronic 10 out 10 pains.

The pain has got worse week by week.

Now I have extreme burning pain from the mid of my neck down to the upper thoracic spine.

I have not been able to manage this pain very well.

I have been to the hospital’s ED twice in the last 2 weeks.
They gave me pain management (1 oxycodone 10mg) then they discharged me.

I then ask them to investigate the problem but was told to wait for an appointment with the neurosurgery clinic in the coming weeks. Very disappointing!

I tried to book a few private neurosurgeons urgently, but there is a 3 month wait.

The burning pain is so bad at the base of the neck that prevents me from sleeping.

I also feel burning pain in my lower back, legs, and feet.

My neck is very tight and stiff.

If I flex over, I feel burning pain in the neck and in the feet.

I have referred pains in my traps, shoulders, scapulae, arms, hands, fingers, back, groin, legs, and toes.

I am getting headaches, earache, jaw ache, cheek bone ache on the left.

My GP has put me on Gabapentin 300mg and Tramadol 50mg, but it is not managing the pain well. I have oxycodone but I do not want to take it too frequently because of side effects.

Currently my life is unbearable, I feel depressed and lonely.
I stopped driving the car since I got back because of my neck stiffness and range.

I asked Dr Deuk about the stiffness. He answered the I have muscles spasms.
I have taken Robaxin 750 mg, but it is not doing much.

I feel that there is nerve compression, but I am not sure.

Where do I go from here?

I would appreciate to hear from people that are going through the same pains.

These are my neck surgeries videos

DLDR C5-C7

I am worried about the hematoma in the facet joint.

CERVICAL SPINE

Procedure Date: 12 September 2023 Report Date: 13 September
2023

Examination: MRI - CERVICAL SPINE

Technique: Sagittal T1/T2/STIR, right and left sagittal oblique T2 and
axial T2.
Clinical Data: Neck pain

Findings:
Comparison was made to previous MRI of 08/08/2023.

There is generalised inflammation of the posterior neck muscles left
related to recent surgery.
There is a localised ill-defined hyperintense region seen adjacent to the
left C6-C7 facet joint ?Haematoma or collection.
Normal craniocervical junction.
Atlanto axial joints are unremarkable.
Vertebral bodies are normal in height and marrow signal intensity.
No spondylosis or spondylolisthesis.

At C2/C3, no disc herniation, no canal stenosis, no foraminal stenosis
or nerve impingement.
At C3/C4, there is disc degeneration. Disc osteophyte bulge indents the
anterior thecal sac. No canal stenosis. There is uncovertebral joint
arthrosis with severe right foraminal stenosis. There is mild left
foraminal stenosis.
At C4/C5, there is disc degeneration with disc osteophyte bulge
indenting the anterior thecal sac so mild canal stenosis. There is
bilateral uncovertebral joint arthrosis with severe bilateral foraminal
stenosis right>left.
At C5/C6, there is disc degeneration with disc osteophyte bulge
causing mild canal stenosis. There is bilateral uncovertebral joint
arthrosis with bilateral foraminal stenosis.
At C6/C7, there is disc degeneration. Broad-based disc bulge is noted.
No canal stenosis. There is bilateral uncovertebral joint arthrosis and bilateral foraminal stenosis.
At C7/T1, no disc herniation, no canal stenosis, no foraminal stenosis
or nerve impingement. There is bilateral facet joint arthrosis.
Spinal cord is normal in size and outline and shows no focal lesion.
There is a soft tissue mass arising from the left T2-T3 neural exit
foraminal only demonstrated on the left sagittal oblique sequence. It
measures 25 x 23 mm in size and is suggestive of a nerve sheath
tumour.
Comment: Postprocedural inflammation of the posterior neck
paraspinal muscles. There is a focus of ill-defined hyperintense
collection adjacent to the left C6-C7 facet. Superimposed infection
cannot be excluded and clinical correlation is recommended.

Stable appearance of multilevel disc degeneration and foraminal
stenosis when compared with previous study.

LUMBAR SPINE

Procedure Date: 12 September 2023 Report Date: 13 September
2023
Examination: MRI - LUMBAR SPINE
Technique: Sagittal T1, T2, STIR and axial T2.
Clinical Data:? Radiculopathy

Findings:
There is scoliosis of lumbar spine convex to the left with the apex at L3.
Conus terminates at T12 and shows no focal lesion.
Vertebral bodies are normal in height.
There is lumbar spondylosis.
At L1-L2, there is disc desiccation and mild bulge. No canal stenosis.
There is moderate right foraminal stenosis.
At L2/L3, there is reduction in disc height with endplate Modic 1 signal
change. There is slight retrolisthesis of L2/L3. No canal stenosis. There
is mild right foraminal stenosis and right facet joint arthrosis.
At L3/L4, there is disc desiccation. Disc bulge indents the anterior
thecal sac. No canal stenosis. No foraminal stenosis.
At L4/L5, there is disc bulge indenting the anterior thecal sac with mild
canal stenosis. There is mild bilateral foraminal stenosis. There is mild
bilateral facet arthrosis.
At L5/S1, there is disc desiccation and mild bulge. No canal stenosis.
There is left foraminal stenosis. There is left facet joint arthrosis.
Facet joints and spinous processes are unremarkable.
Comment: Scoliosis of lumbar spine convex to the left.
Multilevel disc degeneration and bulge.
L5-S1 left foraminal stenosis. Mild bilateral L4-L5 and right L2-L3
foraminal stenosis. Right L1-L2 foraminal stenosis.

Thank you

Best regards

Alfred