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  • Robertden
    Participant
    Post count: 12

    What kind of revision is necessary if only 1 screw is loosened?The MRI was looked over by pain management and he referred me to a different neurosurgeon to look it over.He wants a second opinion if it’s compressing my spinal cord. Like so many patients that I read about here, my headaches and neck pain returned after 3 months post-op. I have headaches and neck pain on the right side. C3,C4,C5,C6- 3 level.Anterior or posterior?Will my neck be weaker? And what do they do -replace or remove the screws?-sounds simpler than original ACDF.BTW my fusion worked “fantastically” according to the original surgeon who left.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8653

    Generally, a loose screw in an ACDF means a lack of fusion (pseudoarthrosis). You need a flexion/extension x-ray and a fine cut CT scan to determine what the best surgery for you would be.

    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.
    Robertden
    Participant
    Post count: 12

    Wow thanks for the timely reply. I’ve been referred to a different neurosurgeon to look into it. I’ll keep in mind your advice about the Xray and CT and will update here. Thanks so much for the advice! I’ve had headaches and neck pain for 3 years now.

    Robertden
    Participant
    Post count: 12

    Hi Dr., I know you haven’t seen the MRI and I’m awaiting the referral to a new surgeon. At least before they said I had good fusion. Hypothetically if there was a loosened screw causing compression that may be causing my return to pain 3 months after the ACDF which had given me relief from pain, what would be the approach? Anterior? Tighten or remove screw if not necessary? And tell me it’s easier than the previous 3 level ACDF?There was no other problem showing on the MRI.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8653

    Again, a loose screw is an indication of a lack of fusion. The screw would not loosen if there were no motion in the already “fused” segments. I have seen one instance where a loose screw was not associated with a lack of fusion but countless ones with.’You need in my opinion x-rays and a CT scan.

    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.
    Robertden
    Participant
    Post count: 12

    Thanks Dr.. I was hoping for an easy solution and not revision surgery but that may be in the cards.

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