[rileyreese]

#34096

I had an ACDF on November 19,2020. The recovery was a little rough but I was I would say mostly recovered. On April 18, 2021 my puppy flipped me out of my hammock, I landed on my left shoulder/head/neck area. Since then I have been having neck pain again. At times I have had tingling fingers. I have also had extreme headaches that start in my neck almost daily. Recently my neck pain has increased, my right hip hurts and I have had some tingling in my toes. I have seen my neck doctor and his PA since this happened, they believe I just irritated the original injury although I have explained this is a different place in my neck. We have tried muscle relaxers, melaxacan and I am on week 6 of PT.

Here is my MRI from last week:
Findings:
No osseous fracture. No subluxation. C1 and C2 are aligned.
C3-4, small central disc protrusion.
C4-5, central disc protrusion suspected moderate spinal stenosis approximately 8 mm AP dimension.
C5-6, loss of disc space height with the central disc protrusion with posterior osteophytic ridging along posterior disc level. Moderate spinal stenosis approximating 6 mm AP

dimension. There is likely mass effect on the spinal cord. Mild bilateral neural foraminal narrowing.
C6-7, loss of disc space height with a central disc protrusion, posterior osteophytes along the disc level. Moderate spinal stenosis approximately 8 mm AP dimension.
NO significant degenerative changes at the remaining levels. NO paraspinal hematomas. Lung apices are clear.
Impression:
1. Degenerative disc disease from C4-5 to C6-7 with moderate spinal stenosis at C4-5, C5-6 and C6-7. C5-6, the disc likely has mass effect on the spinal cord. Findings could be better characterized cervical MRI.

With the symptoms and my MRI results if they still want me to wait the summer to see if there is any improvement should I do that or get a second opinion? I have felt all along they should have probably fused at least 2 disc and if that is where this is headed I would rather do it sooner rather than later.

[rileyreese]

#34097

Also I have pain in my upper right arm and when I lay down (or that is when I notice it) and my head is bent my hands tingle.

[Donald Corenman, MD, DC]

#34098

The first thing I’m concerned with is that your MRI reading does not note any suggestion of an ACDF surgery. Are you sure this reading is not of an old reading of your neck prior to ACDF surgery? Your canal is very narrowed (“Moderate spinal stenosis approximating 6 mm AP. There is likely mass effect on the spinal cord”). and you might have myelopathy or radiculopathy.

See https://neckandback.com/conditions/radiculopathy-pinched-nerve-in-neck/ and
https://neckandback.com/conditions/cervical-central-stenosis-and-myelopathy/.

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.

[rileyreese]

#34099

You are right, I am so sorry, that was one of the MRI’s from before my ACDF surgery. Here is the most recent MRI from 5/26.

Comparison:12/19/2020
Findings:
There are several mildly prominent but nonspecific cervical chain lymph nodes. There is a representative 1 cm lymph node in the right mid cervical region. No bulky adenopathy. Consider follow-up as indicated.
Postop changes again seen from anterior fixation at approximate C5-6. Metallic artifact identified. No acute fracture identified.
The cervical spinal cord appears unremarkable.
C2-3:No significant canal narrowing. C3-4:Mild facet arthrosis.
C4-5:Mild to moderate degenerative disc disease. Small disc bulge. Small posterior central disc protrusion. Mild/moderate anterior canal narrowing. This is stable. Mild bilateral neural foraminal narrowing.
C5-6::No significant canal narrowing.
C6-7:Mild to moderate degenerative disc disease. Small disc bulge. Mild to moderate anterior canal narrowing. No significant change.
Impression:
1. Postoperative changes again seen with anterior fixation at C5-6.
2. Mild to moderate degenerative disc disease above and below the fixation.
3. Mild/moderate anterior canal narrowing at C4-5. Mild to moderate canal narrowing at C6-7. The narrowing is stable.
4. Mild neural foraminal narrowing at C4-5.
5. Mildly prominent but nonspecific cervical chain lymph nodes.
***** Final *****

[Donald Corenman, MD, DC]

#34101

You have moderate degenerative changes above and below your ACDF: “C4-5:Mild to moderate degenerative disc disease. Small disc bulge. Small posterior central disc protrusion. Mild/moderate anterior canal narrowing. This is stable. Mild bilateral neural foraminal narrowing. C6-7:Mild to moderate degenerative disc disease. Small disc bulge. Mild to moderate anterior canal narrowing. No significant change”.

There appears not to be significant root or cord compression so I’m unclear what the cause is of your arm “pins and needles”. Neck pain radiating into the shoulder could be from degenerative changes aggravated from your hammock fall. I assume you have gone through PT and failed this treatment. The way to diagnose this is to have TFESIs performed at each level and then keep a pain diary. The could help to point out the most painful level.

See: https://neckandback.com/treatments/epidural-injections-and-selective-nerve-root-blocks-diagnostic-and-therapeutic-neck/ and
https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections-neck/

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.

[rileyreese]

#34103

I have just finished 6 weeks of PT with no help in the symptoms, they are actually continuing to get worse.

Would either of those levels cause the headaches?

My doctor feels I have just aggravated the fusion and “a summer of rest” will make it better. We did try a Medrol dose pack along with the PT and so far the symptoms are just increasing.

[Author]

Posts