westie California

Hello Dr,

The EMG was performed after surgery. My procedure was August 2015 and EMG April 2016.

A CT scan was performed and states solid fusion anteriorly from C3-T1 and C3-C7 posteriorly.Report states post surgical degenerative changes throughout cervical spine.

I sent my CT and MRI scans for review and was told laminectomy did not decompress nerve roots. So I’m back to the drawing board. Any thoughts?

Ashley

Thanks

Good evening Dr. Corenman,

I hope all is well with you. My neck continues to bother me on a day to day basis. The base of my neck, arms(biceps),shoulder blades and right side occipital headaches with dizziness.I’m still hearing popping and crackling when i move my neck in different directions. Any sitting or walking will significantly magnify the pain and discomfort.

Per my neurosurgeon, the MRI and CT scan shows post surgerical multilevel degenerative changes within cervical spine and multiple level facet hypertrophy. Recent EMG/Nerve conduction shows moderate chronic C5, C6, C7 radiculopathy bilateral nerve irregularity. The following reports was provided:

C3 Productive changes of the posterior elements mildly impinging the posterior aspect of the spinal cord

C3-C4 mild productive changes of the joints of Luschka and facet joint degenerative
changes causing mild left neural foramina narrowing

C4-C5 mild productive changes of the joints of Luschka and facet joint
degenerative changes causing mild right neural foramina narrowing

C5-C6 prominent facet hypertrophy and bony ankylosis of the bilateral C5-C6 facets

Straightening of the expected cervical lordosis

T2/3 & T3/4 left paracentral disc herniations are noted both levels deforming the thecal sac. Loss of disc space height and signal is noted at both levels.

T4/5, T5/6 and T6/7 disc bulges notes at all three levels deforming the thecal sac. Bilateral paracentral components are noted at T4/5. Right paracentral components are noted at T5/6 and T6/7.

T7/8 and T8/9, paracentral disc herniations are noted at both levels deforming the thecal sac.

My surgeon said nothing surgerical can be done. Pain doctor performed Occiptial nerve block which helped with headaches for approximately 4 days. The pain came back.

C5, C6 and C7 facet block on left and right side with minimal relief. Still have pain in base of skull and muscle spasms at injection site and levels below.

I also had a third party neurosurgeon review my scans and in his opinion my laminectomy did not decompress nerves. He would like to perform:

Foraminotomy

Laminotomy

Percutaneous Discectomy

Facet Thermal Ablation

I’m still in disbelief with how long this has played out. Any suggestions you would take with the above findings and issues? If you recalled I had 3 ACDF’s C3-T1
1 Foraminotomy (left side C6, C7) and 1 Laminectomy (bilerateral C3-C7).

Any suggestion would be appreciated.

Ashley

Dr. Corenman,

A big thank you! I did see my neurologist today and she stated surgery should be a last resort, I’ve been through too much. After a review of my scans, and my symptoms, she noted that my C7/T1 subluxation is mild and highly doubts, neck pain, muscle spams, headaches, bilateral arm pain, forearms, fingers numbness (tingling) etc is from this subluxation.

Her thoughts are most of my symptoms are in line with post-laminectomy syndrome. She also heard the cracking and popping with flexion/extensions and did not know why. After sitting with her for approx 30 minutes things tightened up further, which she stated was in the area of C5 to T1 (both left and right side). She wants to think about my issues and look at the information further, and she will call me in a few days on what my next steps should be.

You mentioned flexion/extension studies. Are you referring to X-rays or MRI and would contrast be required if MRI? Also if an ACDF is performed due to instability, what range of motion can be expected to be lost at this level? I thought, I read somewhere that C7/T1 has the lowest movement in cervical spine? Thanks always for your response.