[aprokop]

#30618

I had an ACDF on my C5-C6 18 months ago. I have had right trap pain, along with neck stiffness and limited use of my right shoulder. I have not been happy with the results of the surgery. For the most part I feel worse then I did before my surgery. All my pain and stiffness has been on my right side. I recently had a CT scan and I was wondering if you could help me with my results?

Indication: Cervicalgia. Unenhanced CT examination of the cervical spine was performed. Sagittal imaging demonstrates reversal of the normally seen lordotic curvature of the cervical spine. Postoperative changes with fusion of C5 to C6 with no postoperative complications identified. Minimal facet degenerative changes seen, primarily at the C2-C3 interspace.

Axial imaging through the entire cervical spine was performed. The C2-C3 interspace demonstrates no significant central canal or neural foraminal narrowing. The C3-C4 interspace demonstrates mild central canal, mild to moderate left neural foraminal, and moderate to marked right neural foraminal narrowing secondary to a mild broad-based disc bulge with hypertrophic changes. Interspace otherwise negative.

The C4-C5 interspace shows no significant central canal or neural foraminal narrowing. The C5-C6 interspace demonstrates mild central canal and moderate right neural foraminal narrowing secondary to hypertrophic changes. Interspace otherwise negative with no significant left neural foraminal narrowing. The C6-C7 interspace shows no significant central canal or neural foraminal narrowing.

Do you believe I have fused? Does it look like most of my problems are at C3-C4 or C5-C6? Does it look like I would need surgery to improve C3-C4 or are there more conservative options?

Thanks

[Donald Corenman, MD, DC]

#30619

I will have to assume that your symptoms and physical examination led the surgeon to the C5-6 ACDF. Did you have a selective nerve block to confirm the diagnosis? Did you have at least some temporary relief before the symptoms returned or did you not have any relief from the surgery?

The radiologist reneged on his responsibility and did not note anything regarding the fusion or lack thereof on the CT scan. I would call him and directly ask him if he thinks there is a fusion present. You do have “moderate to marked right neural foraminal narrowing” at C3-4 which could cause neck and shoulder pain as well as “moderate right neural foraminal narrowing secondary to hypertrophic changes” at the previously operated C5-6 level which could continue to cause symptoms.

With continued symptoms over 1 1/2 years after the ACDF with no resolution, I would pick another surgeon and get another opinion.

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.

[Author]

Posts