Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

posterior cervical foraminotomy recovery

Vince in PhillyVVince in Philly Posts: 4
edited 06/11/2012 - 8:43 AM in Back Surgery and Neck Surgery
Hi - this is my first post on the spine-health forum. I had a C5-C6 and C6-C7 right side posterior cervical foraminotomy almost 3 months ago. My main complaint prior to the surgery was rhomboid muscle spasm, shoulder ache and weakness, and burning numbness in my upper arm. After seeing some initial improvement immediately following the surgery, my symptoms have returned, only worse. I'm also experiencing the same symptoms on my left side now.

A post-op MRI showed no nerve root impingement, but some fluid buildup. My spine surgeon thought that the nerve roots were simply inflamed following the surgery and PT, and sent me back to my physical medicine rehabilitation specialist for an epidural steroid injection.

When I received the steroid injection 5 days ago, the doctor said that the dye pattern he observed during the injection suggested that there was some scar tissue formation in the area that disturbed the flow of steroid, resulting in a different pattern of distribution than he had seen when giving me injections before the surgery.

So far I have not shown any improvement from the injection, which is not typical for me this many days after the procedure.

Does anyone have any advice or information they can share with me? Seems like 3 months after this type of surgery I should be almost completely recovered and better, not worse. After not seeing any benefit from the steroid injection either I'm not sure what to do next, but feel like I'm running out of options.


  • Hi Vince,

    First let me say welcome to spine-health. Have a look around and you will find members whom have gone through what you are or are going through it now. I have had the posterior surgery twice. One was the foraminotomy and the second was a redo on a fusion surgery. The one thing I do know is it takes a lot longer to heal from posterior surgery than the anterior approach. With that being said it concerns me the doctor felt something was blocking the dye pattern. I would hope, that the doctor who put the injection in is going to follow-up with your surgeon. What was your initial diagnoses to have the surgery? I should say what were they trying to fix a such as a herniated disc or bone spurs? Doing a foraminotomy is less invasive of a surgery than a fusion but I have seen members who ended in the long run with a fusion. However I am not saying that necessarily the case with you. I would suspect if there was a pattern with the dye they may want to get a myelogram to look at the canal itself, which will also give them a better look at the nerve's. I am of course speculating, your surgeon will need to make that call. They can also put in selective nerve root blocks on the effected nerves and see if that helps and can also be used as a diagnostic purpose.

    As you stated you are in therapy. Are they doing in message therapy? Sometimes after posterior surgery that can have a lot of benefits. Another thing don't gage your recovery by others as each person is different and while the procedures are similar the conditions can be totally different.

    Just thought I would stop by and welcome you to spine-health. If there is anything i can do don't hesitate to pm me. Take care and keep us posted.
  • Thanks for your response. The diagnosis that prompted the surgery was foraminal stenosis. My spine ortho didn't think an anterior fusion was warranted at this point in time. I'm sure my physical medicine doc will send a note to my spine ortho about the change in dye pattern possibly indicating scar tissue, but I'll follow up with him when I see him next week. I did have 4 weeks of PT after the surgery, but it was all McKenzie extension therapy and it might have done more harm than good. Both docs suggested no more PT until the nerve inflammation settles down, at which point maybe I'll look for a different therapist who might try other modalities. I'll take your advice on the massage and see if that loosens things up a little for me. Swimming used to help me quite a bit, but since the surgery swimming seems to really aggravate things too.
  • SpineAZSpineAZ WiscPosts: 1,084
    I had a PCF in 2008 two years after having an ACDF. After the PCF I did a few epidural injections to calm down some nerves that were firing pain constantly. I have never fully recovered from the PCF though it did give me some relief. I had about a 6 month reprieve and then had pain again. The pain is better than it was before the PCF.

    The beauty of the ACDF is they go in from the front and don't disrupt muscles. The PCF goes through muscle and that has led me to have muscle spasms (at times somewhat unpredictably) and I still have neck problems leading to pain in my arms. However it's now only to the bicep level so my doctor is trying to determine if scar tissue from the PCF is a problem or perhaps I need another ACDF whit additional levels included.

    Massage therapy for my low back was only slightly helpful. But massage therapy on my neck, especially post PCF, was very useful in managing neck tightness, spasms, etc. I also naturally seem to carry tension in my neck so that doesn't help as well.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Vince I think I am in the same boat with you. I had a microD,lami and foraminectomy back in January. I recovered very quickly from surgery. About 3 wks after surgery I discovered my eye problems and the neuro sent me for mri to rule out possible causes. At that time they discovered my fracture of the pedicle from the surgery.

    I've always been achey through my first rib/collar bone but that is from the fracture. In the past 2-3 weeks I have noticed that my other symptoms are returning. Increased sensitivity in forearm, neck pain, ear pain. All of this was gone but now is coming back.

    The MRI that was done at 4 weeks post op also showed substantial pockets of fluid. Enough that they noted it on both sides of my spine. My PT felt this when he massaged my back but thinks that has gotten better now. I still get some killer spasms. I go in another month for another ct scan which will show how the bone is doing. Don't think it will show fluid.

    I would find a good PT who does massage. It will help to breakup the fluid and the scar tissue.
  • Thanks for all of the feedback - lots of recommendations for massage therapy. Is this going to help with the recovery so that I get some lasting relief, or just help in the short term with muscle spasms? I'd love to hear from anyone who has had a good result from PCF - should I expect that this will get better but will just take more time?
  • PT is supposed to do a few things. It provides immediate relief of the pain from swelling and stiffness. The massage breaks up fluid pockets and moves them around so they get reabsorbed faster by the body. It also breaks up the fibers of the scar tissue and muscle that is spasming. If you search on muscle spasms you will see lots of explanations of why they happen and how you need to stretch and straighten the fibers to get them to heal properly. The final goal of PT is to strengthen the muscles that were directly effected by your surgery and also to build the surrounding muscle so it helps to support the areas affected by surgery.

    A good therapist will be working all of these concepts at once. They almost always start with heat to loosen you up and stim to exercise the muscles down deep. Then you do exercises like the arm bike, band pulls, cable column. Then you finish with massage.

    I am a big believer in PT with the right therapist. A little secret is that you will get huge benefits from PT before your surgery. Makes recovery a breeze.
  • Thanks for the advice. I'll schedule a massage for this weekend and search for a new therapist in the meantime.
  • so in reponse to Vince's "I'd love to hear from anyone who has had a good result"

    I had this procedure for C5-6,C6-7, to the left, ONE YEAR AGO You should expect the burning to last for about 3-4 mos - I had an ice pack literally clamped to me 24/7, even in bed.
    Then you will remain frozen for about another 4 mos. (then heat is good) The burning stops & pain lessons (but still painful).
    Then the last phase is the thawing out, which last approx 4 mos. Total approx recovery time is about a 12 mos, for the 3 stages of recovery.
    You will discover that you are non-responsive to many, if not all, trmnts. Tens unit may bring some temporary relief. Everything will be temporary relief, until it runs its course of about 12 months.
    If you need more info, read up on adhesive capulitis - its something that sometimes cannot be avoided following surgery. Like your Posterior Cervical Surgery, 2 levels, almost impossible to escape this from occurring.
    BUT Im done now! So, I can tell you that the results are definitely rewarding & so glad we were candidates for this procedure. Not to mention VERY LUCKY! My problem was the foramin stenosis too. Recovery is insane though. So, having said that, take a chill pill, relax, & do whatever makes you comfy, because nothing out there, but TIME, will get you through this. I took vicodin, flexeril, and meloxicam for a year. One of each per day. It helps with taking the "edge" off, so you can move about easier, which help in breaking up the scar tissue that has formed in you neck & back area.
    phew it was rough
  • I had the above surgeries in April and July, respectively, this year to hopefully treat nerve pain in the left hand. The PCF surgery happened after there was no relief from the ACDF. So it's a little difficult to gauge where my 'recovery' should begin, April or July, but I'll assume July. After 4 months the back spasm subsided. The drugs, methocarbomal, gabapentin and flexural, taken at different times, on took the edge off the pain. Ice packs and rest were more impactful for me. I did have PT and it was great for soothing the muscle spasms, but when we started exercises, especially very light weighs, I regressed. My suggestion is to use PT for the muscle spasms while early in recovery, but be very cautious of starting weights and such until after the nerve has subsided for a few months. After 4 months the left arm nerve pain comes and goes, most of the time without apparent trigger. I am fascinated by Zack's mentioning of adhesive capulitis and the likely 12 months for it to run its course. I'd like to hear more about this phase of recovery and what should be done.
  • I am new to the site, also newly diagnosed with cervical radiculopathy. I have been looking for people who have had a cervical foraminotomy to see if it gave them relief from pain. My question to anyone is, how long were they in pain, meaning how long was the nerves being traumatized before your doctors decided it was time for surgery?
  • How long were you in pain before your doctors decided it was time to do surgery?
  • I just had two of these. Two separate operations.

    I had one five weeks ago on c6-7 right which was said to be as severe as it could be. A lot more complicated than the MrI showed (it was in he third plane)

    Then a week ago I had a second on c5-6 left.

    I guess it's somewhat uncommon for
    People to need one left one right at levels above and below each other. Because it would
    Require two Incisions it had to
    Be separate surgeries.

    Anyway I've tried epidurals (7) and physical therapy as well as traction over the course of 18 months. Initially an orthopedic surgeon wanted to fuse 5-7 but the stress to 4 which is already somewhat bad would probably have meant another fusion within five years. So I'm trying this first.

    Age 39 6'5" 225 lbs

    I have some
    Questions about this surgery sill I don't really know he answer to and I see conflicting reports. Like
    Fusion is less invasive but this is a more painful surgery? This preserves motion but fusion has a better success rate?

    I went to barrow neuro and the neurosurgeon said there was a 35% reoperation rate on foramenotomy.

    I hope some of that information is helpful. The operation is. It very painful - or I should say the pain is controlled well by medication. The anti inflammatory meds are probably more important than the pain pills.

    At 3.5 weeks in I had to start a second steroid pack because the inflammation was still pretty bad

    I'm sure the fact I had the same
    Operation a month before made the second more difficult.

    I haven't noticed much of a decrease in radicular pain but my hand strength is significantly improved on my right after a month the left hasn't responded so well or quickly.

  • nz1025nnz1025 Posts: 112
    edited 01/09/2016 - 1:54 PM
    I'm thinking of having a foraminotomy at c5/6 for a herniation. Seeing the spine surgoen again at the end of the month so hoping to get pre-approval started for surgery then - and will prob need to decide on this or a fusion then... So.. it's good to hear from people that have had one.

    My surgeon did mention something about this being more painful after surgery as you have to go through the muscle - so that point sounds right.

    I'm not sure about comparable success rates, but there is always going to be the risk of reherniating - or degradation of the disc - so that you need a fusion in the future. I think I read somewhere (probably on this site) that reherniation is more likely for the first 3 months - and that is might just happen because there are still loose pieces from inside the disc... I think my surgeon just gave me approx success rates for cervical surgery.

    I did ask about stability afterwards - and he said that neither he nor his colleague have had someone have stability problems from a unilateral single level foraminotomy. so yes, preserves motion - and i guess is fine for stability unlesss you already have stability problems (in which case i would have thought your surgeon would have gone for fusion).

    i talso think my surgeon said that fusion is better for pain into shoulder blades, etc. - i really only have radiculopathy and some sensitivity of my upper back muscles (which is def activity related, as it went away when i went back home for 2 months).

    im also worried about the stress on adjacent levels/other areas of back - particularly as i already have an old thoracic injury. my upper back and neck already play off against each other - so not sure my upper back could take something like this...

    35% reoperation sounds high - that makes me worry a bit about this as a choice.

    i haven't really answered any questions, sorry. - but am interested in your progress, so please let me know how you get on.
This discussion has been closed.
Sign In or Register to comment.