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Spinal Cord Disorders Message Board


Spinal Cord Disorders Board Index


They want to go in w / a c4 c5- c5 c6 disc fusion both anterior - w/ the cages & then flip me & do posterior w/ the screws & titanium plates he said based upon my neuro exam when he flicks my fingers my thumb goes in& my reflexes r more abrupt then when examined immediately After mva in late feb. he also stated I have severe torn ligaments that did not show on the MRI - something about they show immediately / mine came later during pt .- something like that-- he said I have spinal cord impingement - & instability w- the disc the MRI in feb that I posted is the same as the one in June - a little more narrowing - I will give it to you so you can compare - yet he's basically going off of the flexion x Ray which shows severe spacing between my vertebre / which the other physician stated that could be something I wad born with - I asked him that he said no - I also asked him an
abou the muscle trap pain in my shoulder - he stated that the muscle is compensating for the instability in my neck that's why I have not been getting better - he scheduled the surgery - July 7 th it's 3.- 4 hours long & they have to flip me - he talked about going thru the front & not being able to talk for a while / raspy but it would subside - he stated he did have one patient that did not get her full voice back - what to do what to do - I have a call in for a 3 rd opinion but I'm not sure I will get it in time - it would be at u of Michigan - - should I go to Cleveland spine ? Should I hold off on surgery - can my neuro symptoms get worse ? Once I find my new MRI read I will post it - oh & I'm 40
here is my CT from feb.
Findings: No vertebral fracture or paraspinal soft tissue abnormality is seen alignment is straightened.The current exam does not assess for ligamentous injury. The spinal canal contents are suboptimally visualized. There is a posterior disc protrusion at c5-c6 with mild central canal narrowing. The visualized portions of the aerodigetive tract, thyroid and larynx are unremarkable. There is a pleural-parenchymal scarring at the lung apices.
Impression No cervical spine fracture or malaligment.
2. Posterior disc protrusion at c5-c6 with mild central canal narrowing.
Now MRI from Feb: Findings:

Alignment is anatomic.
The cervical spinal cord is normal in signal intensity.
There is no evid. of lig injury within the cervical spine
There is no prevertebral soft tissue swelling.
The cervical vertebra are normal in marrow signal intensity. There is mild loss of intervertebral disc height at c4-c5 and c5-c6
At c2-3 there is no posterior disc abnormality, cnetral canal stenosis, or neural foraminal narrowing.
At c3-4 there is no posterior disc abnormality, central canal stenosis, or neural foraminal narowing.
At c4-c5 there is a posterior disc protrusion with narrowing of the ventral thecal space, but no central canal stenosis or neuroforaminal narrowing.
At c5-c6 there is a posteiror disc protrusion eccentric to the right with mass effect on the right aspect of the cervical spinal cored with mild central canal stenosis. There is mild left and no right neural foraminal narrowing.
At c6-7 there is no posterior disc abnormality , central canal stenosis or nueral foraminal narrowing.
Impression:
1. No evidence of ligamentous injury
2. Posterior disc protrusions at c4-c5 and c5-c6. Protrusion at c5-c6 exerts mass effect on the right aspect of the cervical spinal cord with mild central canal stenosis.

Okay now June's MRI>
The cervical spinal cord is normal in signal intensity.
the cervical vertebrae are normal in marrow signal intensity. There is loss of intervertebral disc height and c4-c5 & c5-c6
There is no evidence of ligamentous injury.
At c2-3 there is no posterior disc abnormality, central canal stenosis or neural foramiinal narrowing.
At c3-4 there is no posterior disc abnormality, central canal stenosis or neural foraminal narrowing.
A5 C4-5 there is a posterior disc protrusion with effacement of ventral thecal space, but no central canal stenosis. There is a mild left and right neuroforaminal narrowing. Findings unchanged.
At c5 -c6 there is a posterior disc protrusion eccentric t the right with mass effect on the right aspect of the cervical spine cord and mild central canal stenosis. There is mild left and no right neural foraminal narrowing. Findings are unchanged.
At c6-c7 there is no posterior disc abnormaility, central canal stenosis or neural foraminal narrowing.


Impression: right paracentral disc protrustion at c5-c6 with mass effect on the right aspect of the cervical cord and mild central canal stenosis. finding are unchanged.
2. Posterior disc protrusion at c4-c5 with effacement of ventral thecal space.
3. Mild left neuroforaminal narrowing at c4-c5 and c5 -c6.

Now the # 3 under (impressions: )is new on this recent MRI. We asked our 2nd of opinion NS. she said she see's no change. Nothing dramatic that would need surgery. Yet my 1st opinion is showing instability based on the flexion xray along w/increased narrowing at levels and spinal cord impingement. along w/ several neurological changes.
when my 2nd referral NS looked at the flexion xray she stated I could be born like that she see's no issue just need strengthening exercises. I heard that stand up mri's show instabiltiy ? could this be true?
In pt they wanted to start strength training. They stated my muscles are still lig. sore torn ..I'm just wondering will not having the muscles around that area working up to 100% effect the growth or fusion...I noticed that in another thread that her disc did not fuse because of the loss of muscle and therefore blood flow to the area. ? Please help.
I have surgery scheduled in 1 week..should I cancel should I go ..? should I get a 3rd opinon again....Once the 2nd neuro see's the bone scan she was going to consult w/colleagues regarding my case that she worked with when she was chief resident of nuerosurgery at UofMichigan...I'm thinking I should take that bone scan w/her & see what else she has to say.? This is a big step once surgery is done it's a long recovery....Is my body up to it...?





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