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Thread: Need some input...

  1. #1

    Need some input...

    I would appreciate any input that the members could give me. I am a 53 year old male.

    Back May, 2009, I fractured C5, 6, and 7. C6 had to be replaced with a cadaver C6, and all three fused together. After 90 days of recovery, the only symptom that I had remaining was the numbness of my right index finger. Yes, I know, I was an extremely lucky man!

    Fast forward now to 2011. In September, I started getting mild pain in my neck and occasional bouts of a firery numbness (I have a high tolerance for pain and this was about a 5 on the 1 to 10 scale) in my right forearm and hand. I also began to lose manual dexterity in my right hand. My General Practitioner performed an MRI and it was determined that I had degenerative disc disease between C4 & C5 and that C4 was impacting on my spinal cord. I was referred to a Neurosurgeon.

    The Nerurosurgeon first tried at-home neck traction (10lbs/15munites daily) and put me on Gabapenten (800mg three times a day). No improvement. It was decided that I needed C4 fused to the existing C5 through C7 fusion. Surgery was performed January 17, 2012. The last thing he said before we went into surgery was "When you come out, you're going to feel a noticable improvement in your arm" (while he had his hand on my right arm).

    This is where it gets interesting. When I came out of surgery, not only was there no improvement, I had a constant EXTREME fire-like electrical nerve pain down BOTH ARMS (on the same scale as above... a 12) and remember, I had no problems with my left arm prior to surgery! The pain was so bad that if even a bedsheet touch it, it would cause me to yell out in pain. After trying every IV pain med they could, they rushed me down for a CAT scan to make sure that the hardware was correctly in place. All normal. They discharged me the next day with oral pain meds which did nothing.

    After 2 days of agony, my lovely wife finally found (doing internet research) that people had had some success using a topical gel known as Biofreeze. We immediately went out and bought some and it brought the pain level back down to about a 5 (yippee!). Went to my follow-up on Monday (6 days after surgery) and explained to the Dr. He sent me for an MRI on Wednesday and found that my spinal cord was inflamed inside of the column. He put me on massive doses of Prednisone, and, the morning after the first dose (9 pills), I had no symptons at all! Then, each day as I decreased my dosage, symptoms started coming back. Not the firery feeling, but the electrical numbness in both forearms and hands.

    I went back to him last Friday (one month post-surgery) and explained to him what was happening. He put me on the 6 day pack of Methylprednisone. Again, after the first day's dose, everything was much better. As the dose goes down, symptoms in the arms started coming back.

    Starting Saturday night, the numbness in my forearms and hands was back. Yesterday (the 3rd day of my pack), things started going crazy. Yesterday morning, I started having an issue where, when I tilted my head forward, it was like someone was turning up the voltage in my forearms (increased tingling and shock feeling). By yesterday afternoon, if I tilted my head foreward, I was receiving the same feeling all the way down both arms, both should blades, down the left side of my back, across my lower back, and across the lower front of my abdomen! Today remains the same, although this morning, not quite as intense. I'm sure that by this afternoon, it will be back into full swing!

    I'm a 53 year old man that, because of a recent career advancement with another company, am not covered by the FLMA (haven't quite been there a year yet) and am having a huge problem with my short-term disability with CIGNA. I need to overcome this so that I can return to work. Again, I know that I have been extremely lucky and that my situation is mild compared to others on this forum. Comments and or suggestions are extremely welcome!

    I have attached a photo that I took with my iPhone of the MRI. The area I circled is supposedly waht is causing me the problem.

    Thank you!
    Last edited by SCI-Nurse; 02-20-2012 at 02:22 PM. Reason: Attached photo...

  2. #2
    I am going to ask Dr. Young to comment. Meanwhile, I would tell the neurosurgeon that you want a second opinion and need his help to find a different neurosurgeon to consult.

    (KLD)

  3. #3
    Thank you! The one thing I forgot to mention is that my neurosurgeon is actually the head of the Neurosurgery Department at one of the major hospitals here in Jacksonville, Florida. He has great credentials. There's just someting wrong here that I'm not getting any relief from.
    Last edited by lbeckner; 02-20-2012 at 12:57 PM.

  4. #4
    If that is the case, he should have no problem providing you with the names of some equally competent neurosurgeons who can give you a second opinion.

    (KLD)

  5. #5
    I am not entirely sure what is going on but several parts of your story caught my eye. First, you have had almost all sensory symptoms involving your C6 dermatome. This dermatome covers the medial (thumb) side of your forearm, your thumb, and index finger, as shown in the attached picture. This strongly suggests involvement of your C6 roots (on both sides). Second, the fact that prednisone remarkably eliminated the pain confirms that the pain is related to inflammation, probably of your C6 spinal roots. Third, the MRI shows higher signal in your spinal cord, indicative of edema (greater water content). Was this a recent MRI, while you are having your pain bilaterally?

    One possible approach, since you did respond to methylprednisolone, is to inject some local steroid and lidocaine on either sides of C6. Because you had surgery only 6 weeks ago, I am a bit worried that the steroids may interfere with your fusion. I don't have any experience with steroid injections at 6-8 weeks after a fusion and you may want to ask your doctor about that. The fact that you don't have any motor loss suggests strongly that this is not an issue relating to your spinal cord and you should not worry about that.

    Wise.

    Quote Originally Posted by lbeckner View Post
    I would appreciate any input that the members could give me. I am a 53 year old male.

    Back May, 2009, I fractured C5, 6, and 7. C6 had to be replaced with a cadaver C6, and all three fused together. After 90 days of recovery, the only symptom that I had remaining was the numbness of my right index finger. Yes, I know, I was an extremely lucky man!

    Fast forward now to 2011. In September, I started getting mild pain in my neck and occasional bouts of a firery numbness (I have a high tolerance for pain and this was about a 5 on the 1 to 10 scale) in my right forearm and hand. I also began to lose manual dexterity in my right hand. My General Practitioner performed an MRI and it was determined that I had degenerative disc disease between C4 & C5 and that C4 was impacting on my spinal cord. I was referred to a Neurosurgeon.

    The Nerurosurgeon first tried at-home neck traction (10lbs/15munites daily) and put me on Gabapenten (800mg three times a day). No improvement. It was decided that I needed C4 fused to the existing C5 through C7 fusion. Surgery was performed January 17, 2012. The last thing he said before we went into surgery was "When you come out, you're going to feel a noticable improvement in your arm" (while he had his hand on my right arm).

    This is where it gets interesting. When I came out of surgery, not only was there no improvement, I had a constant EXTREME fire-like electrical nerve pain down BOTH ARMS (on the same scale as above... a 12) and remember, I had no problems with my left arm prior to surgery! The pain was so bad that if even a bedsheet touch it, it would cause me to yell out in pain. After trying every IV pain med they could, they rushed me down for a CAT scan to make sure that the hardware was correctly in place. All normal. They discharged me the next day with oral pain meds which did nothing.

    After 2 days of agony, my lovely wife finally found (doing internet research) that people had had some success using a topical gel known as Biofreeze. We immediately went out and bought some and it brought the pain level back down to about a 5 (yippee!). Went to my follow-up on Monday (6 days after surgery) and explained to the Dr. He sent me for an MRI on Wednesday and found that my spinal cord was inflamed inside of the column. He put me on massive doses of Prednisone, and, the morning after the first dose (9 pills), I had no symptons at all! Then, each day as I decreased my dosage, symptoms started coming back. Not the firery feeling, but the electrical numbness in both forearms and hands.

    I went back to him last Friday (one month post-surgery) and explained to him what was happening. He put me on the 6 day pack of Methylprednisone. Again, after the first day's dose, everything was much better. As the dose goes down, symptoms in the arms started coming back.

    Starting Saturday night, the numbness in my forearms and hands was back. Yesterday (the 3rd day of my pack), things started going crazy. Yesterday morning, I started having an issue where, when I tilted my head forward, it was like someone was turning up the voltage in my forearms (increased tingling and shock feeling). By yesterday afternoon, if I tilted my head foreward, I was receiving the same feeling all the way down both arms, both should blades, down the left side of my back, across my lower back, and across the lower front of my abdomen! Today remains the same, although this morning, not quite as intense. I'm sure that by this afternoon, it will be back into full swing!

    I'm a 53 year old man that, because of a recent career advancement with another company, am not covered by the FLMA (haven't quite been there a year yet) and am having a huge problem with my short-term disability with CIGNA. I need to overcome this so that I can return to work. Again, I know that I have been extremely lucky and that my situation is mild compared to others on this forum. Comments and or suggestions are extremely welcome!

    I have attached a photo that I took with my iPhone of the MRI. The area I circled is supposedly waht is causing me the problem.

    Thank you!
    Last edited by Wise Young; 02-20-2012 at 04:07 PM.

  6. #6
    Yes. This MRI was prompted by the bilateral symptoms (post surgery). I have an MRI from 11/2/2011 that only showed stenosis /disc degeneration in the area of C4 (which started this whole thing). I also have a spot (roughly the size a quarter) on the left hand side of my neck that is painful internally and is lateral to and just a tad bit higher than the incision.

    My doctor has been pretty good about responding to e-mails so I send him my new symptoms from over the weekend along with the attached diagram. The areas in yellow are the areas that get the electric/numbness feeling when I tilt my head forward 10 to 15 degrees. With the exception of the hands and forearms, they contantly have it and when i til my head forward, it gets more intense.

    Prior to surgery, I had NO problems on the left hand side of my body. The surgery was to correct numbness and pain in my right forearm and hand.

    Thanks for your input!

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