Question
47 yr cauc female , don't drink, no past Hx, smoke, good health usually until--Car wreck Oct 2002 ACDF performed Loma Londa Hospital. C 5, 6, 7-titanium plate---severed ligament sutured makes spasm at the base of my head.I have lived through this, my doctor who performed the procedure usually doesn't get to talk to patients who come in with the degree of this injury. I am here. I have lived with pain at a 4-6 level since--more severe when I bend over goes to a 10 always feels like a vice grip on my head--tingling down right arm not all over it but certain areas to the index, middle, ring finger, have always been good at dropping things since, treated at pain clinic since 2003, never had a good night sleep due to accident and pain, can never get comfortable laying straight on my back, always had numbness and or tingling on both sides of my face that comes and goes, difficulty with slight incont of bladder, painlike tingling numbness sometimes during BM goes up to head if hard bm, limited neck movement, plenty of head aches, but I function and keep on getting it as well as possible--I have had two pain blocks ( don't want them no more)
Question: I have been experiencing chest pain behind sternum, burning radiating out up neck, face, left shoulder and right, to back, feels like I can't breath even though O2 sats are normal, EKG normal, cardiac cath normal, stress test normal, this has really been occurring a lot for the past two months since middle of October 2008; was in hospital and cardiac cath was normal, thyroid normal, all blood labs normal. When these spells occur my BP goes up up up. I am on atenolol 25 mg qd po, vicodin po prn, nitro prn, 81mg asa qd --when these spells occur relieved by nitro. I am seeing a doctor to empty my trash can, I am on ativan 1 mg tid po, nexium 40mg po qd as well as I take maalox and tums. The chest pain behind sternum has been from mild to severe and has lasted up to 3 days. The tingling goes down my arms and even in my right leg. I always feel worse after taking the atenolol. I am scared and yes I am worried. What is going on possible cardiac? possible GERDs? possible anxiety? possible espohageal spasms? Is this possible nerve pinching in the area I had my surgery? or possible combination? Please help. Thank you for your time.

Answer
The answer is "yes" to all of your questions. It is possible that any one of these conditions could cause your symptoms. I would venture to say that it is more likely related to your neck condition however. You need to make sure to find a good physical therapist or chiropractor who specializes in rehab to work with you if you haven't already done so. Secondly, you might have had unsuccessful fusion. You mentioned you are a smoker, and it has been clearly shown that smoking decreases the body's ability to create a fusion.

I would suggest you get a repeat MRI of your neck to see what is going on there and follow up with another orthopedic surgeon or neurosurgeon.