Cervical Fusion Creates Weird New Reflex

manual therapy Sep 16, 2017

In this video my buddy Dr. Nick Buonforte treats a young man in my clinic MOMENT INSTITUTE who just has an ACDF (anterior cervical discectomy fusion). After surgery he spontaneously developed a weird new stretch reflex of the upper trapezius. 

Cervical fusion is now a common treatment for cervical spine pain with radiating arm or hand pain, numbness or tingling (cervical radiculopathy).

There are 5 reasons where cervical fusion is warranted: 

  1. The patient experiences unrelenting pain that limits their ability to perform activities of daily living and they fail to respond to more conservative care (therapy, medication, injections).
  2. The patient develops progressive weakness of the arm or hand.
  3. The patient develops a myelopathy (spinal cord compression) and shows signs of gait deficits (walking difficulty), dis-coordination, or leg weakness.
  4. There is a risk of severing the spinal cord during a head trauma if the spinal segment in trouble is not stabilized.

If your patient or client has neck pain with radiating arm symptoms or weakness, and any of the 4 criteria above are positive, then referral to a spinal surgeon may be warranted.  Although there are some serious risks with cervical fusion, there are also dangers to not taking action on a progressive neurological condition. 

Just last year I had a patient present to my clinic in a wheelchair with paraplegia. He had had severe cervical spine stenosis that should have been fused, then he took a simple fall and hit his head which severed his cord. In his case, he had satisfied criteria #4 above, and a fusion may have stabilized the vulnerable segment and saved him from his spinal cord injury.

In this video, “Cervical Fusion Creates Weird New Reflex” you will see an interesting finding on a young man who recently had an ACDF.  Typically, there is no “upper trapezius reflex.” I had performed Graston on this patient’s neck a number of times pre-surgery with no reaction. But, after surgery (which was very successful) he developed a skin-stroke reflex that was not present before surgery.  Check it out...


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