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Neuropathy - Hand/Wrist Surgery

JoydancerJJoydancer Posts: 463
edited 06/11/2012 - 8:49 AM in Neck Pain: Cervical
Re: Hand/Wrist Surgery - Wed., 12/23

Mixed feelings going into a hand surgery this coming Wed., what we hoped to be fixing = neuropathy (nerve/muscle/ligament damage in elbow/wrist/fingers), is now only doing a second wrist carpal tunnel surgery and a thumb fusion.

Now that all the diagnostics have been done re: assessment C-Spine and source of neuropathy (left arm nerve/muscle damage) had review and follow-up with hand . We were initially planning to do elbow ulnar release, wrist carpal tunnel 2nd release, gunyon's ulnar release.

With all information assessed from new MRI CT C-Spine, MRI Brachial Plexus and 2 EMG/NCS tests, and assessment by Neuro and Hand Surgeon, agree majority of my pain/disability with neuropathy in left hand/fingers is coming from my C-Spine 5/6/7/8 nerve compression, bone spurs and neural foraminal compression. So when I had hoped it was a double-crush, entrapment at elbow and wrist, which could be corrected, it is primarily only initial compression in C-Spine as "primary".

The surgery on Wed will be to hopefully gain some (little) improvement in wrist pain and two of the middle fingers. It was hard to hear my hand surgeon agree with the assessment by Neuro and in reviewing the reports, as well, the disability of my hand, pinkie and ring finger, middle finger is because of C-Spine. As well, it is not the answer I had hoped since my initial diagnosis and surgery needed by OS C-Spine (highly specialized c-spine complex surgeries) gave poor prognosis for successful outcome for neuro-damage symptoms in arm/hand. Getting second opinion assessment with recent diagnostics NS on Jan. 11.

So hoping to gain something (removing scar tissue and wrapping the nerve) and nearby median nerve, at this point I decided is worth all that is not done or can be done. Because it is total loss disability progressing on my hand.

Not what I had so much hope that nerve entrapment in arm/hand/wrist could be relived by hand surgeon being the better solution. Trusting my hand surgeon that we are "giving my 2 fingers a chance of improving some, and a thumb middle joint fused, more strength" (failed thumb surgery 5 yrs ago).

Not much, but at this point I'll take any, even if it is only slight improvement and hopefully from losing ALL of my hand function, which is where this is going.


p.s. Jan 11 NS final assessment = C-spine surgery/prognosis



  • Howdy Janelle,

    As you know I went through that surgery 2.5 years ago. The post op pain was not as bad as I thought it would be. I was rather surprised by that! I will send you my usual spiney twin positive energy that all turns out well, and that you too get some more function back.

    I'm hoping you'll be open to grilled steaks the following Monday or Tuesday night!!! We are planning to be in your neighborhood (same camp) as last time. Bring the beer and your appetite!! :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Yes, feel really okay about procedure itself...simpler than most I have had before, carpal tunnel and thumb procedures re-do.

    Only concern is the neuropathy discomfort, aching in my arm and then to have iv in top of hand where I have lost so much sensation. Tourniquet will be on for 4-5 min. short period of time, talked to surgeon no injections in arm/hand = that's good. I flared up sooo bad with c-spine nerve root epidural injections.....

    Concern to not have things go worse from this past flare-up which has never levelled out to no aching in upper arm and tourniquet goes there....

    I'm gaining so little with this surgery, hoping and praying things won't get worse with trauma of iv. torniquet and pain waves.

    p.s. Surgeon is doing collagen wrapping the nerve in carpal tunnel area and mentioned nerve not far to the right (name of nerve ?) doing the same collagen wrap - - protection of nerves...neat stuff.


    p.p.s. PM you re: RV plans okeeey?!
  • Janelle,

    I understand the trepidation concerning the benefits, but even a little can be big. The bummer part is it can take a year to 2 years to see how much of that nerve is going to recover thanks to the recovery being about 1mm a day. The main nerve branches are your Medial, Radial and Ulnar. The Radial is on the thumb side, Medial in the middle, and Ulnar pinkie side.

    I understand the tourniquet, had that too, but how are they going to numb your hand if you can't get the shots? A little confused, or are they using a different numbing agent? If they end up just doing your wrist/hand, you might just have a protective wrap on it. Mine I had the half cast, half Ace bandage up to just under the armpit.

    Just keep that positive energy and attitude, and you will do fine Janelle. According to my last EMG, I have carpal tunnel now in my right hand. The funny part? It isn't bothering me, yet the left does every once in a while. I think of it like a big nasty looking neck MRI, but no symptoms! (G) I am assuming you're going to be done outpatient? Mine was. This will help I am sure!! :) *HUGZ*


    Pps.. Yes RV trip planning continues on track. :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • I thought Dr. C said she'd do iv with pain meds make me slightly out, you know not awake. No injections she said.

    She's doing open-incision at wrist, believing she'll clear out scar from possibly first carpal tunnel surgery that formed, doing collagen wrap of nerve, and then wrap of nerve (name?) just to the "right of carpal tunnel, not that far", she'll fuse the middle of my thumb now unstable/weak (have a failed thumb basal joint/implant, big joint in wrist).

    I'll have sterile gauze pads bandage and then wrapped with flex wrap on hand/wrist, thumb might cause more of a contour cast, which got added to the procedure in phone call, from original plan not eliminated after all with, and not when I was in appt with her on Thurs.

    Yes, definitely out-patient will be home that eve.

    Hey, will PM you tomorrow -- it's close to midnight eclipse time! enjoy!!

  • Janelle,

    That makes sense. They knocked me out for mine, as he wanted to retest the ulnar at Guyon's - but he couldn't do that if they blocked my arm. It turned out I was crushed more in the wrist and hand than the elbow! And my nerve was very close to the surface, which isn't normal. I've never claimed to be normal, so that's okay! (G)

    So it sounds like she is going to free up your median and radial nerves while in there - maybe Guyon's as well. I guess we'll have to cut your steak for ya! (G)

    Eclipse starts in just over an hour... :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Well, this was unfortunate, my hand/wrist surgery had to be cancelled and re-scheduled. Time slotted for my surgery was to do only wrist nerves and not my thumb.

    I noticed the surgery plans on paperwork sent to me for pre-surgery instructions, the thumb was not listed along with the wrist surgery. Called drs office, after couple phone calls back/forth, found out in eliminating initial surgery plan two months ago which included ulnar nerve surgery for elbow and wrist, and replanned to do wrist median, radial nerves, the thumb procedures did not get included.

    Since there was insufficient time to add on the two procedures required for the thumb, my surgery has been rescheduled now for March. :( Sorry to have to do this, but I did not want to do 2 surgeries!

    This hand surgeon is excellent and worth the wait, I just so hoped that by March my hand and therapy would be well along to recovery phase, sooooo nothing new, another set-back with all this spinal nerve compression and losing my hand. :W

    So, as this spiney journey has been for the whole year of 2010, lots of patience and delays, tests, puzzles, hurdles...

    Had an appt with surgeon this afternoon, she reassured me more time should not hamper what needs to be done and results.

    So...all I wanted for Christmas was my wrist/thumb surgery - - now it's not even "my two front teeth" LOL!!! 8>

  • Janelle,

    Bummer that it is getting rescheduled, but good that you caught the thumb wasn't listed! Did they give you a date for when they're doing this now? They did all 3 of my surgeries together (elbow, wrist and palm below the fingers). Are they going to try and do all of yours in one 'setting?' Support *HUGZ*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Yes, it was tough to give up the 12/23 date, waited 2 mos. for, but it will be median, radial wrist procedures, plus cmc thumb joint fusion and basal joint reconstruction arthroplasty (ligament to joint).

    Surgeon assessed thumb more fully today, with all the ulnar nerve damage, alot of focus was on elbow/wrist ulnar damage, and possibly fusing thumb (unstable from 2005 surgery basal joint arthroplasty w/ implant.

    So overall she'll do everything she can for the hand wrist/thumb, excluding elbow.

    But....are you ready for this...the re-scheduled surgery is Mar 17th - - almost 3 mos.!! I sure didn't like that - - it's more trusting, waiting, you know the drill! ugggghhhh

  • I'm like that with my Neurologist appointment! And yeah, "argh!!" For sure!!! As we have said to each other a zillion times woman, "Things happen for a reason." So maybe there is something good with this delay - of course might not be realized for a while.

    The fusing of the thumb sounds rough. But if it helps in the end, I guess it would be worth it? Did you ask them to add you to the 'call' list should a cancellation occurs? I'm on it for my Neurologist. *HUGZ*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • popped in to wish you well for your surgery , then read the update.
    glad you picked that up about the thumb fusion!
    oh well. maybee it is better to just go through the one surgery and get it all done in one hit
    sorry you have to wait , after having your mind set/focused for it to happen now
    hang in there as best you can
    take care

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