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Old 08-28-2012, 02:13 PM   #1
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CT Scan Results Discouraged!!!!!

11 Months ago (10/1/11) I had a C3-C4 Anterior fusion due to a disk issue as well as some neural issues. At the time the MRI said about this level "There is moderate to severe left foramen narrowing due to uncovertebral and facet osteoarthritis.

6 months later (3/2/12) I was still having the same left arm issues and they did a Foraminotomy/Laminectomy on the left foramen area in C4-C5.

Things were great after that surgery. Immediate relief and I felt so good for a period of 5 months and then the same symptoms of left shoulder arm pain came back. this was about 5 weeks ago.

I just had a CT Scan and these are the results:

C2-C3 there is a mild disc bulge and a mild broad based central disc protrusion, which partially effaces the cerebrospinal anterior to the cord. No cord deformity is seen. The neural foramen are patent.

C3-C4 there is a residual disc osteophyte bulge and central protrusion that mildly deforms the spinal cord, partial effacing the cerebrospinal fluid around it. There is moderate to severe left and minimal right neural foramen narrowing due to uncovertebral and facet osteoarthritis. This may affect the left C4 nerve root.

(*This is the level that there was surgery and the same verbage about the nerve openings is the same as what started this whole ordeal 11 months ago*)

C4-C5 there is mild left and minimal right neural foramen narrowing. There is mild flattening and deformity of the spinal cord due to a disc bulge and broad based central disc protrusion.

C5-C6 there is moderate severity right and minimal left foramen narrowing. There is a disc osteophyte bulge and broad based central disc protrusion that mildly deforms the spinal cord.

C6-C7 the neural foramen are patent. There is a mild disc bulge and a minimal broad based central disc protrusion without spinal cord compromise.

C7-T1 there is a minimal disc osteophyte bulge without spinal cord or neural foramen compromise.

I am very discouraged can someone help me make sense of this and what is ahead of me at this time. THX

Last edited by wlcasper; 08-28-2012 at 02:15 PM.

 
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Old 08-29-2012, 03:54 AM   #2
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Re: CT Scan Results Discouraged!!!!!

I could be wrong, but I doubt that an ACDF could reach the facet problem. I don't know about the uncovertabral problem, either. That might depend on the surgeon. Anyway, it would seem that the surgery left you with a "moderate to severe" foraminal problem at left C4. Perhaps as bad, the surgery did not even fix the disk-osteophyte complex at C3-4. And I really don't understand the "protrusion" that's still there. What, exactly, is "protruding"? Usually, when a radiologist uses that word, he means that a disk is protruding, but your disk was removed, wasn't it?

Looks like they sort of fixed the C4-5. When you say "laminectomy", do you mean they removed the entire lamina at that level (and that level only?), did they just remove part of it, or did they just shave some off the inside (usually called a "laminotomy")?

At C5-6, if you don't currently have a symptomatic problem, if looks like you are heading for one.

WL, I want to stress that I'm just an amateur with more experience than he'd like to have (three cervical operations over sixteen years). I would also like to stress that you need TWO more opinions, OTHER THAN from the doc who operated or anyone he knows. You need to hear from people who feel no need to justify or excuse past actions and, frankly, I think you need to hear from people who are BETTER than this first guy. You need a comprehensive explanation of what SHOULD have been done the first time, and what should be done now.

Get the best opinions you possibly can, even if you have to travel and/or pay out of pocket.

BTW, what, exactly, did your first MRI say about the C3-4 level (including the disk problem), and also the C4-5 level?

Last edited by WebDozer; 08-29-2012 at 03:55 AM.

 
Old 08-29-2012, 06:35 AM   #3
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Re: CT Scan Results Discouraged!!!!!

see post below

Last edited by wlcasper; 08-29-2012 at 07:03 AM. Reason: Double Answer

 
Old 08-29-2012, 06:44 AM   #4
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Re: CT Scan Results Discouraged!!!!!

I don't see the point in removing only half the disk.

What, if you know, did the first MRI say about that C3-4 disk?

 
Old 08-29-2012, 07:00 AM   #5
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Re: CT Scan Results Discouraged!!!!!

Quote:
Originally Posted by WebDozer View Post
I don't see the point in removing only half the disk.

What, if you know, did the first MRI say about that C3-4 disk?
I thought the disc was removed as well so I went back to the operative report and this seemed weird. I believe about half the disk was removed in the ACDF C3-C4 last October. The surgeon felt that the fusion would make enough room to solve the nerve issue and if he had to he would go back in and do the foraminotomy. C4-C5 became a problem as the fusion "settled" a CT mileogram (sp) showed the nerve issue. I believe the proceedure was a foraminotomy. As for C5-C6 I am symptomatic here, however the symptoms are so much like what I have had before I do not know if C5-C6 is an issue.

 
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