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Spinal Cord Disorders Message Board


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Hi, Everyone,

I am 3 years post ACDF C5-6 (donor bone). My last MRI was almost 3 years ago (6mos after surg). I've been having some more numbness in my hand and possibly my foot and weakness. Some pain in my neck, spasms -- not terrible, but nagging. I decided to go back to the doctor and here are my new MRI results:

C4-5there is a mild disc ridge complex which partially effaces the ventral fluid column. A discrete disc herniation is not identified.

C5-6 there is a posterior ridge. There is effacement of the ventral fluid column and flattening of the vental aspect of the spinal cord. There is narrowing of the AP diameter of the central canal. These findings are unchanged (same as last MRI in 2007/6 months POST fusion at this level).

C6-7 there is a moderate to large right paracentral disc herniation, increased compared to the prior examination in 2007. This disc herniation flattens the right ventral aspect of the spinal cord. It narrows the AP diameter of the central canal, particularly on the right. There is a disc ridge complex.

IMPRESSION:
Right paracentral disc herniation at C6-7, increased compared to 2007.
Status post anterior fusion C5-6.
Disc ridge complexes at C4-5 and C6-7.

I have not yet spoken with the orthopedist. Any thoughts? Do you think I'll need more surgery?!?!? Flipping out a little here :(

Thanks everyone,
Lisa
Once they do a fusion, even a small one, it puts pressure on the disc below and sets you up for more trouble down the road. That is why they are working on non-fusion surgeries for these problems.

You could end up with a lengthening of your fusion to include C7 depending on how long your doc thinks you can wait. I am 4 years out from C3 to T1 and have moderate compression of the nerves at C4 inside my fusion and trouble developing at T1-2 similar to yours but I will wait as long as I can. As my doc put it, this can become a "never ending story"!

See what your doc thinks and then decide if you can wait a while or do some PT and see if that helps or try something other than surgery. You know you always have that as a back up if nothing else works.

sorry and hugs.............Jenny
Hi, Jenny,

I know that having a fusion puts stress on other levels. The other levels weren't so great back in 2007, but the surgeon only wanted to do one level (the others were good enough).

I am not sure if "Cord Flattening" is very serious and would require a surgical consult/surgery. I know the signal is normal. Before my ACDF in 2007, I had spinal cord compression at C5-6 with myelomalacia. That sounds more serious than this MRI, but I don't know. Has anyone had surgery with "Cord Flattening"?

Thanks,
Lisa
I had a C5-C6-C7 ACDF in 06 and then a posterior foraminotomy in 08. I now have signs and MRI/CT/x-ray findings that show C4 has a problem, C6 is loose and there is some developing problems at other levels. Surgery is an option but my excellent orth spine surgeon and I have had ongoing discussions about what to do and when. Age plays a large part in this. Being 44 my surgeon doesn't want to fix what he sees and then I need more work in 3-5 years. He said if I was in my 60's he'd fix all the stuff right now. So it may be a very personal decision as what to do and when. I hope to see if the can do anything minor to fix some of the more prevalent problems but unfortunately the neck is not like the knee. I've had some minor repairs on my knee becuase they can use an arthroscope and get a good diagnostic view of the joint, that just can't be done in the spine.
[QUOTE=SpineAZ;4640317]I had a C5-C6-C7 ACDF in 06 and then a posterior foraminotomy in 08. I now have signs and MRI/CT/x-ray findings that show C4 has a problem, C6 is loose and there is some developing problems at other levels. Surgery is an option but my excellent orth spine surgeon and I have had ongoing discussions about what to do and when. Age plays a large part in this. Being 44 my surgeon doesn't want to fix what he sees and then I need more work in 3-5 years. He said if I was in my 60's he'd fix all the stuff right now. So it may be a very personal decision as what to do and when. I hope to see if the can do anything minor to fix some of the more prevalent problems but unfortunately the neck is not like the knee. I've had some minor repairs on my knee becuase they can use an arthroscope and get a good diagnostic view of the joint, that just can't be done in the spine.[/QUOTE]
Hi, Spine,

Thanks for the reply. Wow, you (and others on this board) have had a lot of problems --how are you doing now? How was your multi-level ACDF? What are your current problems w C4 and C6 is loose (even though fused)?

I am in my late 30s, so I worry about having to have one surgery after another at my age. I am not sure whether to try to avoid surgery with "cord flattening" or consider a consult with my prior neurosurgeon (who did my ACDF C5-6 in 2007). I am going for a CT scan and x-rays tomorrow and then will follow up with the orthopedist. I wonder whether he will recommend a surgery consult with the neurosurgeon, epidural injections, ?

I have some minor weakness (but noticeable) and a little clumsyness in my L hand. I think I also notice numbness in my L foot. I can "live" with it, but am wondering if I should or not. I am able to work, run 6 miles/week, be active. I only use a lidoderm patch, no other meds (although I could use some).

Lisa
I have a history of lax ligaments and tendons so joints (including spine) tend to move too much and thus I've had additional spine levels that don't do well. Same reason I've had a bunch of knee surgeries and a few foot surgeries as well and I've started to experience pain in both thumbs.

I knew the C5-C6-C7 fusion had not worked well and my former orthopedic spine surgeon ignored my concerns, I later changed to a new doc who has been able to clearly see what levels in my spine have difficulty and match it pretty well to the symptoms I experience. Thank goodness for spine surgeons that will take on the "difficult" cases or those who didn't have a successful outcome before. And I have a wonderful pain management doctor as well.





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