justkat12

Hello Dr. Corenman…hope all has been well. Just wondering if you had the chance to view my records that I sent to you? I think it has been almost 3 weeks ago, give or take. Thanks so much. Anxiously awaiting your reply :)
K Plymale

These are the findings verbatim from my 2 CT reports:
3/14/2013
There has been an anterior discectomy and fusion at C5-C6 and C6-C7. The fusion appears solid and complete at the C5-C6 level. There are posterior osteophytes that project off the posterior vertebral body at C5-C6 to project into the epidural space but no encroachment into or involvement of the exit foramen seen.
The C6-C7 interbody fusion plug appears fractured horizontally across its midportion. Clinical significance is uncertain. The cranial and caudal components of that interbody fusion plug are solidly fused to the respective endplates. Posterior osteophytes do minimally project into the epidural tissues. This is best appreciated on the sagittal images. Exit foramen are normal. Spinal canal dimensions and the craniovertebral junction appears normal.
Anterior bone plate from C5 down to C7 is seen. No evidence of fracture of that bone plate. Screws are intact.
Conclusion: Postsurgical changes to C5-C6 and C6-C7. There appears to be a lineal irregular fracture line through the interbody plug but no displacement. Cervical spine otherwise appears generally satisfactory for this postsurgical status.

9/11/2013:
Comparison: with 3/14/2103 CT scan
The CT examiniation demonstrates the patient to be status post anterior cervical plate with screw fixation at the C5 through the C7 levels. Interbody disc spacers are seen at the C5-6 and C6-7 levels. There is a lucency within the midportion of the C6-7 spacer (series 6 image 35). This may represent a fracture and was present on the prior study and appears stable.
There is loss of the normal cervical lordosis which may be secondary to positioning. The vertebral heights and rest of the intervertebral disc spaces are maintained. The atlanto-dens interval is maintained. The osseous structures are intact without fracture.
At C5/6 level, the patient is status post fusion. There is mild osseous ridging. There is no neural foraminal narrowing.
At C6/7 level, the patient is status post fusion. There is mild osseous ridging. There is no neural foraminal narrowing.
Impression: Patient status post ACDF at C5-C7 with interbody disc spaces in place. Stable exam

I would be happy to send you the disc associated with these reports if it would be easier for you to appreciate the fracture. All my Dr. said was that he didn’t think there was a solid fusion at C6-C7 and that it appeared to be a fracture of the bone that was used for the fusion. He told me in so many words that if it wasn’t fused he would have to “bolt me down from the back” in order to achieve stability so that the area could fuse??? That this failure to fuse could very well be the source of my neck/arm pain. Let me know if you want me to send the images and where I should send them to. I sooo appreciate your response to my questions and would be happy to see if my insurance would pay for a second opinion from your office. I think that the “Beech Street” insurance that was listed under your covered plans might be who my plan, issued through the hospital I work for uses for “out of network”. I can check. Again, your professional courtesies are so appreciated!!!

If you do 2nd opinions from across the USA, I would be more than happy to send you all of my films. I have had an MRI post fusion, but I believe that was back in October, or 1 month post op, because I was still complaining of significant R arm radiculopathy and neck pain. I have also had an EMG study done. I have copies of all test done and the discs as well from the MRI’s and CT exams. I could also provide you with a copy of my OP report.
Thank you so much for all your help thus far. I have to agree with the other posters on this forum. You are a godsend for giving of your time to answer all of these questions!!! You are appreciated!! :)