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in reply to: Posterior foraminotomy of the cervical spine #32829
Good Evening Dr. Corenman,
I’m more confused now, sorry, I thought when your fused anteriorly and posteriorly (360 degrees) the facet’s should not cause any pain? I would think no motion should exist at those levels. Placed a call to your office, and spoke to answering service. Will reach out tomorrow, and see if my insurance will cover a telemedicine appointment. Thanks
in reply to: Posterior foraminotomy of the cervical spine #32825I want to confirm for C4, C5 and C6, levels also had ACDFs with laminectomies however those levels also has unconvertebral spurring as noted below on my CT scan with mild foraiminal narrowing should not be addressed?
EXAM/TECHNIQUE: CT Cervical Spine Without. Protocol: Routine. Iterative reconstruction wasutilized to minimize dose.COMPARISON: Outside MRI Cervical Spine 5/19/2018 .FINDINGS:Postsurgical Changes: Postsurgical fusion changes, appears to reflect a revision/addition since 5/19/2018,now appears to involve C3-T1 with multilevel postoperative hardware and decompressive laminectomies. Hardware appears intact, appropriately positioned without evidence of failure or loosening. Bony fusionappears solid at C3-4 through C7-T1.Alignment: Lordotic straightening.Vertebrae: Normal in height.Soft Tissues: Expected postoperative changes.Disc Spaces: C2-3: Tiny central disc herniation. There is associated minimal mass effect on the anterior thecal sacwithout significant central canal stenosis No significant change.C3-4: No significant disc disease. Bilateral uncovertebral spurring and bilateral facet arthropathy, mildlyprogressive since 5/19/2018. There is associated mild right and moderate to severe left foraminalnarrowing.C4-5, C5-6, C6-7, C7-T1: Postsurgical changes. No significant disc disease. Spondylitic ridging anduncovertebral spurring at C4-5, C5-6 and C6-7, mildly progressive since 5/19/2018. There is associatedforaminal narrowing, mild on the right at C4-5 and C5-6, mild on the left at C6-7. No significant foraminalnarrowing at C7-T1. No significant central canal stenosis at any of these levels.
Spinal Canal Contents: Limited by CT technique, grossly unremarkablein reply to: Posterior foraminotomy of the cervical spine #32824Thank you so much Dr. Corenman! I can’t say enough, thanks.
I have a sit down with my surgeon in September and I will see if he can perform C3-4 facetectomy the same day T1-T2 revision to address psuedorthosis. .
Have a wonderful evening.
in reply to: Posterior foraminotomy of the cervical spine #32822I should probably get a second set of eyes to look at my CT scan. If I understand correctly, a properly fused segment should not develop bone spurs?
in reply to: Posterior foraminotomy of the cervical spine #32821Dr Corenman,
I currently have a plate in front at C3-4, however all rods were removed from C3 thru T2 Posteriorly. That’s correct, I did have an ACDF at C3-4 segment along with posterior laminectomy at this level. I’m told fusion is solid at this level.
in reply to: Posterior foraminotomy of the cervical spine #32817Thank you Dr. Corenman!
The bone spur is located on uncovertebral joint causing modererate to severe foriminal stenosis after an ACDF, including Laminectomy at this seqment. From previous conversations any posterior fusion procedures ablate medial nerves at this level, so a medial nerve branch block is a waste of time.
In addition, there’s currently a plate fixation at this level, so my best option is a posterior foramenotomy with the hope of getting some pressure off the nerve. My concern’s are will this be enough and two what’s the possibility that this bone spur will grow back into this space again?
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