Jellyhall

Thank you Dr Corenman, I will try very gently doing 2 or 3 at first.

I attend a Pilates class and the exercise lying on the front is similar to one we do in that class, although there our head starts from a flat position rather than dropped down.

Thank you for your reply Dr Corenman.

I suspect, having read about degenerative kyphosis, that it is my very degenerated neck that is causing the problem. The two levels below my fused levels, are very degenerated with loss of disc height and the scan report states ‘broad based bulged disc and bilateralhypertrophy of the Luschka joints with bilateral foraminal stenosis. Am I correct in thinking that I need to try to strengthen my muscles to that my head is lifted into a more normal position to slow down further degeneration? My surgeon, after my ACDF, told me that these lower levels either had or would fuse themselves. I am concerned that they might fuse themselves in a forward bending position.

There wasn’t a period after my surgery where I felt great. The only benefit really was reduced headaches. My surgeon had warned me though, that the surgery might not help my symptoms. He said he was doing surgery to get the compression off my cord that was being damaged. He also said I might need further surgery from the back later. When I asked which levels of my neck that would be on, he said all of it. He saw me a year ago and is happy that there is still room for the spinal fluid to flow around the cord, so no surgery is planned.

I have been referred to see another neurosurgeon, but am in the UK, so am likely to have to wait for a few months. I will tell him about the way my head slow falls forward when I am sitting and relaxing. Is there something that I can do to help while I am waiting to see him? Would sitting with my head supported in a high backed chair help?

Thank you for your advice.

I have now managed to obtain a copy of the MRI scan report. This is, I believe, a far more accurate of what is going on in my spine. It is very long, but I will post what it says below :

The scans were, Sagittal T1, T2, stir 2, axial T2 gradient echo fat-sat, axial T2 of the cervical span, axial T2 and thoracic spine, axial T1 and T2 of the lumbosacral spine.

Attenuated cervical lordosis with preserved vertebral alignment is noted.
The signs of long-standing anterior cervical discectomy and fixation with intervertebral cages noted at C3/4 and C4/5, with preserved intervertebral height. (This ACDF was done in Noveber 2012)
C2/3: Broad-based left paramedial sagittal post posterolateral disc protrusion without neural impingement.
C3/4: Bilaterally patent central spinal canal and foramina.
C4/5: Bilaterally preserved patency of the central spinal canal and foramina.
C5/6: Broad based bulged disc and bilateral hypertrophy of the Luschka joints with mild bilateral foraminal stenosis. There is a probability of bilateral impingement on the C6 rootlets.
C6/7: Broad based bulged disc without secondary neural compromise.

Late postsurgical appearances are noted of bilateral L4 laminectomy, excision of the L4 spinous process, L4/5 discectomy followed by interbody fixation with a cage and posterior spinal and orthosis with bilateral L4 and L5 pedicular screws connected by ipsilateral distraction rods. There is residual inflammatory signal change noted within the overlying of retrovertebral soft tissues. (This surgery was done in March 2010)
There are T2/stir hyperintense halos around the vertebral trajectory of instrumentation material – this change may be artifactual or related to loosening, please correlate.
Lumbo-sacral multifocal spondylitic changes noted.
Minor spondylitic retrolisthesis of T12, with a broad-based T12/L1 disc that does not impinge on neural structures.
L2/3: Broad-based disc protrusion that impinges predominantly on the right foramen, with secondary compression of the right L2 nerve root.
L3/4: A broad based posterior disc bulging and bilateral hypertrophy of the ligamenta flava are superimposed on a constitutionally narrow central spinal canal, with circumferential compression of the theca/cauda as well as asymmetrical compression of the exiting right L4 nerve root.
I am wondering what that looks like on an MRI scan and how to tell the difference between hypertrophy of the facets and this ligament.
L4/5 and L5/S1: No neural impingement is noted
No intrinsic neuro meningeal abnormalities are noted. Does this mean no MS?
No signs of paraspinal or spinal malignancy are noted.

Conclusion: Late postsurgical appearances are noted on the cervical and lumbosacral spinal segments, without adjacent neural impingement. There is possible loosening of the lumbosacral spinal screws – please correlate. Mild multifocal spondylotic changes are described, with probability of bilateral impingement on the C6 rootlets, bilateral impingement on the T2 rootlets, probable compression of the left T9 rootlets, compression of the right L2 and of the right L4 nerve roots, as described.

Could you please tell me how they can correlate as to whether there are loose screws or not?
Also, could you please explain to me what the comments that I have changed into bold text mean?
Thank you again, very much, Dr Corenman for your expert opinion and help in this matter.