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Foraminatomy after ADR

I am about 2 years out from a two level ADR.  I had excellent results until about January of this year.   X rays show some pretty serious foraminal stenosis on those levels.  One looks severe, a big mountain osteophyte right in the middle of the foraminal canal.  

Symptoms - shoulder pain on one side, forearm pain on both sides.  Some hand pain.  Pain is steady and gets unbearable.

Has anyone else had this happen?  

Can they do a foraminatomy after ADR?

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Comments

  • BRONCOFANBBRONCOFAN Posts: 124
    edited 05/08/2019 - 8:24 PM

    Hi Darcy,

    Only a surgeon is going to be able to answer that one definitively... I had a failed ADR at the same levels you have them - but mine failed right from the start with severe neck pain / facet syndrome.  Did a quick google search and found some information that seems to indicate this might be possible in some cases, but again really would take a surgeon to review the MRI specifics.. 

    If for some reason a foraminotomy won’t work, I will tell you that my ADR to ACDF conversion was not bad at all.  They  popped the devices out (what type did you have?  Mine were Mobi-Cs), clear out all that bone, and convert to a standard ACDF.  I lost almost no ROM with my C5-7 ACDF.  Hope they don’t have to do that, just want to set your mind at ease that the problem is fixable one way or another!

    Kevin

  • Thank you Kevin!  I have Mobi-C ADR as well.  I think the ADR is ok.  I have had a lot of relief from the neck pain.  

    The hard part is waiting a month for my neurosurgeon appointment.  I could see in the x ray an oseophyte that looked like a mountain taking up 2/3 of the foraminal nerve canal.  When I saw that -- the pain and muscle control issues made a lot more sense.  

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  • Darcy,

    I agree with you - if you are having mostly arm pain the nerve impingement is the problem, and your ADR would be fine I think... I had intolerable neck pain immediately after surgery that never went away and so I had the revision.  Interestingly I’ve read that most people who have facet syndrome from an ADR have it start soon after surgery, so you are probably in the clear.

    Based on what you’ve noted, I would sure think a foraminotomy should be possible.

    Good luck - does the NS have a call back / cancellation list where you might be able to get in sooner?

    Kevin

  • Hi Kevin,

    The NS mentioned that right after surgery it's normal to have some pain in the arms, as moving the neck vertebrae can irritate nerves after surgery.  I can see that this could also be the sign that something did not go as planned during the ADR.  My doc explained that some of the pain I dealt with is because of the way they strapped me to the table with my arms/shoulders behind me so they can  get a good x ray view during surgery.  Hmmm... Ooooo Kaaayyy.......

    This is definitely a new problem that is progressing.  I honestly thought it was a rotator cuff tear or something at first.

    I am on the high priority cancellation list. I think about asking my primary care doc for an MRI to speed up the process, but with my luck he will need some special view, contrast etc and I will have to pay for two.  

    Until then, I'm hanging in there.  I asked the primary for some pain meds so I can get occasional relief when it's unbearable.  I was trying to manage without but I was really hurting.  

    -Darcy

     

  • Doctor appointment went ok yesterday.  He wants a myleogram (CT with dye) and a nerve study.  My right arm didn't show any reflexes that I could see.  He kept doing the test, changing arms, and I could tell it was not good. Now I wait for insurance companies to authorize, imaging people to schedule, and then revisit with doctor.  He did mention if I need surgery again, it will probably be to do fusion.  

    So, more waiting...  

    On a side note, there was a CBD specialty pharmacy in the same building.  I went to go check it out.  They pull out just one of the compounds in the CBD and get rid of THC and the other compounds in CBD that are not effective for pain..  I'm trying it out. I already feel a slight improvement which may be the placebo effect.  No psychoactive effects at all, minus maybe slightly more relaxed.  I ended up taking a small nap during the day, which I can never do typically.  At this stage I will do anything I can to not have to take opiates. 

    -Darcy

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  • Hi Darcy,

    Hope it all goes well from here - the waiting to find out what's going on and put together a plan is tough!  Glad you got some relief with the CBD....

    Kevin

  • Is foraminotomy safer than ACDF revision. I am curious why we did not all get forminotomy. Theoretically they can even remove the bulge from the other side to relieve the cental canal as well? It does look extremely difficult. 

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