[Juliet1971]

#28130

I’ve received a cervical fusion c3 through c7 and a laminectomy from extreme spinal compression. I’m in about the 10th year of that fusion.Unfortantly I do have degenerative disc disease in its most aggressive form and spinal stenosis. I’ve had more progression on my lower back and a fusion with laminectomy also. My question to you is I’m haveing extreme neck pain but not like previously. The muscle (i think its muscles) that run from the base of the skull down to my shoulders hurt. It hurts so badly at times I can’t touch it. Now I have a burning between my shoulder blades. I’m wondering if my current mri would explain this an if I need to see my neurosurgeon? I’m not sure how to attach the mri.

[Donald Corenman, MD, DC]

#28133

You can copy and paste the radiological report here.

If you have a solid fusion of C3-7 then you might have breakdown at C2-3 and C7-T1. Both levels would explain base of the neck pain and headaches (C2-3) and “shoulders hurting” (C7-T1).

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.

[Juliet1971]

#28146

MR Cervical Spine wo Contrast
IMPRESSION:
1. Postsurgical changes from a anterior spinal fusion from C4 th ro u g h C7.
2. Mild degenerative changes at C7-T1 are identified. Mild central canal narrow ing is seen.
3. The exam ination is limited by p a tie n t m otion.
INDICATION:
GENDER/AGE: Female, 46 years
ORDER INDICATION: M89.00:Algoneurodystrophy, unspecified site HISTORY PER PATIENT: Algoneurodystrophy
TECHNIQUE: Sagittal T1, sagittal T2, sagittal STIR, axial TI, and axial gradie nt echo MR images of the cervical spine were obtained.
COMPARISON: None.
FINDINGS:
Postsurgical changes from a spinal fusion from C4 through C7 are identified. Artifact from the hardware at the C6-7 level limits the exam. Straightening of the cervical lordosis is seen.

Holliman, Juliet E (MRN 01039601) Vertebral body height is maintained.
There is anterolisthesis of C7 on T1 of 2 rnrn..
Desiccation from C2 through C4 and at C7/T1.
There is no evidence of a marrow infiltrating process.
No edema is identified on the STIR sequence.
The cerebellar tonsils end normally above the foramen magnum.
The cervical spinal cord demonstrates normal signal intensity and morphology.
Findings by level:
C2-C3: Normal.
C3-C4: Mild left foraminal narrowing is seen.
C4-CS: Postsurgical changes are identified. There is no central canal narrowing or significant foraminal narrowing.
C5-C6: Postsurgical changes are identified. There is no central canal narrowing or significant foraminal narrowing.
C6-C7: Postsurgical changes are identified. There is no central canal narrowing or significant foraminal narrowing.
C7-T1: There is a posterior disc occupy comments. Mild central canal narrowing is seen.
DICTATED BY: Akshay Gupta, M.D., on 4/13/2018 3:26 PM PDT DICTATION LOCATION: 400 9th St. -Florence, OR 97439
End of Diagnostic report for accession: 4251600 Interpreted/Electronically Signed By: Akshay Gupta, MD on 04/13/2018

With my knowledge of my condition and how rapidly it progresses and the previous experiences of the determination that wasn’t detected and my new pain. Do you think a second option is warranted since they have nothing to go by and no knowledge of my condition? Thank you for exsplaing the current pain I’m having. It isn’t something I’m used to. It isn’t going away and now my hands are tingling. ?

[Donald Corenman, MD, DC]

#28150

OK- for some understanding of what surgically has been previously performed. You have had an ACDF (anterior fusion) at C4-7, not a posterior laminectomy and fusion from C3-C7 (“Postsurgical changes from a anterior spinal fusion from C4 th ro u g h C7”).

You do have a degenerative spondylolisthesis of C7-T1 (“There is anterolisthesis of C7 on T1 of 2 rnrn”). See https://neckandback.com/conditions/degenerative-spondylolisthesis-cervical/. His comment also included:”C7-T1: There is a posterior disc occupy comments. Mild central canal narrowing is seen”. I think he means there is a posterior disc herniation that mildly narrows the central canal. He made no mention of any narrowing of the foramen which means either he did not see anything or he ignored this area as normally there is some mention of the foramen on the exam report.

You do have some degenerative changes of the upper discs “Desiccation from C2 through C4” but there is no descriptions of how severe or mild these degenerative changes are.

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.

[Juliet1971]

#28151

So Dr.Corenman since they have nothing to compair my condition against and the fact that Im new to this small town, do you think its warranted to contact my neurosurgeon? As I said previously im having increased pain. The base of my skull is painful, the pain going down my neck between my shoulder blades and tingeling in my hands with headaches now. I just had an emergency lower back fusion and was back in 8 weeks later with another emergency surgery. The cage backed out and was wedged against my spinal cord. The bone essentially crumbeld. She had to stableize the cage and do a laminectomy.
I just don’t want to over react but on the same hand everytime I ignored my body its turned out badly. As an Doctor would you want your patient to contact you if they were going through this?

[Donald Corenman, MD, DC]

#28158

I might be somewhat apprehensive about your neurosurgeon. There are times that an “urgent” lower back fusion is called for but I see that need maybe 1-2x/year and I see scores patients who don’t need urgent fusion surgery. The second point is the cage “backing out”. This can occur but should be very rare. For example, I have had three cage back-outs in 1500 cases and mainly due to patient falls in the very early days after surgery. Was this cage placed by an anterior (belly) approach?

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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