Grandmother457MemberAugust 13, 2013 at 2:51 amPost count: 3
Hello.I gotten hurt on the job of Sept.12,2012.Found on the MRI that i had C4-C5:A large disc herniation centrally,extending slightly greater to the left with compression of the cord.All the others were normal.Had surgery on Dec.7,2012.I am still having pain in my neck and left arm and burning.After three months I started having it on my right arm.So,my neurosurgeon done another MRI and Ex-ray on June 24,2013.He called me 20 minutes before my appointment to tell me the results.He said that the fusion is not healing and I have another disc that is bulging and that is why my right arm hurts.Wanted to do shots before another surgery.i have a workers comp nurse,she didn’t like that so they sent me to a different doctor for a second opinion.This doctor looked at the disks and said that he didn’t see it not healing or another disk.He sent me for a CT Scan.Have not heard anything yet.Could someone tell me What my Mri readings says.Vertebrae:No marrow signal abnormalities to suggest neoplasm Post surgical changes of ACDF with anterior plate and screw fixation spanning.C4-C5:An interbody graft is present at this level.C1-C2:No significant focal abnormality.C2-C3:The same.C3-C4:Minimal central disc protrusion which effaces the ventral CSF space without contacting the cord.Neural foraminal are grossly patent bilaterally.C4-C5:Acdf with anterio plate and screws fixation changes.No significant central canal or neural foraminal stenosis at this level.C5-C6:Right paracentral disc herniation contact the ventral cord which may be mildly flattened.No cord signal abnormality.So it says,Conclusion:Postoperative changesof Acdf with anterior plate and screw fixation spanning C4-C5.At the operative level,there is no evidence of significant central canal or neural foaminal narrowing.2.At C5-C6:a right paracentral disc herniation contacts and perhaps mildly flatten the ventral aspect of the cord.So,where does it say that the fusion is not healing up?Thank YouDonald Corenman, MD, DCModeratorAugust 14, 2013 at 2:49 amPost count: 8652
MRIs are not the best imaging studies for understanding the integrity of a fusion. If you had X-rays with flexion and extension views (bending the head backwards and forwards), this would be a better study for fusion results. The CT scan is the gold standard for fusion results and will yield good information.
The MRI reading does not indicate if fusion is or is not solid. Remember that the surgeon might have a better understanding of image interpretation than the radiologist. You did however go to a second surgeon who did not note a pseudoarthrosis (lack of fusion).
You note that you did not get better after the ACDF surgery. This could be from one of three potential problems. One is that you had a chronic nerve injury (chronic radiculopathy-see website for description). The next is that the level above is causing symptoms. This can be determined by a selective nerve root block (see SNRB and pain diary).
The last is that there could be a co-morbid diagnosis (rotator cuff syndrome or something like that) that was not previously diagnosed.
Dr. CorenmanPLEASE 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.Grandmother457MemberAugust 14, 2013 at 6:51 amPost count: 3
I had an ex-ray done before the first MRI and it showed that my rotator cuff was good.So,the first MRI showed C4-C5;That there is a large disc herniation centrally,extending slightly greater to the left with compression of the cord.Everything else was good.Now after surgery about three months i started having pain again and this time both arms,but more hurting on the left.id the bending on of the neck with the ex-ray.So,on July 16,2013,my doctor that did the surgery tells me that he sees it not healing.Am still burning and hurting in my neck.I have not been back at work been out since a week before Thanksgiving.And my work I do alot of bending standing;lifting;moving.Thank You
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