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  • rbryant
    Post count: 5

    Hello, Dr Corenman. You assisted some time back (Pre Covid) with a lumbar issue.
    I also have cervical issues that will likely require surgery. In 2019, I had an ACDF of my C5/C6, with good results. Over the past year and a half I have developed periscapular pain on my right side, as well as tricep pain and occasional weakness. Interestingly, I have little, if any neck pain or stiffness.

    An MRI from July was read as:

    C1/2: mild degenerative changes, craniocervical junction is normal in appearance.
    C2/3: Minimal endplate spurring. no central canal stenosis, no neural foraminal stenosis.
    C3/4: broad based right paracentral disc protrusion and mild endplate spurring. mild central stenosis and no neural foraminal narrowing.
    C4/5: central disc protrusion. mild endplate spurring. moderate central canal stenosis. moderate bilateral foraminal narrowing.
    C5/6: prior fusion with minimal central stenosis. no foraminal narrowing noted.
    C6/7: broad based disc protrusion. minimal endplate spurring. mild central stenosis. no foraminal stenosis.
    C7/T1: no central stenosis. no foraminal stenosis. mild endplate spurring.

    Interesting a PA for a neurosurgeon consulted with feels that I do have right side foraminal stenosis at C6/7.

    I have had a consult with neurosurgery and he has proposed an ACDF at C6/7, with a cervical laminoplasty from C2 to C5. He feels that the central stenosis will be progressive and lead to a spinal cord injury at some point. As such, he has advised against higher risk activities such as mountain biking, horseback riding, skiing, etc. At this point I have not had any symptoms of myelopathy, but I’m aware that the risk is there. I will seek a second opinion to see what other treatment options are available. However, it seems that this would be the best approach for long-term stability, and to prevent myelopathy.

    Does a laminoplasty with fusion seem to be a reasonable solution? If so, will I be able to return to somewhat higher risk activities such as biking?

    As a side note, I have had multiple steroid injections into the C6-7 space. These have been very effective in relieving discomfort and pain. However, I am aware that this only used to treat pain, thus more of a “band-aid.” All of my imaging is recent and will be making a decision shortly after second opinion visit. Hopefully surgery to follow this Fall, depending on Covid. So, second question, what is the typical average range in recovery from a procedure such as this? Thanks for your time.

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