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  • johnkacprowicz
    Member
    Post count: 2

    Dear Dr. In 2009 i had a 3 level fusion in my cervical spine. Left with a bad facett joint . Now my me mri states that at c 5-6 there is major central posterior ridging affecting the ventral thecal sac. Mild biliateral unconvertebral hyperttrophy,mild right neural formamen and mild left facet hypertophy. This is one dics that was operated on. Next at c 6-7. Also operated on now there is residual disc material present in the disc space. Servere bilateral uncovertebral hypertrophy causes mile to moderate right and mild left neural foraminal narrowing. At c-7 t -1 mild central posterior disc osteophyte complex with mild right neural foraminal narrowing on the basis of mild right uncovertebral hypertrophy. Im told a revision surgery is the only answer. Is this true?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    Your description is somewhat confusing. You have had a three level ACDF (fusion) of the cervical spine but do not indicate which levels. 90% of the time, the fusion levels would be C4-C7. Is that correct? Also, did you obtain a solid fusion as fusion rates in some institutions can be as low as 75%?

    You note a large C5-6 ridge compressing the thecal sac. Does this spur also compress the cord? Is this one of the fusion levels?

    At C6-7, there is “residual disc material present in the disc space”. Did you have a simple discectomy (removal of the disc) without a fusion? That is the only explanation for residual disc as an ACDF fusion typically completely removes the disc. You have foraminal stenosis at this level which could cause C7 nerve compression (see website for description).

    You ask if revision surgery is necessary. It really depends upon your symptoms, your examination findings, what the imaging reveals as well as what treatments you have already undergone.

    Dr. Corenman

    johnkacprowicz
    Member
    Post count: 2

    I’m sorry it was 2 levels C5-6 and C6-7 they removed the disc’s and put in cadaver bones i’m told at C 6-7 the bone is falling apart this is what the mri reads and my surgeon told me . my spur is in the fluid that protects the cord , also being told that they will continue to move until they compress the cord. I had shots, get headaches tingling numbness in arms and fingers. just had carpal surgery on hands and had a pinched nerve in each elbow . didn’t change a thing. my surgeon tells me when you have a fusion most times levels above and below will start to go, he thinks that’s whats happening at C 7-T1 he told me he never seen a disc fall apart and could be stuff they missed . now I’m left with more pain a plate and screws in my neck. I’m being told with everything we tried and because of this never showing up on other studies . Surgical intervention is the only answer

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    You have developed a pseudoarthrosis (lack of fusion) at C6-7. This is not that unusual with the use of allograft (about 15-20% chance in some studies). It is not fully true that fusion by itself will cause the significant wear on the levels above and below. Genetics plays a significant role in further wear of the discs.

    C7-T1 typically develops a degenerative spondylolisthesis (see website) below degenerative changes at C5-7, with or without a fusion.

    You would do well to have some pain mapping. That is, selective nerve root blocks to determine if any of the roots are causing pain, possible facet blocks and possibly even an anesthetic discogram at the level of the C6-7 pseudoarthrosis (see website).

    Dr. Corenman

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