Expert: Dr. Victor Dolan, DC, DACBSP - 10/24/2008

Question
Hi...thank your for answering my question.  Five months ago I had an anterior cervical fusion (4/5 and 5/6) to prevent further nerve damage from ruptured discs.  At the time, my only symptom was difficulty lifting (couldn't put gallon of milk back into fridge..etc) I was not in pain at all (though I had been earlier in the year) but I was told the surgery would prevent my right shoulder and upper arm weakness from progressing.  Instead, the surgery caused more serious weakness, specifically involving the deltoid, supraspinatus and ultraspinatus, teres minor and maybe another one I can't remember.  I can't raise my arm above my waist or lift anything (although my forearm and hand are not effected,) can't touch the top of my head, and even putting my hand in my pocket is difficult.  I've been going to phys. therapy for over four months, but now the therapist tells me it is unlikely therapy will be successful in restoring significant function, since I have not made any progress at all.   I have been referred to a university hospital for possible nerve transfer surgery, but in light of my recent experience with surgery, I am understandibly leery.  My life will be changed forever if I remain the way I am...I'll never play golf or swim again, and I can't even pick up a child. Do you have any advice for me?

Answer
failed back syndrome, failed back surgery, paralysis due to surgery, cervical fusion failure, cervical fusion,

Hello Barbara,

Sorry to hear of your pain.  Sorry to hear of your condition.  Sorry to hear that conservative non-invasive therapy (chiropractic, acupuncture, physical therapy) failed to address your problem prior to surgery.  Sorry to hear of your surgical failure.

Cervical Fusion with an anterior approach is a BIG deal!  I do not have to tell you of the complexity of treating your back (your neck) by surgically approaching your back (cervical spine)  from the front!  Skin, muscles, nerves, structures such as the esophagus and trachea have to be moved to allow access to the spine.  Complicated stuff.

#1) have you spoken to your surgeon and the doctor(s) that   
   recommended this surgery?  Your surgeon and these doctor(s) are
   the experts you have to talk to and rely upon given your specific
   individual case.  What have they told you?

#2) what is the risk/ benefit ratio of now another surgery?  What is
   the complexity of this new surgery to fix the problems caused by
   the old surgery?

#3) You have to go for a second- even a third opinion before making
   your decision.  The NEW doctors/ surgeons that you see have to be
   in another town, a different hospital,,, have no ties to the
   first doctors/ surgeons who did this to you. You need a second
   and third opinion on what was done, what could be done, what
   should be done in the future.

#4) Your 'architecture' has been changed.  Your 'structure' has been
   altered/ modified.  You are NOT 'original equipment' anymore.
   Changes, consequences of this change could be good, or
   unfortunately in your case, bad; but changes have been made, and
   you cannot go back to where you were before the surgery.  That is
   why surgery is always 'the last resort', AFTER conservative
   methods have been tried (once you drop the atomic bomb (surgery)-
   you cannot send in the foot soldiers (conservative therapy)- the
   'radioactive' changes are permanent).

#5) I would also be leery if this was me.

As a Doctor of Chiropractic, we try to treat people conservatively, naturally, efficiently, non-invasively in our offices.  I am not a surgeon.  As to the risk/benefit of your possible future procedure; I do not feel competent to render an opinion. You have to find that second and third opinion FROM INDEPENDENT sources as to the risk/ benefit of another surgery.

Changes have been made to your structure.  This Staten Island Chiropractor is very very very very cautious and leery when treating surgical failures.  As a Chiropractor, my opinion is biased because I do see surgical failures in my office.  When it is a surgical failure, the conservative treatment options are severely narrowed.  My treatment approaches are limited due to the changes in the spine.

I am sure that surgeons opinions are biased about chiropractic as well, but our treatment does not stop them from doing their treatment.  Their treatment does stop or at least alter our chiropractic treatment.

The new opinions you seek should offer you treatment OPTIONS.  Surgery again is always an option.  But perhaps chiropractic, acupuncture, nutrition, different physical therapy could STILL be helpful in your case.  Seek health professionals in all of these disciplines for a hands on, personal physical examination and evaluation to assess if options do exist for you.

For neck pain, back pain, pinched nerve; this Staten Island Chiropractor is in favor of conservative, noninvasive treatment for a prolonged period before undergoing surgery (the last resort).  Even after failed surgery, I am in favor of at least an evaluation by conservative, noninvasive health professionals.

I know I have given you a big homework assignment.  But this is YOUR body, YOUR decision, YOU should get as much of the information out there before making decisions that affect your body, your health so greatly :  ".....My life will be changed forever if I remain the way I am...I'll never play golf or swim again, and I can't even pick up a child. Do you have any advice for me?....." - yes, my advice:  GET FURTHER EVALUATIONS from independent sources, from other disciplines before making a decision.

Sorry.

Wish I could have been of more help.

I wish you Good Luck and Good Health Naturally, your Staten Island Chiropractic friend signing off,

Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com     (email newsletter)