[OswaldOtte]

#35084

Since my acdf c6-c7 over 2years ago, I have had nothing but neck pain, around the area of surgery. 6 month follow up mri showed very little bone growth. 12 month showed bony overgrowth. But now, a bone scan shows that there is a lot of ‘activity’ at c6-c7, and the bony overgrowth only covers a very small area.
Surgeon says pseudoarthrosis may be causing my pain. Other levels show normal wear and tear for my age with some minor bulges.
He suggests removing the screws and then trying to pull c6 and c7 apart. If he can pull them apart he would replace peek cage with a larger one, that is also titanium coated. If he can’t pull them apart he would add donor bone around the old peek cage, and then install a plate.

I’m not keen on having another surgery. I asked if I could do another series of PT. He said it won’t hurt and if I do decide to get surgery again, the PT will help me prepare for a better surgery outcome.

Your opinion on PT and his surgery suggestion?

I was 40y at time of acdf. Peek cage was used with B-TCP. No tobacco, no alcohol use. I do have rheumatoid arthritis.

Thanks in advance.
Oswald

[Donald Corenman, MD, DC]

#35085

A pseudoarthrosis can be quite painful. I don’t believe you at one time had a solid fusion (“12 month showed bony overgrowth”) as once a section is fused, the fusion does not change.

You had a cage (spacer) placed and it is not uncommon to have a lack of fusion, especially with a PEEK cage without autograph. This can be revised to a solid fusion but in my opinion, the graft used for a pseudoarthrosis should be an autograph (a small piece of bone from the side of your pelvis) as this has the absolute best rate of fusion. The surgery has to be meticulous as the graft has to fit perfectly against the interface with the vertebral endplate.

PT is fine but might not give you the relief you seek until you have a surgical revision. If PT does give you good relief and you have a “stable pseudoarthrosis”, you might not need surgery.

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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