Neck pain doctor for St. Charles. Fused, still hurting, still options.

NECK PAIN · ST. CHARLES

St. Charles patients cross the Blanchette Bridge to see us for neck pain, most often after neck surgery that did not stop it. If you have already had neck surgery and the pain is still there, you are not out of options. You are not an unusual case.

Getting here from St. Charles

Cross the Blanchette Bridge on I-70, then take a short run to Natural Bridge Road. For most of St. Charles it is a simple drive that avoids the inner belt entirely. There is parking at the door rather than a hospital garage.

Why this page is about surgery that did not work

Because it is the single most common reason people cross the river to see us. Lasting pain after cervical fusion is common enough to have a large body of research of its own. Being told the operation was technically successful does not answer why the pain is still there.

There are usually specific, testable reasons. The wrong level was addressed. Adjacent (neighboring) segments now carry load they were not designed for, and their facet joints have started to cause symptoms. Hardware has loosened. Or the pain was never coming from the structure that was operated on.

Sleep after cervical surgery

It is severe, it is common, and it is almost never addressed as a problem of its own. People cannot find a position. They wake again and again, and they end up getting by on broken sleep for months. That raises pain sensitivity and makes everything else harder to treat.

It is worth setting up on purpose rather than enduring. Support the neck in neutral rather than pushed forward. Support the arm rather than letting it hang. Time medication for the night where it is needed. We treat this as part of the problem, not as a complaint to be waited out.

Bring the operative note if you can

Which levels, which approach, and whether hardware was used all change the differential (the list of possible causes) substantially. Anterior (front) and posterior (back) procedures produce different long-term problems. A posterior decompression and fusion carries a clearly different profile for rotation loss and lasting pain than an anterior procedure does.

If the note cannot be obtained, come anyway. The exam still does most of the work, and post-operative imaging fills in a good deal of the rest.

What we do not claim

That every lasting pain after a fusion has a treatable cause, or that we can undo an operation. Some of what we find is adaptation to a mechanical situation that has been changed for good. Saying so is more useful than implying otherwise.

What we can say is this. A substantial share of this group has an untested facet joint at an adjacent level. Testing it is an outpatient procedure, not a commitment to anything.

What a second opinion here actually involves

A full exam rather than a review of somebody else’s notes. Range measured in degrees. Strength graded muscle by muscle. The facet columns pressed on segment by segment, above and below the fusion. And a clear statement of which structure we think is responsible, and what test would confirm it.

You leave with a named structure and a plan, not a general impression of whether the surgery was reasonable.

What we test for after a fusion

• Facet-mediated pain at the levels above and below the fusion. It is testable with a diagnostic block and treatable with radiofrequency ablation without another operation.
• Rotation loss, measured rather than described. That is because it is disabling in ways people are rarely asked about.
• A leftover or new radicular (nerve-root) pattern, told apart from a peripheral entrapment (a nerve trapped farther down the arm) by nerve studies.
• Sleep disturbance. It is severe after cervical surgery and almost never addressed as its own problem.

Before any second operation

We test before anyone routes you back to a surgeon on the strength of a scan and a description. A second operation for pain after a first one is a serious decision. It deserves a diagnosis established by testing, not an assumption that more surgery will finish the job.

Where we are

12174 Natural Bridge Rd, Suite 302
St. Louis, MO 63044

Suite 302. Parking at the door.

Adjacent segment disease, specifically

Fusing a segment shifts load to the ones next to it. Degeneration (breaking down) at those levels is a recognized long-term result. It matters most in younger patients, who have the most years for it to develop.

The practical point is this. Adjacent-level facet pain is testable with a diagnostic block and treatable with radiofrequency ablation, as an outpatient, without another operation. It is one of the more common findings in people who come here after a fusion. It is also one of the more satisfying to identify.

If you are considering a first operation

The most useful questions are which structure is generating the pain, and how that was established. Is a fusion being proposed for neck pain rather than for arm pain or cord compression? Then ask whether a diagnostic block has been done.

A surgeon with a clear indication will answer all of that directly. Trouble with the block question is the signal worth noticing. That is because the risks of the two options are badly lopsided: a wrong ablation wears off, and a wrong fusion does not.

Rotation loss, which people rarely raise

Loss of neck rotation after a posterior fusion is disabling in ways that do not show up on a pain scale. Checking a blind spot, talking with somebody beside you, and turning in bed all take effort. People adapt by turning the trunk, without ever calling it a symptom.

We measure it in degrees rather than describe it. That is because it is the only way anybody can tell later whether anything changed.

What St. Charles patients ask

My surgeon says the fusion looks perfect. Why do I still hurt?

A solid fusion means the bone healed. It does not tell you whether the level that was fused was the level generating your pain. Nor does it tell you whether the neighboring segments have since started to cause symptoms. Where the practice sits in St. Louis.

Can anything be done without more surgery?

Often, yes. Adjacent-level facet pain is testable with a block and treatable with ablation. It is one of the more common findings in this group. What happens at the first appointment. Where surgery is clearly right, and where the question is premature.

Is the drive worth it?

That is your call to make. What we say is this: if nobody has done a diagnostic block, the question has not been asked yet. What gets missed after fusion.

Do you do second opinions before surgery?

Yes, and that is a substantial part of the work. Confirming the level before a permanent decision is the point. Where the practice sits in St. Louis. The three questions worth putting to any surgeon.

Related reading

• Failed neck fusion
• Posterior hardware failure
• Loss of neck rotation after fusion
• Ablation or fusion?
• Sleep after neck surgery
• Neck pain doctor in St. Louis
• Neck pain care for nearby Florissant
• Neck pain treatment for St. Peters patients