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Old 02-22-2010, 10:46 AM   #1
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Talking Hello, back after 7 years

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.

Findings:
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.

Impression:
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.

Cheers
Cliff

Last edited by Administrator; 03-26-2010 at 08:43 AM.

 
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Old 02-22-2010, 02:18 PM   #2
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Re: Hello, back after 7 years

Sorry to hear of the progression of your neck.....some call it transitional syndrome. From your report (obviously you had to go to the doctor to have the new MRI done) it sure sounds like you might be needing further surgery. While MRIs can be overread, a good doc does a thorough exam and listens to your current symptoms. People can have horrible looking MRIs but not be all that symptomatic.

Can you tell us more about what you are experiencing at this time?

 
Old 02-22-2010, 04:06 PM   #3
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Re: Hello, back after 7 years

This time started out slow, at first was not even sure, slight numbness on pads of fingers. Then started to feel a cool feeling on back of left arm & hand. I then told my PCP that I think you should send me back to see my spine doc. He did, but it took four months to get in. In that time the slight cool feeling has become a burning sensation and the whole arm and shoulder ache and has weakness. Neck pain now that radiates down shoulder blade and up back of skull, sometime screaming pain. Doing anything aggravates the neck pain. Now back of right arm has cool sensation and aches occasionally. And when right is acting up quite a bit of pain between shoulder blades. I have so far seen a PA (just figured that out today, thought he was a young doc in training due to his age) who set me up for the CT/Myelogram and has prescribed Gabapentin, in ever increasing dosages. The Gabapentin he prescribed does seem to dull the worst of the pain, but I still hurt. (guess that is why the ever increasing doseages) (but still the arthritis in my knees, hands and most other joints still ache, especially at night. What a joke on me, hands are numb, but the joints still ache a lot. :-)
The next appointment, in just over a month will include the original doctor. (hallelujah, I like her a lot, she knows her stuff and tells it like it is, no wishy washy crap.)
Oh, ya, forgot to include middle to little toes are numb most of the time as well as some of the feet. And yes, I have fallen, but I CAN get up. :-)
I expect at that time I will be able to get some answers. I am quite worried about the long term now considering some of the verbiage in the report. It looks to me like I need surgery now and from what little I understand of the report can only expect my bones to continue to fall apart. So I am worried as how many times can they cut me before the results are not worth the effort?

I have to laugh, crying does not do any good, I saw a rheumatologist about my joint pain, the knees & hands get so bad at times I can hardly walk or use my fingers, just before the numbness became constant and all I got out of her was I was getting older, no sh*t. She kept on and on about gout, but when my left wrist acts up the only thing that seems to help is apply pressure to the wrist, which rules out normal gout, which she said. But she does want me to contact her when that wrist acts up again so she can try to fit me in so she can then stick a needle into the wrist to run test. (COLD COLD day in hell before I let her stick a needle in a wrist that is already in excruciating pain, and I told her that and she still wants me to call)(I HATE needles, a phobia that is only getting worse as I age)(The Myelogram was not fun, good thing they strap you down, ha ha, I laugh now, at the time is was in a panic)

Cheers
Cliff
__________________
Apr 03 C5 corpectomy C4-C6 strut graft with titanium
May 03 Heart Attack, Balloon Angioplasty & Stent implanted
Apr 2010 sched for ACDF and laminectomy & stabilize C3 (maybe C2) to C7

Last edited by IonMan; 02-22-2010 at 04:18 PM.

 
Old 02-22-2010, 08:54 PM   #4
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Re: Hello, back after 7 years

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.

 
Old 02-22-2010, 09:28 PM   #5
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IonMan HB User
Re: Hello, back after 7 years

Thank You for your reply.
You have confirmed much of my interpretation and explained the “big words”. I had already resigned / persuaded myself that more surgery is in my future. Now the question is how much and (in a depressed voice) how often. My next appointment is with the surgeon who worked upon me in 2003. I like her quite a bit and even better I trust her. She is a straight shooter and no BS, and even better if you ask a question she responds, good or bad. So when / if she asks I will respond with, “How soon can you clear it with my insurance?” Besides the symptoms are progressing fast. I just hope I have some bend in my neck (got to tilt my head to focus my progressive lenses, LOL) when it is all over and not need more surgery for a long while.

Cheers
Cliff
__________________
Apr 03 C5 corpectomy C4-C6 strut graft with titanium
May 03 Heart Attack, Balloon Angioplasty & Stent implanted
Apr 2010 sched for ACDF and laminectomy & stabilize C3 (maybe C2) to C7

Last edited by Administrator; 03-21-2010 at 08:58 PM.

 
Old 03-24-2010, 07:12 PM   #6
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IonMan HB User
Talking Re: Hello, back after 7 years

Update::

I saw the surgeon today.
I was told her first opening is on 1 April , what in 8 days!! Hell, I had not even heard from the cardiologist and he was suppose to set me up for a stress test, and I saw him on the 11th and was awaiting a call with the appointment. Well, my surgeon had one of her people on to their office and most definitely got things moving. They called shortly after I got home, asked a few questions and said they would call me tomorrow with date, time, and place. Got my pre-op physical set up today too.

I was told that I had a congenital condition where my spinal canal is narrower than normal. Well, isn’t that special, my neck is falling apart and no spare room in the spinal canal. She is going to do ACDF and laminectomy (not sure how many) and stabilize from C3 to C7. (maybe C2 too, depending upon what she sees)

Pretty much what had figured. Just so soon, I was putting getting ready off, expected at least a couple of weeks to prepare. So much to do now to get ready, lay in supplies, have my trusty lazy-boy moved into bedroom. Damn, sold the small refrigerator I bought the last time. Lets see, bendy straws, soup, water, fudgesicles, popsicles, go-gurt, and so many other things, Oh, ya gatta have an air horn. LOL

Also asked about head movement after and was told just about what you have now. Ha, I act like I have a stiff neck now, IE.. I don’t bend, twist, nod, spindle or mutilate, as is.

I guess a job sitting behind a desk is out. How do you look down with out hunching over? Guess I’ll have to be a wal-mart greeter.

Time to go before I get morbid again.

Cheers
__________________
Apr 03 C5 corpectomy C4-C6 strut graft with titanium
May 03 Heart Attack, Balloon Angioplasty & Stent implanted
Apr 2010 sched for ACDF and laminectomy & stabilize C3 (maybe C2) to C7

 
Old 03-25-2010, 01:02 PM   #7
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sk84life HB Usersk84life HB Usersk84life HB User
Re: Hello, back after 7 years

Glad you got in to see your doc, she gave you the 'straight shoot' and got the ball rolling with the cardiologist! Sometimes it is better to be busy in the remaining days! I remember having only 10 days to get an EMG, stress test, H&P, lab work, stuff for the house, etc. It was whirlwind of activity while still working full time! I had become very unstable from C3 to C5 and was already fused C5-6. I won't kid you, going into the neck a second time and up to C3 can be a rough recovery. Lots of pillows for the bed and many light mysteries to read helped. It was the muscle spasms that almost did me in, but the chiro in my doc's office got them relieved in 4 visits.....and I had to drive 60 miles each way by myself. It can be done! I too have progressive eyeglasses and found using half reading glasses (cheapo at Ocean City Job lots - $2 each pair) a big help for reading in bed. As for range of motion, it will gradually improve to where you are now. Be patient! Don't forget to keep the TP within easy reach and take stool softeners right away - have them start it while you are in the hospital.

Since this is congenital, this should fix you up real good! Sorry you have to go through this again, but I know you have a good attitude!

 
Old 03-26-2010, 08:44 AM   #8
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Re: Hello, back after 7 years

Good advice, especially keeping the TP within reach.
I saw my primary yesterday for the pre-op and was astonished to have the nurse tell me that I was 5' 7", I am 5' 9 1/2" and have been for years and I am sticking to it!!

I had to sleep in my recliner the last time as the damn J-collar would not cooperate with pillows to let me lay on the bed without sudden sharp pain once I thought I had found a comfortable position and lay there for a bit, I tried and tried. The chair was not too bad once I sort of got used to it, but was very glad once the j-collar was gone, eight long weeks. I was told this time I won’t need the collar more than a few days as the “struts” will be nailing most of the cervical vertebra together. I will admit I am a bit apprehensive about the posterior surgery. With the ACDF, been there, done that, so I know what to expect. With the descriptions of the posterior work, it sounds a lot more involved and intrusive with the muscles and such in the back of the neck. And my surgeon did say it would take longer to heal. It is a bit disconcerting to read of muscles being peeled from the bones.

I never had any trouble with the plate that was inserted back in 2003 when flying, but with the rods, clamps, plates and screws I have to wonder if I will set of the current detectors they use. Not that I have much reason to fly much anymore, I used to travel a lot for that work.

Actually probably won’t be doing much flying anymore. Part of the reason I left that work was the huge changes over the years with airlines and airports. I started flying in the mid 70’s and for business in 81. Back in the days when you were treated as a customer, a valued customer. (I once was the only passenger on a 727, unthinkable now) Now once they have your money, you have to pony up more money for them to fly and loose your baggage, then everyone from the counter agents to the “flight attendants” treat you as if you were cattle, and don’t even get me started on the TSA. Then if you do try to speak up you are threatened with being arrested for annoying them.
Well this rant needs to wind down, or else I will really tell you what I think of the airlines that have been bailed out by the taxpayers whom they have no regard for. Personally I think the bailout should have been that each taxpayer should have gotten a voucher to fly and then we all would have gotten something out of the huge bailouts. Using the vouchers would have given the airlines a boost as well as the public feeling like they got something too, other than the bill.

Don’t mind me I am just a grumpy old man.

Cheers

PS: every since when ever I sit in that chair for too long I fall asleep.
__________________
Apr 03 C5 corpectomy C4-C6 strut graft with titanium
May 03 Heart Attack, Balloon Angioplasty & Stent implanted
Apr 2010 sched for ACDF and laminectomy & stabilize C3 (maybe C2) to C7

Last edited by IonMan; 03-26-2010 at 05:14 PM. Reason: removed rant

 
Old 03-26-2010, 08:50 AM   #9
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Re: Hello, back after 7 years

I suggest that everybody reread the FAQ occasionally.
__________________
Apr 03 C5 corpectomy C4-C6 strut graft with titanium
May 03 Heart Attack, Balloon Angioplasty & Stent implanted
Apr 2010 sched for ACDF and laminectomy & stabilize C3 (maybe C2) to C7

Last edited by IonMan; 03-26-2010 at 05:12 PM. Reason: post deleted

 
Old 04-13-2010, 08:29 AM   #10
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Re: Hello, back after 7 years

Hello all,

OK first post since surgery. I underwent surgery on the 1st of April.
Luckily I did not have to have C2 nailed too. So it is just C3 to C7.
I can not tell you how much I disliked the intubation tube when I awoke. Then the indignity of having my hands tied so I could not disturb it. I vaguely remember it being inserted. “swallow, swallow” and them the lights were out.
I admit I was quite sore for the first few days. But compared to where I was at this point 7 years ago, well there is no comparison, I feel great. The last time I was hurting for a few weeks just to move and was on the pain pills for at least a month and a half and had to wear that modern invention, the Miami-J-collar.

The incision in front is not even noticeable, pain wise. The back of neck, well it was surgery, need I say more? I really did not like the oxy-whatever, so went of them ASAP. Taking extra strength Tylenol now for pain. Most of the time that is sufficient, other times I lay back in my recliner with a small pillow and give it a little time. I did get to see the x-ray they took prior to leaving the hospital and have plenty of metal in the back of my neck, including a long row of staples. She did remove the old plate in the front, from the surgery 7 years ago. (should have asked to have it as a charm)
This is my first time with staples, and I really dislike them. I am hopefully going to have them out tomorrow. (that should prove enlightening
The incision, from what I am told, kind of hard to see myself, is clean and healing well. So I stopped putting a dressing on it the other day. The next morning shortly after getting up I was sitting up in a chair letting the brief twinges from the motions of getting out of bed, whoopee, I don’t have to sleep in the recliner all the time!, anyway, I felt some liquid run down my neck and around to the front where I could see it, it was serum with a tinge of blood. (sort of look like the iodine cleaner they use when I wiped it up, betadine is it?)
Can anyone tell me if this is normal? Is it because of the staples that I ooze after moving a little too strenuously?? When I touch / probe the area I do not have any areas that feel inflamed or tender. Of course I am back to keeping it covered.
Eating now requires a bib, as I don’t bend the head forward much now.

Symptoms since surgery: Still feel much of the numbness, although it might be receding. (wishful thinking?) The pain in my left shoulder is back, but the freezing sensation on back of left hand and arm is much relived. Since I had to stop taking my daily aspirin and Relafen (for my arthritis) my hands are driving me to distraction. So some days the hands feel like nothing but clubs that ache. Eating solids is slow and not much at a time as solid food feels as if it sticks in my throat. I drop my pills into applesauce to get them down, although it is slowly getting better. I guess much of the swelling has gone down. I was told that the day after the surgery the diameter of my neck was easily twice that of normal. (hence the damn intubation tube, gotta breathe somehow) Also a little unsteady on my feet at times, but again I hope that is getting better. Typing is still a chore, still takes more time to correct then anything else. (if not for spellchecking & Google (not too good of a speller) this would be indecipherable), using the mouse is much easier as I have an arm rest.

Well the arms want to hang and rest now.
Good luck to the rest of you.

Cheers
Cliff
__________________
Apr 03 C5 corpectomy C4-C6 strut graft with titanium
May 03 Heart Attack, Balloon Angioplasty & Stent implanted
Apr 2010 sched for ACDF and laminectomy & stabilize C3 (maybe C2) to C7

Last edited by Administrator; 03-23-2012 at 09:39 PM.

 
Old 04-13-2010, 07:03 PM   #11
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jimsage85 HB User
Re: Hello, back after 7 years

Welcome Back!
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"I wear female eyeglasses because they want me to see things their way” - improved from Jayson Feinburg's quote

 
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