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Hello Dr Corenman
I have been having a lot of problems post op acdf 456 two years ago so I had a new MRI done. It saysPostoperative changes of ACDF from C4 through C6 are visualized with anterior fixation
plate and screws causing susceptibility artifact.
Vertebral body height: Normal
Marrow signal: Normal.
Alignment: There appears to be slight retrolisthesis of C3 on C4. Otherwise
unremarkable.
Cord: There are some changes of focal central myelomalacia involving the cord at the
C5 level, similar to the previous study.
Facets: Unremarkable. There is a small posterior midline disc protrusion at C2-3 which does not cause neural
impingement and is unchanged. There is right uncinate spurring and mild diffuse
posterior disc bulging at C3-C4 that is effacing the ventral subarachnoid space without
definite neural impingement unchanged. There also appears to be mild diffuse posterior
bulging of the C6-C7 disc unchanged.IMPRESSION:
1. The patient is status post anterior interbody fusion at the C4-C5 and C5-C6 levels
which causes some artifact partially reducing the resolution for the images at the levels
of fusion.
2. Focal myelomalacia involving the cord at C5 is unchanged.
3. Right uncinate spurring and mild diffuse posterior disc bulging at C3-C4 as well as
mild diffuse posterior bulging of the C6-C7 disc appears unchanged. No definite neural
impingement is identified.The neurosurgeon said that the neck has no change and no new problems but the lumbar is what is causing numbness and pain. They say nothing can be done so they are sending me to pain clinic. From this MRI what do you think.
You don’t note the symptoms that you have now and what they were prior to the surgery. That would be a good place to start. See https://neckandback.com/conditions/how-to-describe-your-history-and-symptoms-of-neck-shoulder-and-arm-pain/
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.Oh no I am so sorry. Here is what’s up so far
I started out with shoulder pain some time back that just got worse and worse. pain started down my arms and hands and then i ended up with temporary paralasis of my arms. i went to my doctor and he said i had carpal tunnel so he sent me for an EMG. the Neuro said that i did have carpal tunnel but that she thought i also had Cervical Dystonia. my PT suggested a second opinion so i got a new doctor. She sent me to get an MRI and they found this:
The visualized part of the posterior fossa, craniocervical junction, paraspinal soft tissues
are unremarkable. The bone marrow signal intensity is within normal limits. No
significant signal abnormality is seen within the spinal cord parenchyma.
C2-3: There is a small central posterior disc protrusion without significant stenosis.
C3-4: There is a broad posterior disc protrusion causing a small ventral impression
upon the dural sac, mildly narrowing the subarachnoid space.
C4-5: There is disc space narrowing with posterior endplate spurring, and associated
posterior disc herniation. There is also prominence or buckling of the dorsal ligaments
contributing to severe stenosis of the spinal canal. There is bilateral neural foraminal
stenosis. There is abnormal hyperintensity within the spinal cord parenchyma.
C5-6: There is disc space narrowing, and there is a posterior disc herniation more
prominent to the right of midline, compressing the right anterior aspect of the spinal cord
and likely impinging upon the ventral nerve roots. There is moderate stenosis of the
right neural foramen and mild narrowing of the left neural foramen.
C6-7: There is disc degeneration with disc space narrowing and a broad posterior disc
protrusion narrowing the subarachnoid space.
IMPRESSION:
1. Severe spinal canal and neural foraminal stenosis at C4-5 with spinal cord edema.
2. Prominent right posterior disc herniation at C5-6 and other degenerative changes as
above.
My nuerosurgeon told me that if i didnt have surgery that i would be paralized from the neck down. so i had it done. i woke up from surgery and could hardly walk. my legs shook so bad i could not stand, but they sent me home anyway.it took me a month to be able to walk half way normal but the tremors and extreme wide gait on left was still there. at my next post op check up i told the doctors assistant, (who was surgery assistant) about my hands and shoulder pain coming back so he sent me for another MRI.FINDINGS:
The patient is status post anterior interbody fusion at C4-C5 and
C5-C6. The patient has undergone partial corpectomies from the previous study.
The central canal is patent at these levels of surgery, as are the lateral
recesses and neural foramina. There are some changes of myelomalacia involving
the cord at the C5 level, similar to the previous study.
There is posterior spondylosis at C3-C4 that is causing thecal sac effacement.
However, the cord is not deformed. The lateral recesses and neural foramina are
widely patent at this level. Similar findings are seen at the C6-C7 level.
C2-C3 and C7-T1 demonstrate widely patent central canals, lateral recesses, and
neural foramina. There are no perivertebral abnormalities.
IMPRESSION: The patient is status post anterior interbody fusion at the C4-C5
and C5-C6 levels. The central canal and lateral recesses are patent at these
levels. There are some persistent changes of myelomalacia involving the cord at
C5. No significant neural compressive abnormalities are present.
i went to a sleep doc and he said i now have Clonus, Hoffman’s Reflex, Hyperreflexia, babinsky, restless leg syndrome, sleep apnea, and wide gait in walking. i dont understand why all of this came on AFTER the surgery when i didnt have it before surgery.
The Neurosurgeons assistant told me that none of my symptoms have anything to do with the surgery and that there is something else wrong with me. I am so confused and scared of everything i have read about these findings. i still cant feel anything in my hands and the pain is excrusiating.
Now after two years of dealing with this I now am getting numbness and pain in the right leg. My tremors are getting worse. My hands and arms are getting worse. And now I have numbness in my nose and cheeks and in my shoulder blades. -
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