Cervical 2-level adr 4 weeks post surgery question
 

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Hello everyone,

4 weeks ago I flew into Texas and underwent a 2 level (C5-6, C6-7) cervical Mobi-C clinical study at the Texas Back Institute with Dr. Zigler. (What a wonderful experience it has been dealing with both him and his staff). My surgery was on March 13th and I flew home on the 17th.

My question is this. I was told to start weaning off the soft collar at the 4 weeks which is now and I am feeling tightness at my c-spine at the adr levels. I know that there is no more post surgery swelling which I attributed the tightness to before now. The only way to describe the feeling is as if the adr's pushed the vertebrae forward and there is a protrusion in my throat. It feels quite uncomfortable. When I extend my neck backwards it almost feels like a pinch in the same location - only from the back in stead of the front.

I called his office and they said it was probably from swelling but I know there is not enough residual swelling to cause these sensations.
Has anyone else had this experience with the cervical adr's at any level?

Also, I was wondering how long was it post cervical adr before any arm or scapula pain you were experiencing prior to the surgery went away.
It has been 4 weeks post my surgery and my arm and scapula pain have increased as well.

I know it takes time for nerves to heal, but I was wondering if anyone else out there has had a similar experience to mine and how long the healing process takes.

Thank you so much for your responses and have a wonderful rest of the week!

Lyndies

Lyndies:
I cannot tell you for sure what's going on but here are my thoughts:
I am about 10 weeks out from Prestige ST at c5/6. Neck and shoulder muscles were extremely tight--after all, my neck was being stretched by the ADR and I gained some height. I am wondering if that is what you are experiencing both with the tightness in your throat and the arm pain (although the throat issues are also the result of being intubated during surgery). In addition, I experienced problems with my left shoulder (on which I had had a rotator cuff repair previously) which I think were the result of positioning during surgery, since I woke up with a bruise on that shoulder. Flexoril helped with the muscle spasms and PT and massage helped with the shoulder issues, as well as a side-sleeper memory foam pillow. At this point, the muscle spasms in my neck are just about gone.
All I can say is that this has been my experience. I hope you will experience improvement soon but if you are worried, the best advice would be to call the surgeon.

At 4 weeks you have the onset of new symptoms? Or, is this a slight worsening of existing symptoms?

When are you due for follow-up xrays?

When you get ADR, you reorganize the system... even more so with multi-level procedures. Your muscles, ligaments, etc... are all being called upon to support you in different ways... kind of like doing a sport you are not used to and getting really sore. If this is the kind of feeling you are describing... it makes sense that you have the onset of these symptoms when you reduced collar use... and probably upped your activity level... and possibly are reducing med levels???

Is increase in arm / scapula pain sudden or gradual.... along with other symptoms?

When are you due for follow-up xrays?

Mark

Hi,

Thank you both for responding.

To answer your question Mark, the symptoms radiating from my neck, scapula into my L. arm and hand were symptoms prior to surgery, but have exacerbated to a much higher level since the surgery with or without the collar.

I have increased my activity level since the 3 week point, but taking it very slowly ... not lifting and am engaging in only light activities. And yes, I did decrease my pain meds - (soma and hydrocodon) (how did you know) but still taking 600 mg of lyrica daily. Why...should I continue taking the prescribed meds? Is there something more I should be doing?

I will be returning for my 6 week follow-up at which time they'll take x-rays.

I agree that this might be from the restructuring and stretching of the nerves and support structures of the spine as you both noted, but even with the restructuring, the nerves are no longer being compressed so why the higher level of pain?

Over the past year or so in my research of adr's, people write about becomming non symptomatic right after surgery....not an exacerbation of the symptoms that brought them to a surgery to begin with so I am a bit baffled.

So I was wondering if the people who remain symptomatic post disc replacements have less of a chance of healing and becomming symptom free or at least less symptomatic?

Also, sahuaro brought up a good point about the tightness in my throat which feels like a protrusion. I guess the intubation could have caused it, but it's weird when I flex or extend my neck (during ROM exercises), I feel a pinching in extension and an obstruction in flexion and protraction. But there is no residual swelling....hmmm?

It sounds like this is all part of the process and I thank you both so much for sharing information. We are all different in our healing and just need to continue to do what is necessary to maxamize the outcome. That's why I am trying to figure out what is going.

Glad to hear that after 10 weeks the neck spasms you were having are gone and I hope your shoulder heals up well. Sounds like therapy has worked well for you.

Be well!

Lyndies

Med questions should be reviewed with doc, but it's typical for patients to be reducing their meds and increasing their activity levels after surgery. You may get to crossover point where med reduction or activity increase (or both) is too fast based on how your recovery is going.

I know a lot of ADR patients with new symptoms after surgery... or old symptoms returned or stronger after surgery... these can take a long time to fade... sometimes it goes very fast... sometimes not... Yes... we all have a chance to heal and 4 weeks is not very long in the scheme of things for spine patients.

Re: throat... did you have big anterior osteophytes (bone spurs). Still there?

All the best.

H Mark,

Thanks for writing back. You seem to have alot of knowledge about these disc replacement surgeries.

To answer your question, no I do not have any spurs or anything else going on with my spine that would justify the sensations in my throat and neck.
And yes, I plan to discuss all that is going on with Dr. Zigler when I see him in a couple of weeks.

So in your broad experience Mark, have you seen or heard of individual's after their adr surgery have an exacerbatio of symptons the heal up and go away after a period of time? Or have you seen people with a chronic herniation with nerve aimpingement typically not become non symptomatic at all??? Not all surgeries change the symptoms. Sometimes the surgeries are necessarh to relieve the pressure off the nerve and prevent further damage.

Thanks for keeping the discussion open because there is no information even from the doctor as to what to expect regarding symptoms post surgery.

Have a wonderful Thursday!

Many Smiles,

Lyndies