I am a 43 y/o male with a history of DDD, Acute rupt. @L5-S1 w/caudae equinae syndrome.
The L5-S1 episode was in 1990 and required 2 subsequent surgeries including fusion at that level.
I was left with a significant amount of radicular pain, fascics, etc. in the affected dermatomes. However, after struggling for several years to overcome that problem have
done well for the last two years and was able to discontinue all meds (including the Neurontin, which broke the pain cycle for me). and have been working steadily as
well as an S.A. in surgery since notwithstanding the time off during recovery from the above.
In August of 1998 I underwent a C6-7 ACDF after putting it off for 4 years after diagnosis.
I was returned to work 6wks post-op with no restrictions, had occasional pain in back of neck w/parasthesia over the traps
bilaterally and rad. pain in lt. C5-6 dermatomes(back of arm into index finger)that was not present pre-operatively.
Also present at times was a "catching" type pain on the rt. that my surgeon classified as possibly of facet origin.
A month ago while assisting on a morbidly obese abdominal surg. I began to have severe pain between scapulae
and back of neck so as to cause me to drop out of the case. I now have "shocky" pain down the spine to mid-back with flexion as well as increased C5-6 derm symps, increased paras over the traps, general post cerv pain that is sometimes severe in nature. Also present are fascics in all groups from hips to chin, but mostly pect tricep bicep forearm hands delts and occasionally abdominal.(The pre-op MRI also showed a C5-6 HNP and moderate bulge at 4-5, as well
as moderate to severe canal stenosis from 3 to 6 and a general spondylosis from 3 to T1.)
I was sent to PT following the episode at work (without an exam of any kind)
for ultra,cryo,heat,traction and manipu;ation. On week 3 after no significant improvement, an OT was seen
as well and an aggressive exercise program initiated. The exercises exacerbated the pain and fascics.
The PT and OT recommend a change in vocation as a solution. However, when I returned to the neurosurgeon
after the PT for re-eval, he announced that he was releasing me to full duty with an Aspen-J collar, and that I needed to get back to leading as normal a life
as possible, despite my protests. I returned to work with the collar as ordered
however was unable to complete even a half day in the OR considering the pain I am experiencing, which is exacerbated it seems by putting any significant stresses on my neck such as one gets when looking down in the OR for hours at a time, or in my case for now, for 15 minutes or so.
Also I have noticed some leg cramping and "heaviness' occasionally (not frequently) and some mild pain in kind.
I called to report the situation but was told there was nothing in my MRI to suggest a source for my symptoms!
I saw the report myself and as I have had no neuro exam by the surgeon or new studies since the occurence at work, and considering the original MRI result
do not understand how this conclusion can be reached. Could it be that the canal stenosis is causing the above symps or am I losing my faculties?
I wonder if the fact that it has become a workman's comp case now could be an issue, and also if you feel I should now seek a second opinion.
Thank you for giving your valuable time in this forum. It is greatly appreciated by me.
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Dear Todd,
You have new symptoms since your previous surgeries and worsening problems that may or may not relate to what was seen in the past. It is difficult to assess these complicated situations over the net.
Your best bet at this point is to see your original surgeon again raising the concern of the new problems. He may consider a new MRI to investigate the situation. This would effectively rule in or out any surgical conditions. If you do not find satisfactory answers, take the films to another spine surgeon for a second opinion to be sure you are doing the right thing.
Good luck.
