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Spinal Cord Disorders Message Board

Spinal Cord Disorders Board Index

Hello all, I was a squeeky wheel here seven years ago and after sussesfull surgery sort of faded away.

Well I am back. Same old story
I am hoping someone in the know can help sort these terms out.

I apologize for spelling & othet typos, but hands are numb and my "fat fumble fingers" just dont seem to do what i want them to. Aslo I think the gabapentin makes me stupid.

There are postoperative changes of anterior plate and screw fixation with corpectomy and interbody bone graft at C4-C5 and C5-C6, which are new since 6 March 2003. Hardware is intact in standard position. There is good incorporation of the bone graft. On the sagittal images, the AP diameter the spinal cord is flattened by disc
osteophyte complex at C3-C4. The ventral cord is minimally indented at C4-C5 due to residual endplate osteophytes. Remaining cervical spinal cord is normal in size and signal without intradural extra medullary lesion. There is no cerebellar tonsillar ectopia.
There is redemonstrated diffuse degenerative disc disease and degenerative facet joint arthritis without listhesis. The extant cervical vertebral bodies are preserved in normal height and alignment. The remaining intervertebral discs are normal in height.
There are atlantoaxial degenerative changes.

The report also has other terms I am not sure i understand. Funny how even after you have looked up the definition you still cant quite put it into the correct context.

At C3-C4, there is disc osteophyte complex, with prominent broad-based central disc component, uncovertebral spurs and degenerative facet joint arthritis, which result in severe acquired spinal canal compromise and moderate bilateral neuroforaminal narrowing. The AP diameter the spinal canal is narrowed to 3 millimeters at this level with flattening of the AP diameter the spinal cord.
At C4-C5, there are residual endplate osteophytes with uncovertebral spurs and degenerative facet joint osteoarthritis which result in acquired spinal canal compromise severe right and moderate left neuroforaminal narrowing. The AP diameter the spinal canal is narrowed to 6 mm with minimal ventral cord margin deformation.
At C5-C6, there are residual endplate osteophytes with uncovertebral spurs and degenerative facet joint osteoarthritis, which result in severe right and moderate left neuroforaminal without acquired spinal canal compromise. The AP diameter the spinal canal measures 9 mm at this level.
At C6-C7, there is disc osteophyte complex with uncovertebral spurs and degenerative facet joint osteoarthritis, which result in moderate to moderate to severe bilateral neuroforaminal narrowing without acquired spinal canal compromise.

1. Anterior fusion, corpectomy, and bone graft placement at C4-C5 and C5-C6, new since 6 March 2003, with intact hardware in standard position. There is good bone graft incorporation.
2. Diffuse degenerative disc disease with severe disc osteophyte complexes at C3-C4 and C6-C7 and residual endplate osteophytes at C4-C5 and C5-C6, which result in spinal canal compromise at C3-C4 and C4-C5 with cord impingement, most severe at C3-C4.
3. Multilevel degenerative facet joint arthritis without listhesis.
4. Varying degrees of moderate to severe neuroforaminal narrowing from C3-C4 through C6-C7, and with moderate to severe bilateral at C6-C7, severe right and moderate left at C4-C5 and C5-C6, and moderate bilateral at C3-C4.

Any help is appreciated greatly.

I hope you had some good times in those 7 years since your surgery - it looks like the degeneration kept going in your spine and also the pressue of the fusion might have made the other levels in your neck more susceptible to faster degeneration. I tried to put it in laymans terms, basically you have a severe compression of the spinal cord and also in your neuro foraminal channels where your nerve roots come off your spinal cord and go on to your arms. Most likely they are going to recommend you get a revision surgery
and get that pressure off your cord and clean out some of those bone spurs. Physical therapy will probably make you feel very bad because of those nerve roots being compressed.

I agree there is a point where you don't want to do more surgery, I am there myself, but I kind of draw the line when it moves from moderate to severe and I loose feeling which could lead to loss of function. Pain we can try to treat and live with although pain is our body signal to tell us to get it fixed. Also at some point pain can get so bad if we don't fix it that we have no choice. At one point before my surgeries I was taking 4800mg of gabapentin - I know how fuzzy it can make your brain feel at the higher doses.

The level immediately above your fusion at C3-4 is flattening your spinal cord with both a disc bulge and bone spurs (osteophyte). The best way
to describe a disc bulge is to think like a marshmallow when you squeeze it. The way they describe the bulge it is probably on the large side. The arthritis you have is very common in spines where the discs have gone bad (degenerated). As we age or from damage the discs dry out, shrink and then
just do not do their job as shock absorbing cushions. Uncovertebral and facets are joints where the vertebrae connect and move and in there you have grown some bone spurs because the lining in there has worn down probably from rubbing-wear and tear. Now as the discs shrink they lose height and then this will cause narrowing in the neuro forminal channels. These are like canals where the nerve roots come off our spinal cord and exit on to our body parts. there is a foramin on the left and the right, you have narrowing on both sides - I bet you have symptoms on both arms!

It also says that at C4-5 a level which is in your fusion, there is a bone spur on the endplate of the vertebrae that is slightly indenting your spinal cord. The endplate is the horizontal edge of the vertebra. It is very common for bone spurs to grow there. Again more bone spurs and they are getting large enough where they are narrowing your spinal canal and the neuro foramins. It is very common for bone spurs to grow in these canals. When we get bone spurs there we get severe arm pain, tingling and even complete numbness. At this level your right is worse than your left. It says you have significant narrowing and there is a word blanked out but it looks like the rubbing is so bad there that the outer margin of the cord is losing some of the signal or even the outer sheath. Your narrowing is very bad at this level when you drop in the 6mm size that is getting pretty narrow - when above 9mm is the preferred amount of space in there.

At the other C5-6 which is also within your fusion it looks like they are describing bone spurs that they believe have been there since your surgery (residual). More of the same things described in the level above.

Then finally, the level immediately below your fusion t C6-C7, there is more bone spur and disc bulging (disc osteophyte complex) and more arthritis in the joints, and again more neuro foraminal narrowing.

You could kind of wait and follow to see how fast this continues to progress -but most likely they will pressure you to correct this stuff unless you have a larger health problem that puts you at risk.

Hope this helped.

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