[Alaskaguy9]

#32661

Good morning Dr.Coreman

I had a follow up on my fusion, I would appreciate your interpretation of the CT scan.
I am post 2 years of my ACDF.

C5/C6 Asymmetric disc osteophyte resulting in severe right and moderate to severe left neural foraminal encroachment. Crowding of the traversing nerve roots with probable impingement. No central canal stenosis or cord impingement.

C6/C7 mild.to severe neural foraminal encroachment, with right greater than left.No evidence of nerve impingement

What treatment would you recommend..I am having pain in my shoulders, headaches and extreme weakness in my arms down my elbows with tingling again around my right thumb.
Thank you

[Donald Corenman, MD, DC]

#32664

I am confused. What levels were initially fused? What does the CT scan note regarding solid fusion of these level(s).

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.

[Alaskaguy9]

#32665

It was a C5/C6-C7 fusion.

[Alaskaguy9]

#32666

It just says postsurgical changes of disectomy and fusion C5-C6 and C6-C7.
Impression is residual foraminal encroachment must evident bilaterally C5-C6 with probable nerve root impingement.

[Donald Corenman, MD, DC]

#32667

So the radiologist was non-committal on the fusion status. This is not uncommon. There are some residual findings of foraminal narrowing which again is not that uncommon. The key is connecting the residual symptoms with the CT findings. You would need a thorough examination to determine sensory and motor strength loss as well as diagnostic selective nerve root blocks of the C6 nerve roots to connect findings with symptoms.

If good relief with the block and a solid fusion, a posterior foraminotomy would be advised. If a pseudoarthrosis (lack of fusion) is noted, then a revision ACDF with your own bone would be more likely to help you.

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.

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