[323marine]

#19980

Hello Dr. Corenman,

I was wondering if you would be kind enough to assist me in reading the CT scan results of my neck. Here are the results as follows:

C2-3: There is no significant uncovertebral hypertrophy. The intervertebral disk height is preserved. There is asymmetric left facet arthrosis with a ventromedial left facet osteophyte. The central spinal canal is patent. There is subtle narrowing of the left foramen. The right foramen is patent.

C3-4: There is a small right uncovertebral osteophyte. There is no significant facet arthrosis. The central spinal canal and both foramina are patent.

C4-5: There is no significant uncovertebral hypertrophy. There is mild right facet arthrosis. A subtle posterior broad-based bulge is present. There is a mild central protrusion. This appears to abut the ventral aspect of the cord. Both foramina are patent.

C5-6: There has been a prior ACDF at this level. The left C5 vertebral screw extends to the medial margin of the left foramen transversarium. There is no evidence of hardware fracture or hardware loosening. There is complete ankylosis of the intervertebral disk. There is a small to moderate right uncovertebral osteophyte.
There is a right central osteophytic spur. This may abut the right ventral to ventrolateral cervical spinal cord. The central canal appears patent. There is no significant facet arthrosis. The right foramen is subtly narrowed.

C6-7: There is no significant uncovertebral hypertrophy. The central spinal canal and both foramina are patent. There is mild left facet arthrosis.

C7-T1: Normal.

There is no significant cervical lymphadenopathy. There is no dominant neck mass. There is no lytic or blastic lesion of the cervical spine. There is a focus of dystrophic ossiflcation in the subcutaneous tissue of the mid neck at the level of C5. The paravertebral muscles are normal.

The 3-D volume-rendered reformations were invaluable in assessing the position of the fusion hardware and the alignment of the cervical vertebrae.

IMPRESSION:

1. Prior ACDF at C5-6. An osteophytic marginal spur appears to abut the right ventral aspect of the cord.

2. Degenerative changes of the intervertebral disks, the uncovertebral joints and the facet joints of the cervical spine are mild in severity. A mild central protrusion at C4-5 appears to abut the ventral aspect of the cord. There is no significant foraminal encroachment.

Any information/advice you can provide would be greatly appreciated.

[Donald Corenman, MD, DC]

#19984

You illustrate the image reading but give no indication of your symptoms. Imaging does not rest in a vacuum. Correlation with symptoms is very important.

You have had a previously successful C5-6 ACDF (fusion). The screw from the plate might be abutting the C6 nerve on the left. See “symptoms of cervical nerve injuries” to understand what symptoms a C6 nerve can cause.

You have mild degenerative disc disease at C4-5 and degenerative facet disease at C2-3, C4-5 and C6-7. See the section on cervical degenerative facet disease to understand what symptoms these structures can generate.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[323marine]

#19995

Thank you Dr. Corenman for your prompt response and I apologize for leaving out the details regarding my symptoms. Nonetheless, here are the symptoms I’ve been experiencing:

Neck stiffness and burning shoulder pain that radiates down to my arms into my wrist, thumb and index finger (primarily on the left side). In addition, I have this pins and needles sensation that starts in my neck that migrates to my legs.

Based on the aforementioned information, is this a cause for concern?

Please advise.

[Donald Corenman, MD, DC]

#20002

Left sided arm pain can result from the potential of the screw impinging on the nerve root. You could try a cervical selective nerve root block (SNRB) of the C6 nerve on the left. If this is diagnostic (see pain diary), you might consider removal of the plate and screws to see if this gives you relief.

“Pins and needles sensation that starts in my neck that migrates to my legs” would not originate from your neck based upon the information you have supplied.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[Donald Corenman, MD, DC]

#20003

Left sided arm pain can result from the potential of the screw impinging on the nerve root. You could try a cervical selective nerve root block (SNRB) of the C6 nerve on the left. If this is diagnostic (see pain diary), you might consider removal of the plate and screws to see if this gives you relief.

“Pins and needles sensation that starts in my neck that migrates to my legs” would not originate from your neck based upon the information you have supplied.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[323marine]

#20028

What is the medical procedure called to remove the plate and screws? Moreover, by removing the hardware, would it cause any instability issues? Thank you again, Dr. Corenman.

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