Ok long time no see my spiney friends...here with some test results since MVA

[logannamath]

I know I have been a bad spiney friend. I do apologize for that. I havent felt much like being on the pc at night when it usually is my only time. Didnt help that my little man had my laptop as he dropped his off the bed while he was sleeping. Can we say thank goodness for extended warranties!!! LOL!! I will post in the party thread as soon as I catch up with everyone. I have been doing my usual running and non stop marathons... Pain though lately has been extremely worse and its wearing me down. I know Mark, I have to slow down. I think I am afraid if I do I will wither away...I know Im a strange one!! Ok on to the results. I see the surgeon on Monday. I went to neuro today...he is just going to work on making me comfy...problem is the meds are not helping the pain but he doesnt seem to want to change that, so I am stuck. He also wants me to try PT and some massage therapy while I am there. I understand some of the mri's but what I dont get are the neural forminal stenosis and the central canal stenosis. What is the difference? What does the future of my spine mean to what you can see. Surgery is not an option at this point to me. I mentally could not handle that again. It sucks that I have another failed fusion at C5-C6 but 16 months out there should be something. I thought there was but I guess the xrays they took were not very good. Hence the need for a CT of the neck. Fun stuff

CT of the neck: shows that there is a non union of the C5-C6 level. It does show a lot more but that is the most important info from the test.


Cervical MRI


At C2-C3: There is no significant bulging.


At C3-C4: There is bulging of the intervertebral disk. There is mild central canal stenosis. There is no significant neural forminal stenosis.


At C4-C5: There is bulging of the intervertebral disk with posterior central herniation indenting the thecal sac. There is facet joint hypertrophy. There is mild bilateral neural forminal stenosis. There is moderate central canal stenosis.


At C5-C6: There is narrowing of the intervertebral disk space. There is posterior disk osteophyte complex with asymmetry to the left. There is bilateral neural forminal spondylitic ridging. There is moderate central canal stenosis. There is mild to moderate right neural forminal stenosis. There is moderate to severe left neural forminal stenosis.


At C6-C7: There is post status interval anterior cervical fusion with resultant susceptibility artifact. There is no bulging of the intervertebral disk. There is no significant central canal or nt L3-L4eural forminal stenosis.


At C7-T1: there is no significant bulging of the intervertebral disk. There is no significant central canal or neural forminal stenosis.
The vertebral body height appears preserved. There is normal appearing fossa without evidence for tonsillar extension below the foramen magnum. The cervical cord shows normal signal intensity as does the CSF space. There is no evidence of increased signal within the posterior spinous ligamentous structures. There is reversal of the normal cervical lordosis. The facet joints appear in anatomic alignment.


Lumbar MRI


At L3-L4: there is no significant bulging of the intervertebral disk. There is facet joint sclerosis. There is no significant central canal or neural forminal stenosis.


At L4-L5: There is mild bulging of the intervertebral disk. There is facet joint arthropathy and ligamentum flavum hypertrophy. There is mild central canal stenosis. There is mild to moderate left neural forminal stenosis.


At L5-S1: There is intervertebral disk desiccation. There is bulging intervertebral disk with annular tear and posterior central herniation indenting the ventral theca sac. There is facet joint arthropathy. There is a 5 mm synovial cyst located posterior to the right facet joint. There is no canal stenosis. There is moderate bilateral neural forminal stenosis.

[Mark N]

Brigitte, welcome back. First the " neural forminal stenosis" is about where the nerves leave your vertebra so the disk could be casing stenosis if it is cutting off some of the room for the nerve root. The "central stenosis" has to do with the spinal cord and how much room there is for it in the spinal canal. On to the MRI: L4-S1 shows issues that are probably causing a lot of pain and the L5-S1 especially is bad. C3-4 can be causing some pain but doesn't look like it is too bad. C4-6 however has plenty of things wrong and probably causing lots of pain and some nerve issues. Based on nonfusion when you have already dealt with nonfusion before I have to say I don't know what your surgeon was thinking of not using hardware as you are now looking at fusion C4-6 now.

I know you want to avoid surgery, I would consider a different surgeon possibly, but with your neck in the shape it is in I can't believe they are letting you drive as another accident could really cause big trouble for you. It is between you and your doctor but please weigh the risk of your neck in this condition along with the issue of surgery.

[logannamath]

Mark your scaring me. Seriously!! I begged him to do the C4-5 also when he did the surgery back in 2010. The reason for no plating is that they could not get a good fit on it. I am thinking a second opinion is in order. I will see him monday but I am doing nothing without another opinion. I was so upset when I picked up the results earlier this week. It just floors me. I want to hide and wish it all away!!

What are your thoughts on the lumbar? Do I leave it? I was told by this dr that there is an extremely large annular tear at the L5-S1. Along with everything else thats there. I know there is no spinal cord inpingment, so what would you think they will do for this? Can anything non surgical be done to help improve the pain and disk?

This sucks and like I said, you scared me. I promise to be more careful in what I am doing. It just sucks and no I cannot stand wearing a brace...the headaches I get from it are awful!! Thanks for your help. You know I value your opinion as you have been there, and done that. It just sucks to be in this boat!!!

[Mark N]

Brigitte, sorry about scaring you as I wasn't trying to do that but to get your attention. There are a number of things they can try with the lumbar spine - the most common would be steroidal injections. Many people get good relief from the injections so there is hope for your lumbar spine. I think you are taking the right step with a second opinion. Good Luck.

[carolnurse]

Hi Brigitte....I don't think I have met you here yet, but I come on here periodically. I've had a very long problem with cervical spinal stenosis and had surgery back in October. I was a nervous wreck(being a nurse and knowing all the bad things doesn't help). Lot of great advice from people here, esp. Mark. I agree with Mark, maybe you might want to see a second opinion, a neurosurgeon, please. Not that ortho isn't good, but with the cord involved, neurosurg is better. About the anular tear: I had one in my lumbar area many years ago and saw a surgeon cos my PCP didn't know what to do.(coincidently it was the same one who ended up doing my surgery on cspine). Anyways, he told me that anular tears are not usually a surgical matter. I had ALOT of pain because all the stuff inside the disc was leaking out onto the nerves. Physical therapy will really help that. They say the discs won't grow back and you run the risk of bone on bone, but my latest lumbar xrays show normal height where that anular tear was. So, it takes awhile to heal and is painful, but it WILL heal.
Back to the cervical, Mark is right, foraminal stenosis is the nerve roots and that is when you usually get pain in arms. Spinal stenosis is when the cord is involved and you typically have NO pain from this. I hope you get the right answers and are able to get the right care. Good luck.

[logannamath]

Hi Carol :) Thanks for the help. I posted a dr appointment update in the pity party room thread. I have had 3 surgeries so far on the neck. The stenosis at the C5-6 level has gotten worse since my surgery on 10/2010 at this level. I just fear letting him go in to clean it up...what if he screws it up?? I dont know plus that level as a failed fusion. I am going to try and find someone else to look over reports and everything.

As for the lumbar, I have had this annular tear since 2007. Back then it was a small tear. 2009 a large tear, 2012 an extremely large tear with herniation. I wish it would heal but my guess is, with more than 5 yrs gone by...I dont think it will. I waited a long time suffering till I went in 2007, cause I dislike dr's!!! LOL!! How long did yours take to heal? I am not sure if there is loss of disc height but I am getting my report so I should find out in the next few days.
Thank again for all your help!!!

[Leeaelle]

Hi Brigette ~ I think I'd want to avoid any surgery at this point. The cervical seems to be stable right now -- nothing seems to be of IMMEDIATE concern. There was an article in the July/August AARP magazine about spinal fusions, and like all other articles I've read, it said that they have increased alarmingly in the last 5-10 years, and that the results are NO better than those people who have had physical therapy! In fact, they said that most often the results are worse because the levels above & below the fusion site have to take on more of the load, and tend to fail! But like Mark & Carol said, another opinion with a Neurosurgeon certainly wouldn't hurt. I'm really sorry you're still having problems.

Please keep us posted on how you're doing, ok? Take care & God bless. Hugs, Lee

[logannamath]

Lee I just saw this. Havent been on cause my son is using my laptop. He broke his. Thank goodness for extended warranties!!! So I am stuck with nook or ipad and typing on these is awful!!

Yes I think another opinion is in order. I think i have truly lost faith in my dr. He says one thing one visit, and next visit, its different. He waffles too much. I may try the injections!

I wish an article like that was around before I ever did my 1st surgery. I have said since that day, it was a huge mistake. Not only did it fail, it required a revision and 9 yrs later a surgery on the level above it. Domino effect sucks!!! Since there was severe cord compression, i cant regret that surgery. But if back in 2001 I did nothing Ithink i woild be beyter off today.

Ok enough of my pity party....thanks for gettingback to me. So happy to see u posying. Missed reading ur posts!! Prayiing for you & your granddaughter!!! HUGS!!!

[Mark N]

Brigitte, it is a shame your dr has developed the attitude he has but I agree that another opinion is needed. By the way, when you had severe cord compression I don't think you had much choice about surgery unless you didn't have symptoms of cord compression. The problem with cord compression if nothing is done is the nerves start to die off and impairment becomes a big problem. The reports about not doing anything and being as well off down the road has to do with herniation of disk and not that of cord compression.

[slipnslide]

Brigitte,

I too have been mostly absent from BT lately. Taking care of my mom who has alzhiemer's just wears me down and kicks my butt, however, I wanted to make sure I responded to your post:o.

You poor thing! You're a mess. I agree with Mark, get other opinions and find a new surgeon if at all possible.

I'm a little confused, your CT shows:

CT of the neck: shows that there is a non union of the C5-C6 level

but then your Cervical MRI says:

At C5-C6: There is narrowing of the intervertebral disk space.

With a fusion without plating at that level, did they use bone where they removed the disk? If so, that should have preserved the disk space between C5 and C6, or am I misunderstanding something?

Also, with L4-L5 having:

There is intervertebral disk desiccation. There is bulging intervertebral disk with annular tear and posterior central herniation indenting the ventral theca sac..

Personally I feel that there isn't much hope of that repairing itself with the dessication you have at that level. I fear that with any more trauma, that disk will fragment.

Best wishes,

Kim