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Dr. Corenman,
This link will take you to the better quality, though still JPEG images mentioned in my previous post with additional views, from which you may be able to provide a more certain diagnosis, though I would like to provide you with the DICOM images on CDROM at some time in the very near future as well as a fairly recent MRI. (05/31/2013)There are 10 plain X-ray views linked. Please do comment if these images allow you to make a certain diagnosis of both non-union and instability at the C7-T1 level.
Additionally, when I place my fingertip on/between the spinous processes at this level I feel limited rotational movement along with some catching when looking from extreme left to right or vise versa.
My sincere thanks for your esteemed opinion. The images linked are of poor quality as they derived from digital camera pictures of screenshots off the monitor to illustrate the change in distances of the tips of the C7-T1 spinous processes. The ImaSight CD Viewer program I was provided won’t export images directly with or without annotations.
These may be off slightly better quality, as they are jpeg exports from the viewer, but the DICOM images would be best for a more complete diagnosis.
December 11th, 2014 Neutral and Flexion – Note 5mm Movement C7-T1
Care and Feeding of Your New Neck
Once the neck is healed, there may be recommendations for activity changes. A one level fusion will allow you to play in the NFL. Even a two level fusion may play tackle football. If a patient needs a three level fusion, activity restriction is necessary to prevent further stress to the remaining discs.
~Donald S. Corenman, M.D., D.C.
This is of course non case specific information taken directly from a page on your website.
I would very much appreciate your expert opinion addressing the issue of activity / work related restrictions for my particular case.
I have an obvious non-union and excessive movement at the C7-T1 level due to the plating of C5-T1 without proper removal of the C7-T1 disk and placement of a proper bone graft.
This causes me a great deal of neck pain as well as left sided radicular symptoms, particularly in the long and ring finger of my left hand. It feels as though I have something stuck under those fingernails, as well as a dull pins and needles sensation and/or numbness.
I would also appreciate a best case scenario regarding activity / work related restrictions following an anterior revision surgery that solidly fuses my spine from C5-T1; if that is what is deemed as the best surgical correction for the problems that currently exist behind the plate.
Thank You in advance for your response and expert opinion.
I am very interested in an e-consult that will provide me an opportunity to explain how and why my spine came to be in its current condition with more specific information to enable you to provide a more informed and detailed prognosis.
Again, I would like to thank you for the encouragement and acknowledgement that you have provided me with your previous responses. This forum is an excellent educational tool for patients and providers as well.
Sincerely, waderoberts
I am very encouraged and hopeful regarding what you have told me thus far regarding your ability to perform a 2nd revision surgery with confidence in a positive outcome.
I fully realize that even if my radicular symptoms and neck pain are markedly reduced, that I will still have some impairment of movement and activity restrictions.
Your honest expectations of what I will be able to do physically in the future, especially career wise is important to me.
This spring there was an opening in a related career field working supervising nonviolent offenders on various community service programs in my home area, that I went to the trouble to investigate, but was discouraged from applying for because of the current condition of my cervical spine and the need for a successful third surgery to enable me to work a full time position dependably.
Addressing the issues raised in this and my previous post will be of great benefit to me in opening the door to a happier, healthier and certainly a more pain free life.
I realize, far better than most that there are no guaranteed surgical outcomes.
That said, I believe you and those you work with at the Steadman Clinic represent my best hope for a positive surgical outcome and new lease on life, here in these United States of America.
Thank You once again for your response and advice.
My former employment was as a Corrections Officer with the Michigan Department of Corrections. It was a collision with a resisting inmate as I ran into a violent situation that caused the initial damage to my cervical spine, not any genetic predisposition towards degenerative disc disease or defect that I’m aware of.
I have been on Long Term Disability since the accurate diagnosis of my cervical spine condition in March of 1997, as my employer decided not to continue with light duty assignments and following 6 months of conservative therapy I had a single level C6-C7 diskectomy in November of 1997 that resulted in a non-union and a revision surgery in November of 2000 that left me as I am today.
Is there any chance that I could return to work as a Corrections Officer or other related career field such as a policeman or probation officer following a successful revision surgery and solid fusion of C5-T1?
Or will I remain restricted to sedentary or extremely limited light duty type of tasks regarding physical work as I am today as even driving for more than an hour can be difficult and a few hours at a desk or on a computer is normally all I can manage in a day?
I am assuming I will remain restricted from contact sports or and high impact activities, employment that would be likely to involve the use of force or physical work that involves repetitive motions and medium to heavy lifting, even with a solid fusion from C5-T1, though I don’t believe I have DDD or any other serious spinal defects.
A fairly recent MRI (05/31/2013) does indicate some existing problems both above and below C5-T1 where I am currently plated, though not solidly fused.
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