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Old 03-01-2007, 12:06 AM   #1
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Question Confusing MRI results

I had surgery in october. I had 3 discs replaced - C4/5, C5/6 and C6/7 -and fused with the plate and screws (sorry its late and I can't think of the correct terminology).

The headaches never totally went away and were becoming worse. I had an MRI done today. Since I have had 6 MRI's done at this imaging center, the radiologist knows me by sight lol. I asked him afterwards if everything looked good and this was just "part of the healing process". He showed me on the MRI where one of the discs that was done (c5/6) looked "ruptured". I also have another disc above the 3 that were fused (c2/3) that has ruptured. At this rate, I only have my first and last cervical disc that won't be replaced and fused.

What exactly is a failed fusion? How is it fixed? More surgery that can go bad?

Thanks for any input.

Jami in TN

Last edited by hugg724; 03-06-2007 at 01:26 AM. Reason: additional information

 
Old 03-01-2007, 03:24 AM   #2
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Re: Failed fusion?

Quote:
Originally Posted by hugg724 View Post
I had surgery in october. I had 3 discs replaced - C4/5, C5/6 and C6/7 -and fused with the plate and screws (sorry its late and I can't think of the correct terminology).

The headaches never totally went away and were becoming worse. I had an MRI done today. Since I have had 6 MRI's done at this imaging center, the radiologist knows me by sight lol. I asked him afterwards if everything looked good and this was just "part of the healing process". He showed me on the MRI where one of the discs that was done (c5/6) looked "ruptured". I also have another disc above the 3 that were fused (c2/3) that has ruptured. At this rate, I only have my first and last cervical disc that won't be replaced and fused.

What exactly is a failed fusion? How is it fixed? More surgery that can go bad?

Thanks for any input.

Jami in TN
that sounds really terrible. regarding the c5/c6 one - it doesn't seem to make sense that a disc that was fused would rupture because that level should be fused without a disc any more. If its due to non-fusion, I've heard of posterior surgeries to correct non-fusions (they do a posterior fusion instead). If you have to have even more levels done you might want to look into cervical ADR (artificial discs) as an alternative as well. Good luck with it sounds like a difficult situation.

 
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Old 03-01-2007, 06:31 AM   #3
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Re: Failed fusion?

I am a little confused how can it be "ruptured" if it was taken out and fused?? Maybe he/she just meant that it was a non-fusion and things were unstable?? If you had mri's/xray before since October did they show any fusion?? bdancer

 
Old 03-05-2007, 02:51 PM   #4
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Confusing MRI results

I have a copy of my MRI results. Any help with what this means would be appreciated. My surgeon told me that other than another bulging disc that we would keep an eye on, everything looks "in line" with my surgery 4 months ago. This doesn't sound too in line to me, especially when I am still having pain and headaches.

At the C3-C4 level, there is disc desiccation and moderate decreased height with right paracentral disc protrusion/spu. There is moderate narrowing of the right C3-C4 neural foramen.

These are the discs that were replaced with bone, screws and a plate:

At the C4-5 level, there is high signal and enhancement within the posterior disc which may be related to surgery.

At the C5-6 level, there is similar finding of posterior disc enhancement. Endplates do not appear abnormal. Left uncovertebral hypertrophy with moderate narrowing of the left C5-6 neural forament identified.

At the C6-C7 level, moderate disc enhancement is noted. Broad-based posterior disc bulging/spurring is identified, greater on the left with moderate neural foraminal narrowing. No frank central stenosis.

At the C7-T1 level, no focal disc protrusion or extrusion. Central canal and neural formina are patent.

Thanks!

Jami in TN

Last edited by hugg724; 03-06-2007 at 01:31 AM. Reason: additional information

 
Old 03-05-2007, 06:39 PM   #5
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Re: Failed fusion? - more info

My first question would be : If you had an ACDF (which includes a discectomy which is removal of the disc) how can there be herniation at those levels? My ACDF was C5-C7 and I am at risk for disc problems at C4-C5and C7-T1 - but C5-6 and C6-7 are gone (discectomy). Is there a chance they fused but didn't remove the discs?
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Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
C5-C7 foraminotomy 08

Last edited by SpineAZ; 03-05-2007 at 06:39 PM.

 
Old 03-05-2007, 07:06 PM   #6
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Re: Failed fusion? - more info

Quote:
Originally Posted by kross426 View Post
My first question would be : If you had an ACDF (which includes a discectomy which is removal of the disc) how can there be herniation at those levels? My ACDF was C5-C7 and I am at risk for disc problems at C4-C5and C7-T1 - but C5-6 and C6-7 are gone (discectomy). Is there a chance they fused but didn't remove the discs?
It was my understanding that the bad discs were removed and a bone graft using bone from a cadaver that would form the fusion with the screws and rods were replaced in those areas. My research indicated this is what a discectomy is. I had the choice of taking the bone from my hip or this replacement. I didn't want the double whammie of surgery to the hip and neck so I chose the cadaver bone graft.

I am pretty confused as well. My NS definitely didn't address this issue at my appointment but I saw on the MRI what the radiologist was referring to. I did have a bone spur formation that was removed during my surgery. Can this be another bone spur that appears as a disc bulge? I am obviously concerned at the conflicting statments from the NS and the radiologist.

Jami in TN

 
Old 03-06-2007, 05:22 PM   #7
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Re: Failed fusion?

Hi - Under this ACDF procedure a surgeon can do a partial removal of the disc. There was someone on this board last year that only had partial removal. It appears from the MRI report that they left the backside (posterior) of the disc.


If I were you, I would have this explained to me what is going on.

 
Old 03-06-2007, 05:58 PM   #8
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Re: Failed fusion?

I have been fused at C5/6/7 (1st time), and then C4/5 a year later. I had been of the impression that all of the disc was removed for an ACDF, but I learned that the surgeon may remove only the portions that are causing trouble. The donor bone used is not the same size as the disc being removed (at least in my case), so there is room for both a bone graft, and some of the original disc if it was not all removed. I believe this 'partial; removal is more common that is generally believed by those of us that have had this done.

A failed fusion would indicate that your own bone is not growing into the donor bone as expected, or that the bone graft slipped (maybe unlikely since the plate and screws would hold everything in place).

In any case, just ask questions to your Drs - they should provide whatever explanations you ask them for.

Good luck!
Bob

 
Old 03-11-2007, 02:40 PM   #9
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Re: Failed fusion?

Hi there,

I think the best thing to do is to call you NS and find out what he thinks about this last MRI....

When did you get this done last?

When was the last time you had a check up with your NS about the fusion?

I wouldn't worry too much over this as sometimes the reports can be very "wordy" with things that sound much more scary then they are....

Most of us with fusions have 'stress' put on the other levels and have to have our NS watch and help fight off other herniations at different levels.......I just had my 3rd cervical fusion and they had to go in from the front AND the back of the neck this time to REALLY fuse me since I guess it was too stubborn the first two surgeries...HAHA....

Anyway.....so you can find out the full story, I would call your NS after he has reviewed your films and has the radiology report and just ask to be sure....which levels were fused and did he take out the full disc? If so...then others are correct in saying that it shouldn't be a rupture because there is no more disc in there....just fusing bone....

I had "total non-fusions" my first two surgeries....The first one in 2001, when I used my own hip bone but no metal or screws...actual resorbed (yes, that's the whacky real spelling) into my system so it actual "disappeared".....so the vertebraes collapsed back on one another....Of course I didn't get another surgery and had to fight for years to get another MRI after complaining of terrible pain and worsening nerve symptoms...I used to joke with my friends like, "where did that piece of bone go??? Am I going to burp one day and have it 'pop' out my mouth"???? HA HAHA

So, back in again on Dec. 2005 and they used donor bone, metal plates, screws, etc...Well, this lasted a total of 2 months before they saw that it didn't fuse at all....I had excruciating and worse pain starting the day AFTER my surgery and kept getting worse....And that surgeon didn't believe in any pain medicine..argh...

Well, this last time I wasted NO time in finding my now FAVORITE surgeon, (he is a HOTTY too!!! who did the surgery in Nov of last year (made sure my toes were painted all nice to compensate for my drooling under anesthesia....lol) with so much metal plating, rods, and screws I get this fun lamenated card to show at the airports...even though it's titanium mostly....i think it's more fun to just show the card to everyone since I "earned" this last 5 hour surgey with a huge Frankenstien scar down the back of my neck...thank goodness my 3rd one on the front of my neck is healing great and small.... The bad news is after all these years with failed fusions I have chronic pain but also see the most wonderful and caring pain managment Dr whom is so sweet and in the same office and works with my surgeon...

Ok...sorry for rambling....just wanted to say that there is a difference between a non-fusion and then just having pressure put on your other discs above and below which is common....I hope and pray that when you talk to your Dr. that everything is ok....and that you don't have to have anymore surgeries for those sites......

Please keep us posted.....literally....hahaha...

Sorry, I am in a goofy mood today

Blessings,
Ingrid

Last edited by TraveltoSL; 03-11-2007 at 02:43 PM. Reason: sp..

 
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