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Hello again,
I am 4 weeks post op after cervical fusion and bone graph.My care was excellent and my neck is healing very well.I find nothing on the forum about the experience of iliac bone harvest.You would remember me as you operated on the day the Bronco’s lost to the Raven”s-and my daughter’s were with me -one worked at the medical center.I was surprised by the consequences of this procedure.Not complaining,as I as fortunate to have had such good care and surgical expertise.It would just be helpful to know that what I am experiencing is normal-I have had a fusion at L4-5 and I am thinking that this could make the recovery longer.I am still using a cane-have great difficulty with steps or incline and sometimes the pain is still intense-especially in the morning.I return for a visit on the 20th-and If I was in the state would have already stopped by as it seems a steroid injection might be in order.Any words of encouragement would be greatly appreciated.PT does nothing but increase the pain.

Thanks,

07/02/2013
Dear Doctor Corenman,
I would be grateful for your evaluation of my neck. c5/c6 fused in 1993 age 28. C3/C4 problematic with a closing of the spinal canal, but not fused.
Age 14, my head and neck were stamped on, since then further trauma. Occasionally, when standing, after sitting, I feel weak and begin to collapse, I hold a table 2-3,seconds until the blackout passes, the message from brain to legs, seem blocked. It seems more often and more intense of late, I quickly sit to avoid collapse, probably more after exercise when the neck joint becomes hyper mobile.
My doctor tested for hyper tension, my blood pressure was alike, sitting or standing. I suspect correlation with the standing motion, further narrowing the spinal canal.
In 1993 the surgeon suggested, come back if i couldn’t cope. I managed until now thinking neuro surgery may have advanced. Quality of life is pain medicated and sometimes fragile, age 48. I struggle to function some days, via C3/C4 nerve pain, movement of my neck can make me unwell.
Another surgeon stated that I had left it too long. I battle to work, it is difficult to sit for any time, type and talk as required and i can feel unwell driving on bumpy roads.
Gym work, arm use, affects my neck. I stopped swimming, 2005 as rotating to breathe, caused neck pain. 2010 stopped running, bad headaches (vertebrae banging together), now cycling, peddle motion and vibration, the more I do the worse the pain.
. I walk 3-5 miles, sometimes slow – nerve compression; however this provides a more comfortable neck position. Some mornings, I have clumsy hands, dull pain near the deltoid and I occasionally trip, misjudging the floor, my arms feel weak, but I am physically strong. My head can feel too heavy for my neck to support and takes hours, to adjust too.
In desperation, I hang by my neck, to pull the bone off the nerve. I also pull my chin inward, to stretch the vertebrae. The joint crunches and is hyper mobile, more so after cycling or exercise, due to movement, it breaks free from its arthritic position, sometimes I feel slightly dizzy and unbalanced and sitting leaning sideways, makes me unwell.
This occurred 2010, settled, but now returned. Last time the circumflex nerve jumped, I had numbness in two small fingers on both hands pending the side I slept, but less at present. Joint instability in sleep causes pain waking me. I turn over until the same occurs.
Last time, 17 hours daily in bed, caused a massive p/ emb going through the heart and wedging in my lung. I fully recovered, adage of being fit the doctor stated.
Ossification – My neck has self-fused with osteo-phytes at all levels, my bones apparently look aged, the last MRI shows a black or white spot on the cord at C3/C4. I now have a new Mri scan awaiting evaluation of which i can send to you.
I can brace the vertebrae, stopping motion, C3 seems close to the nerve. I feel that if c3 was raised slightly and stabilized, the disc may be left and the nerves survive compression. Would the bones just crumble? Could the vertebrae autofuse in time? I sometimes feel wiped out, fragile with pain and uncertainty of what I can do. Sport and activity was my life, now inconsistent. Making plans is difficult as I may be unwell, and managing to do very little is frustrating.
I see on the internet, successful operations with osteo-phytes Please explain what the risks are and what success rate you would expect of any procedure bearing in mind, I am fit and have never smoked.
I read a post on your site, about injections to purposely damage tissue to tighten ligaments. Do all vertebrae have ligaments and would this be an option.
Yours
Karen wagner.

I saw a neuro today d/t spinal pain, often severe, accompanying paresthesia RLE, confirmed nerve damage EMG. Recent change is the bilateral leg pain when walking upstairs. He checked plantar/Babinski reflexes which were absent bilaterally. If you’d be so kind to look at the written reports accompanying my CTs/MRIs of my spine I’d feel grateful!
I’ll be as concise as possible. All studies without contrast.
MRI:
C-spine: straightening of normal cervical lordosis, fusion C5-6 vertebral bodies *(actually was C5-7)* fusion completely fused w/no visible residual disc material; Severe disc space narrowing C6-7. Moderate disc space narrowing T1-T2, T2-T3, T3-T4 & T4-T5 in visualized upper thoracic region.
C2-C3, C3-C4, C4-C5 show no focal protrusion, central stenosis. Neural foramen widely patent.
T1-T2 show minor disc bulging, no significant protrusion or central stenosis. Little disc bulging T2-T3 & T3-T4, but no significant canal narrowing is seen. Levels scanned in sagittal projection only. Spinal cord normal in course, caliber & signal intensity.

Thoracic MRI: Mild dextroscoliosis. Vertebral bodies normal in height. Disc space narrowing at most levels. Most severe T1&T2 and T6-T7. C5-6 fusion at margin of study. Small central canal protrusion at T7-T8, slightly flattens ventral cord, but there remains significant CSF posterior to cord, so significance is unclear. Also appears to be little protrusion at T3-T4 in upper aspect of study w/o central canal narrowing.

Lumbar MRI: vertebral body heights maintained. Slight anterolisthesis L4-L5, alignment otherwise maintained. Tiny Schmorl’s nodes at endplate of L4, inferior endplate L2, superior endplate T-11; mild desiccation of L2-3, thru L4-5 intervertebral discs with slight decrease of disc height most prominent L4-5. Round area of increased signal intensity in L side of L4 vertebral body consistent w/small hemangioma. There may also be a more subtle one at T-11. Conus medullaris terminates at T12-L1. No disc herniation, bulge, spinal canal stenosis or neural foramina stenosis.
At L4-L5 there is a slight anterolisthesis with an uncovered disc. There is severe facet hypertrophy, there is thickened ligamentum flavum, there is slight impression on the thecal sac w/o significant spinal canal stenosis. There is narrowing at the origin of the left neural foramina. Right is patent. Facet hypertrophy at L5-S1.

CT cervical: abbreviated version as they were looking at lymphadenopathy.
Few mm of anterior positioning on C4-C5. Cervical fusion C5-6-7, appears intact. There is a little bit posterior element degenerative change.
CT of thoracic area again to r/o generalized lymphadenopathy showed what was believed to be a bone island on thoracic vertebrae.
Sorry this is so long but I’m trying to find out what can be done to manage s/o pain, paresthesias, pain & weakness in BUEs & BLEs. And to see if my sx are at all justified based in findings noted here. Thank you.