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  • Alaskaguy9
    Participant
    Post count: 10

    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
    Moderator
    Post count: 8465

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

    Dr. Corenman

    Alaskaguy9
    Participant
    Post count: 10

    It was a C5/C6-C7 fusion.

    Alaskaguy9
    Participant
    Post count: 10

    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
    Moderator
    Post count: 8465

    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

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