Will someone please help interpret what Imaging Reports mean post-op
Hello everyone, I am new to the group and was hoping someone could help me interpret my Post-op MRI, CT Scan and X-ray and give some guidance for future imaging?
Some History:
I had severe advance cervical disk degeneration at levels C4-C5, C-5-C6,C6-C7. cervical myleothopy, spinal/ foraminal stenosis, broad based disk herniations at all three levels, osteophytes at each level. Positive EMG/NCS for severe carpal tunnel syndrome greater in right hand. I had surgery February 2012 for cervical and carpal tunnel release on right hand.
Originally my doctor told me he would be doing the ACDF at all three levels, decompression and removal of osteophytes, fusion using cadaver bone. Surgeon ended up only doing ACDF on C5-C6 and C6-C-7, level two Corpectomy and fusion with cadaver bone. Removed osteophytes at only two levels. Surgeon left C4-C5 the way it was, despite this level at the time having a broad base herniation, stenosis and osteophyte and attached the titanium plate and screws from C4 to C-7.
Since surgery my previous severe symptoms have all returned and are worse now than before. I've had an onset of new pretty severe symptoms that are progressing in severity. I'd be more than happy to list my symptoms if that would help, but for now I'll just post the following. The imaging below was performed at 7 mo, 6 mo. And two week post op. I am now 16 months post op.
MRI CERVICAL SPINE, WITH AND WITHOUT IV CONTRAST 11/02/2012
INDICATION: Cervicalgia, postop surgery from February 2012, bilateral
neck and arm pain
FINDINGS: The patient was given 10 mL of Omniscan IV with the enhanced portion of this study. Comparison is made with a CT cervical spine from 9/7/2012. Metallic signal loss artifacts noted due to anterior fixation plates and screws extending from lower C4 down to C7. The C-spine is straightened with loss of the lordotic curvature. The C1-C2 and C2-C3 levels are unremarkable in appearance. At C3-C4 there is no canal or foraminal compromise.
At C4-C5 mild bulging disc causes moderate effacement of the ventral thecal sac and perhaps slight ventral cord flattening. The foramina appear patent.
At C5-C6 bilateral osteophytic foraminal encroachment is noted, left greater than right. There is also
moderate osteophytic ridging of the ventral thecal sac and mild ventral
cord flattening.
At the C6-C7 level there is minimal bilateral osteophytic foraminal encroachment but no cord deformity or significant effacement of the ventral thecal sac.
At C7-T1 there is no canal foraminal compromise. At T1-T2 also no canal or foraminal compromise.The cord shows normal signal characteristic at all levels.
IMPRESSION:
1. Metallic fixation plate and screws extend from lower C4 through C7.
2. Broad disc bulging with osteophytes cause moderate effacement of the ventral thecal sac and slight ventral cord flattening at C4-C5.
3. Osteophytic ridging of the ventral thecal sac at C5-C6 is noted.
There is also slight ventral cord flattening at this level and bilateral osteophytic encroachment, left greater than right.
4. There is mild bilateral osteophytic foraminal encroachment a C6-C7.
TE - by dc on 11/2/2012 at 12:07
Ct Scan 9-8-2012
CT CERVICAL SPINE WITHOUT CONTRAST
INDICATION: Cervicalgia, status post ACDF
TECHNIQUE: MDCT axial imaging was performed, and this was followed by reformatted sagittal and coronal imaging.
FINDINGS: The patient has had an anterior cervical and interbody fusion procedure at C5-C6 and C6-C7. The bone grafts are quite large at both levels, and it is probable the patient has had partial corpectomy at both levels. Vertebral alignment is normal. There is straightening of the C-spine suggesting muscle spasm. There are small bony ridges posteriorly at C5-C6 and C6-C7, but this does not result in significant spinal stenosis. There is neural foraminal stenosis on the left at C5-C6. There is no mass effect within the spinal canal.
IMPRESSION:
1. Status post anterior plate and interbody fusion at C5-C6 and
C6-C7. The bone grafts are large at both levels, and it is probably that the patient has had a partial Corpectomy.
Recommend correlation with operative findings.
2. Straightening of the C-spine.
3. Mild neural foraminal stenosis of the left at C5-C6.
TD JS on 09/08/12 at 1145
TE db on 09/08/12 at 1219
LATERAL C-SPINE X-RAY 02/17/2012
Views are compared to the preoperative study of December 29, 2006. A screw and plate transfixes the C5, C6, and C7 levels. Vertebral body alignment is normal. There is mild straightening of the cervical lordosis again noted. Facet alignment is normal. The metallic devices are grossly intact. There is mild residual pre vertebral soft tissue swelling.
IMPRESSION:
1. Postop change of C5-C7 ACF.
Td: CVM/2/17/12 1445
Te: jt/2/17/12
Any suggestions or opinions are welcome and that you in advance. I am desperate and just want my life back.
1. How can it be or is it possible to have regrowth of osteophytes so soon after surgery?
2. What do my reports mean after the surgeries I had?
3. Is it possible there is non union at the levels of Corpectomy that report are claiming to be so large?
4. Can these problems cause numbing in cervical spine and down to middle spine?
5. What types of imaging or positions in imaging can provide most optimal results to see what is going on?
6. In relation to having the level two Corpectomies, ACDF. fusions and removal of osteophytes what appears to be happening.
8. Is it common to attach a plate to an already diseased vertebrae?
9. Anyone have an idea of what the options to fix these problems having already had the Corpectomies?
10. Would problems in cervical cause legs to go numb when sitting?
11. Is it normal to have an extreme level of pain, numbness, major neurological defects and loss of use hands etc. this far out?
12. Does this surgery cause new problems in middle and lower back? Or could this all be referred?
Some History:
I had severe advance cervical disk degeneration at levels C4-C5, C-5-C6,C6-C7. cervical myleothopy, spinal/ foraminal stenosis, broad based disk herniations at all three levels, osteophytes at each level. Positive EMG/NCS for severe carpal tunnel syndrome greater in right hand. I had surgery February 2012 for cervical and carpal tunnel release on right hand.
Originally my doctor told me he would be doing the ACDF at all three levels, decompression and removal of osteophytes, fusion using cadaver bone. Surgeon ended up only doing ACDF on C5-C6 and C6-C-7, level two Corpectomy and fusion with cadaver bone. Removed osteophytes at only two levels. Surgeon left C4-C5 the way it was, despite this level at the time having a broad base herniation, stenosis and osteophyte and attached the titanium plate and screws from C4 to C-7.
Since surgery my previous severe symptoms have all returned and are worse now than before. I've had an onset of new pretty severe symptoms that are progressing in severity. I'd be more than happy to list my symptoms if that would help, but for now I'll just post the following. The imaging below was performed at 7 mo, 6 mo. And two week post op. I am now 16 months post op.
MRI CERVICAL SPINE, WITH AND WITHOUT IV CONTRAST 11/02/2012
INDICATION: Cervicalgia, postop surgery from February 2012, bilateral
neck and arm pain
FINDINGS: The patient was given 10 mL of Omniscan IV with the enhanced portion of this study. Comparison is made with a CT cervical spine from 9/7/2012. Metallic signal loss artifacts noted due to anterior fixation plates and screws extending from lower C4 down to C7. The C-spine is straightened with loss of the lordotic curvature. The C1-C2 and C2-C3 levels are unremarkable in appearance. At C3-C4 there is no canal or foraminal compromise.
At C4-C5 mild bulging disc causes moderate effacement of the ventral thecal sac and perhaps slight ventral cord flattening. The foramina appear patent.
At C5-C6 bilateral osteophytic foraminal encroachment is noted, left greater than right. There is also
moderate osteophytic ridging of the ventral thecal sac and mild ventral
cord flattening.
At the C6-C7 level there is minimal bilateral osteophytic foraminal encroachment but no cord deformity or significant effacement of the ventral thecal sac.
At C7-T1 there is no canal foraminal compromise. At T1-T2 also no canal or foraminal compromise.The cord shows normal signal characteristic at all levels.
IMPRESSION:
1. Metallic fixation plate and screws extend from lower C4 through C7.
2. Broad disc bulging with osteophytes cause moderate effacement of the ventral thecal sac and slight ventral cord flattening at C4-C5.
3. Osteophytic ridging of the ventral thecal sac at C5-C6 is noted.
There is also slight ventral cord flattening at this level and bilateral osteophytic encroachment, left greater than right.
4. There is mild bilateral osteophytic foraminal encroachment a C6-C7.
TE - by dc on 11/2/2012 at 12:07
Ct Scan 9-8-2012
CT CERVICAL SPINE WITHOUT CONTRAST
INDICATION: Cervicalgia, status post ACDF
TECHNIQUE: MDCT axial imaging was performed, and this was followed by reformatted sagittal and coronal imaging.
FINDINGS: The patient has had an anterior cervical and interbody fusion procedure at C5-C6 and C6-C7. The bone grafts are quite large at both levels, and it is probable the patient has had partial corpectomy at both levels. Vertebral alignment is normal. There is straightening of the C-spine suggesting muscle spasm. There are small bony ridges posteriorly at C5-C6 and C6-C7, but this does not result in significant spinal stenosis. There is neural foraminal stenosis on the left at C5-C6. There is no mass effect within the spinal canal.
IMPRESSION:
1. Status post anterior plate and interbody fusion at C5-C6 and
C6-C7. The bone grafts are large at both levels, and it is probably that the patient has had a partial Corpectomy.
Recommend correlation with operative findings.
2. Straightening of the C-spine.
3. Mild neural foraminal stenosis of the left at C5-C6.
TD JS on 09/08/12 at 1145
TE db on 09/08/12 at 1219
LATERAL C-SPINE X-RAY 02/17/2012
Views are compared to the preoperative study of December 29, 2006. A screw and plate transfixes the C5, C6, and C7 levels. Vertebral body alignment is normal. There is mild straightening of the cervical lordosis again noted. Facet alignment is normal. The metallic devices are grossly intact. There is mild residual pre vertebral soft tissue swelling.
IMPRESSION:
1. Postop change of C5-C7 ACF.
Td: CVM/2/17/12 1445
Te: jt/2/17/12
Any suggestions or opinions are welcome and that you in advance. I am desperate and just want my life back.
1. How can it be or is it possible to have regrowth of osteophytes so soon after surgery?
2. What do my reports mean after the surgeries I had?
3. Is it possible there is non union at the levels of Corpectomy that report are claiming to be so large?
4. Can these problems cause numbing in cervical spine and down to middle spine?
5. What types of imaging or positions in imaging can provide most optimal results to see what is going on?
6. In relation to having the level two Corpectomies, ACDF. fusions and removal of osteophytes what appears to be happening.
8. Is it common to attach a plate to an already diseased vertebrae?
9. Anyone have an idea of what the options to fix these problems having already had the Corpectomies?
10. Would problems in cervical cause legs to go numb when sitting?
11. Is it normal to have an extreme level of pain, numbness, major neurological defects and loss of use hands etc. this far out?
12. Does this surgery cause new problems in middle and lower back? Or could this all be referred?
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