[Indianarose]

#6763

Thanks for the mercury comments and suggestions. In fact all of your suggestions has helped a great deal and I thank you very much for the help.

Just a few more if you don’t mind please.

Going back to my MRI and the disc’s in my neck.

If the initial ACDF at level C5-6 never healed / fused. Would I need to have surgery to correct the unhealed fusion? If so, what kind of surgery? Would it need to be another fusion with a new donor bone? I’m pretty scared of having metal placed in my body, can it be done without metal plates to hold it together?

Also the pain I’m having from the degenerative disc’s at C4-5 & C6-7. Would I possibly need surgery on these as well? If so, would that mean fusions too?

Where it says on my MRI:

shallow left posterolateral C3-C4 protrusion.

Could this disc be a concern with the pain & symptoms I’m having? I ask because it was pointed out in the Impression part of my MRI and that it has a protrusion in that area. Is a protrusion cause for surgery?

[Donald Corenman, MD, DC]

#6766

The pseudoarthrosis (lack of fusion) at C5-6 can very well cause pain. There are pseudoarthroses that are not painful and that fact can be determined by a thorough history and physical examination as well as investigation with appropriate imaging studies.

In general, you will need metal to stabilize the surgical area to allow a fusion to take place. The metal used today (titanium) is inert and stable. I have never found a patient who reacted to this metal.

I cannot comment on the discs above and below. They could be pain generators and a work-up could determine that. It is unlikely that C3-4 is causing pain but again, a work-up is needed.

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.

[Indianarose]

#6839

Hello Dr. Corenman,

I went to see a Nero Surgeon last week and I just got his review in the mail. He did say that he felt my C5-6 fusion has fused since it’s been so many years ago since my surgery in 1995. He did look at my MRI and showed them to me and pointed out certain things on them even though I had no idea what I was looking at. He’s a good Doctor so I took his word for it. He didn’t order any x-rays nor any other ct scans and he felt that fusing any of my other disc’s wouldn’t take away all the pain that I’m having. He gave me a few names of the Nero doctors in my town to see. He suggested to have a nero workup, maybe nerve conduction studies and what ever else they might suggest to try and figure out why I’m in so much everyday pain or go to a pain Doctor to have injections or what the pain Doctor might suggest. Once again I’m at a loss as what to do and am still in horrible daily pain.

Here’s what he’s review says from 8-20-12

History of present illness:

She has no radicular symptoms, but does have a greater than 20-year history of mechanical neck pain, point tenderness throughout the neck, suboccipital pain, and muscle contraction cephalgia.

Physical Examination:

She has no focal neurologic deficits, tenderness throughout. She also has an electric sensation that moves up and down her entire body on occasion, none of this being radicular or myelopathic of Lhermitte’s. She has no evidence of hyperreflexia or clonus on examination. No sensory or motor deficits.

Imaging Studies:

Review of recent MRI of the cervical spine shows excellent fusion at C5-6, mild to moderate degenerative changes at C4-5, without cord compromise.

Assessment / Plan:

There is nothing to offer at this point from a surgical standpoint. At this point, there is no indication for further nerosurgical workup or treatment. She may seek a neurology opinion for these multiple unusual complaints.

Dr. Corenman, would you please once again explain what all this medical terminology means before I go see a neurologist so I’ll understand what he is saying?

[Donald Corenman, MD, DC]

#6857

Review of the MRI can reveal a solid fusion but the MRI is generally unreliable to ascertain if a solid fusion is present.

He notes mild to moderate degenerative changes at C4-5. This can be a pain generator for neck pain. He reports you have no radicular symptoms. This means you have no arm pain or examination findings of weakness, sensory loss or reflex changes.

Standard X-rays including flexion and extension in your case would be important to determine the presence of degeneration, stability and angulation of the C4-5 level as well as helping to reinforce the understanding of solid fusion at the C5-6 level.

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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