mocka300

Hi Dr. Corenman,

Here are my CT results from 7/11/22. I had my ACDF on October 20, 2021. Is “significant partial osseous incorporation” considered normal at the stage of healing? I am still waiting to hear back from my primary doctor on these results.

HISTORY: 55 year old female. Radiculopathy, cervical region.

TECHNIQUE: Spiral CT was performed, and multiplanar images were created. One or more of the following dose reduction techniques were used: automated exposure control, adjustment of the mA and/or kV according to patient size, use of iterative reconstruction technique.

COMPARISON: Cervical spine CT from 04/20/2021

FINDINGS:
ACDF C5-C6 with intact orthopedic hardware in place. Interbody fusion at this level with significant partial osseous incorporation. The vertebral bodies have a normal appearance and the bony alignment is normal. No abnormalities are seen at the craniocervical junction or the C1-C2 level. No fracture, dislocation, lytic or blastic lesion is seen.

IMPRESSION:
ACDF C5-C6 with intact orthopedic hardware in place. Interbody fusion at this level with significant partial osseous incorporation.

This is the full MRI report.
EXAM: MRI CERVICAL SPINE WITHOUT CONTRAST
HISTORY: 55 year old female states neck, right shoulder and arm pain for several years, increased February 2022.
Widespread pain and pins and needles. History of cervical fusion surgery October 20, 2021. TECHNIQUE: Using a 1.5 Tesla magnet, multiplanar T1 and T2 weighted images were acquired. COMPARISON: Preoperative examination of 9/18/2021
FINDINGS:
General Observations: Since the previous examination, an anterior cervical discectomy and fusion has been performed at the C5-6 level. Two screws are present in each vertebral body, slightly eccentric towards the right.
The C1-2 through C3-4 levels are unremarkable.
At C4-5, there is mild central disc protrusion abutting the spinal cord without displacement or compression. The neural foramina are patent. No change from prior.
At C5-6, the two fusion screws appear to extend to the right posterior margin of the vertebral body, and there appears to be some residual endplate hypertrophy indenting the thecal sac and abutting the cord. This is not as pronounced as the disc protrusion noted previously, is accentuated by the blooming artifact caused by metallic hardware. There is no cord edema or myelomalacia. There is no definite foraminal stenosis.
At C6-7 and C7-T1, there is no disc bulge or herniation. Uncovertebral and facet joints are normal. No central canal or foraminal stenosis.
Spinal cord: No cord edema or myelomalacia. Paravertebral/Prevertebral soft tissues: Unremarkable.
IMPRESSION:
1. Status post ACDF at C5-C6 since prior study of 9/18/2021. Some residual encroachment upon the right ventral aspect of the spinal canal cannot be ruled out, but is accentuated by blooming artifact from metallic hardware. Consider CT evaluation for more accurate depiction of osseous structures and metallic elements.
2. Mild central disc protrusion at C4-5, unchanged from prior examination.