Dangling arm post C5-C7 ACDF
 

Hello All,
My name is Curt and Just joined this site in hopes to find someone that can relate to my emotional & physical pain after a botched(My Opinion) level 2 ACDF surgery back in Jan 2014. Surgeon replaced my herniated disk in C6/C7 & a bulging disk in C5/C6. That portion went fine for the most part until I awoke from surgery. I had no use of my right shoulder and my entire arm was numb. Mentioned this to the PACU nurse (twice) as my arm fell off the arm of the chair and dangled straight down. I had tried to find it using my left arm by feeling around. I had a collar on so looking down was not an option. Both times the nurse just put my arm back on the arm of the chair and said "Sometimes this happens after surgery and it should get better. Shortly thereafter they discharged me about 4 hours after the surgery with a drain tube in my neck. (had a lot of bleeding during surgery according to notes). There was a pending snow event happening later that day and they were in a rush to get me/them out of the office before so. The next day at home my right shoulder was still useless but I could move my fingers and bend at the elbow a bit. My right bicep/tricep area was all blue like a lot of blood had pooled under the skin. Went back to Dr. next day to remove drain tube and showed him my arm bruise. He seemed shocked and had no idea what it was. No further talking about that. Fast forward, after 9 months of twice a week therapy to strengthen the atrophy in my arm/shoulder muscles, I still can't lift my arm to the side very much or towards the back at all. According to two (time spaced) Nerve conduction study & EMG tests, My C5 and C6 nerves are showing Severe Acute Denervation, caused by either a hematoma or damage done during surgery were "his" words. The problem is there was no "work" performed in that area of the cervical spine according the operating Surgeon, and he doesn't know what happened...He diagnosed me with Horner's syndrome & Parsonage-Turner syndrome. First Nerve Conduction Study & EMG ruled out Parsonage-Turner syndrome.

After doing much research into my issue and reading my surgery notes, it's my belief that the Dr/staff applied excessive traction to my shoulder in a downward motion in order to get a better Fluoroscopy real-time image of needle placement into the affected disk. The notes state that "the patient has quite large shoulders and on first x-ray the needle placement showed we were at the C4-C5 level. This means that they had lower my shoulders more in order to obtain a radio image further down. This type of trauma caused the Brachial Plexus nerve bundle to become stretched. This accounts for all the nerve damage/pain, VERY little deltoid use and as well as Horner's syndrome.

I've been on 15mg Oxycodone HCL for pain and 10mg diazepam for muscle spasms for 9 months now too. Since the injury is not on the outside for people(family) to see, I don't get much support for what I'm going through. I've applied for SSDI because I cannot work and of course was denied the first go around. Now working on appeal with a lawyer. I feel sorry for folks who are going through any type of severe nerve damage as it makes life not very much fun right now. Finally talked the Surgeon to schedule and MRI of my Brachial Plexus to investigate further. Shopping around for a Malpractice attorney at this time who will take my case.

Brachial Plexitis
 

Wow, I am so sorry this happened to you! Having a severe case of thoracic outlet syndrome ("TOS") myself, I can really empathize with what you are going through. I suggest you re-post this on the TOS forum, and start exploring some of the "sticky" threads at the top of that forum; you will find a wealth of information there, including the names of some of the top TOS docs in the country. I think your instincts are spot-on as to what happened to you during the cervical spine surgery which is causing some of your symptoms post-op. Brachial plexus injuries can be treated, but you need to be very careful about things like PT in order to avoid more damage; you really need to find a TOS-savvy PT (they are hard to find; even if a PT tells you they know all about TOS and how to treat it, in reality, very few do). I would stop the therapy you have been getting. It's not helping and it may very well be hurting you. I also would steer clear of your surgeon at this point. An MRI of your brachial plexus isn't going to tell diddly squat, anyway! Let a TOS doc (usually a vascular surgeon, FYI) determine what tests you need to undergo. Good luck to you, and I hope to see you on the TOS forum. If you include what part of the country you're in, we might be able to help you to find a good malpractice guy as well as the right kind of treatment for your injury.

Alison

Thank you for the advice and support!
 

Alison,
I'll locate the "TOS" forum and post there also. Thank you so very much for taking the time to read my novel and offer some suggestions/advice. You don't know how much that means to me! I'll continue my research and become my own best health advocate, as the medical staff aren't looking after my own best interests. (IMHO) Cheers!

Geographic Location
 

I'm currently in the Greensboro, NC area.

Rfcomm

I also had complications from TOS surgery like Alison stated.
In my case, I had to have 2 extra surgeries after the initial surgery due to "chyle lymph leaks", (Because my history is lengthy, you can view my past posts when you click on my screen name and arrow down to view past posts).
The brachial plexus nerves are vulnerable from being stretched, etc......I had damage to the nerves in the brachial plexus which was evident right after I came back to my room after the 3rd surgery.....my sister noticed it and she said to the nurse "why is her left eyelid drooping?"..."nurse said, was it like that before?" .....my sister said NO !!.....just imagine not once, but 3 times going in the same surgical site !!
Well, fast forward almost 4 years, I still have the droopy eyelid which is more evident when I am really tired & by the way I don't sweat on that side of my face either, which is also associated to the damaged nerves. When I went for eye exam the Doc said that it would not affect my vision in any way.

I know what you mean about the injury not being apparent to people, they just can even imagine what nerve pain is like....if only they could walk in our shoes. It's wise that you are working with attorney for the ssdi, just document everything for the attorney to forward to ssa and it will eventually go thru..count on 2 years from when you applied...you then likely will get a hearing.

With all that went on from my surgeries, etc. I now have more neck pain from scar tissue at the surgical site plus a pretty certain diagnosis of Fibromyalgia, which my current Doc says was triggered from all of the surgeries, nerve damage, etc. On meds to help with getting better sleep without pain although I still wake up in pain.... working on having more positive attitude is difficult when not knowing when the pain creeps up !!

Best to you

chloecasey

So sorry to hear about your ordeal :( Thank you for sharing your story with me. The last sentence of you post says it all, trying to stay positive & halfway cheerful when interacting with family/friends is hard because they don't understand. "working on having more positive attitude is difficult when not knowing when the pain creeps up !!" My Horners syndrome does effect my vision at times because the eyelid covers half the pupil at diff times during the day. Some days are better than others. Thanks for sharing your experience with me. I means a lot to have some outside support!

Brachial Plexus MRI Performed today. (9 months post surgery)
 

Well, I spent an hour+ in my favorite machine today. They performed the MRI with & without contrast. We'll see how long it takes for my inattentive surgeon to get back to me with the results. Either way I'll have a copy for my records to take to another Dr. Still doing research on finding a different surgeon that specializes in "TOS". I would assume that the area I live in would have one specialist between Wake Forrest, UNC or Duke medical. I'll keep all posted about the results when I get them.

Dubious, I was afraid to hear that, as that's what I've been reading about as of late. Nerve transfers and the time-frame they need to occur in. 4-6 month from onset. My Surgeon has been boondoggling me the last 6 months just telling me to wait... it takes time for nerves to heal. (1mm/day) And I have very long arms. 2cnd NCV & EMG test Dr says nerve damage is more than likely permanent at this time. My Surgeon dismisses this as "it's too early to tell". I'm befuddled at the handling of my case to this point with him! I currently have 2 law firms digging in and asking me for more data, although I'm still searching for one that does have a specialty in trail law as well. As I now believe, this Surgeon has breached my "Standard of Care" in a number of ways at this point!! Still looking for new specialist to determine if I am outside the repair time frame.