WebDozer - You're right, the radiologist could have been much more helpful in his interpretation of the MRI.
I have noted worsening neck pain, even when not moving. It really lets me know when I do the neck stretching exercises I have done since my original surgery in 2005, especially to the left side. Normally the pain is dull or aching and is somewhat constant, but can be sharp. I find I can block it out some of the time by concentrating on some task I am doing. Other times, it hurts enough that I have to stop what I am doing until the pain passes. Sometimes, the pain extends down into the shoulder blades or across into my shoulders. I really have pain in my biceps, left primarily, though the right also hurts upon occasion. The pain in my left biceps was like a band across the biceps and was achy and diffuse in nature (if that makes any sense). Recently the orientation and severity changed so that the pain is parallel to the biceps, just off the midline (away from the body). Pain is now sharper and seems more focussed. This pain is even evident when I lay down at night to sleep and often wakes me up; can't seem to find a comfortable position to put it. I also still have the sharp pain into my left ring finger. I do have occasional sharp headaches usually centered over one eye or the other or it feels like a sharp needle-like pain deep inside my head. I am having some balance problems when walking, occasionally when simply standing. No dizziness at any time. I don't know if I would call it clumsy hands or not, but I seem to be losing my grip at times, letting things fall to the floor without realizing I have relaxed my grip. No incontinence , just increased constipation . Oh and increased difficulty in swallowing. Since neither the recent CT or the MRI noted any of my fusion instrumentation or an osteophyte pressing against my esophagus, I guess there is another reason.
I just talked to the pain management staff to get the doc's take on this. He agrees there's a lot of wear and tear, but isn't ready to send me back to the NS yet. Not that I am advocating surgery, I just want to know if the situation just bears waiting or what. And when do I know that I have to get something done?
Reading report again, it looks even worse. he doesn't even say WHICH SIDE has the foraminal problems. It is exceedingly unlikely that both sides are the same.
As for the PM doc, I don't want to question his honesty, but he has a built-in advantage to keeping you coming back.
Can't you see someone in between PM and surgery, like an orthopedist? And get that MRI read by a different radiologist? If you want a name, I will give you one.
WebDozer -
I guess I assumed that with what is occurring at C5-6 and C6-7 foramina (left side) that it would also be that way at C3-4 and C4-5.
As far as the PM guy, at my last procedure, he said something a little odd to me before I went lights out. He said that there was a level of risk associated with these epidural/facet joint procedures and wanted to be sure I was still ok with having them done. I'm like - "Holy smokes, is my number coming up?" - because I have had several procedures over the last 2-3 years. So, I was left wondering if he thought I should stop taking them. His PA told me to relax, he was just making sure that they were doing the best for me. I have no reason to doubt these folks. And they are in the same building as my NS. neurologist, and PT people. One big happy family and all connected to the Huntsville hospital computer database.
There is an Orthopedic association connected to the hospital also. My problem is that my NS (who referred me to the PM doc) has operated on me twice and held if not my life, then my ability to use my arms and legs, etc in his hands both times. I have absolute confidence in his ability, but would not want to jeopardize a good relationship by going directly to him around my PM guy. In fact, I believe the NS practice requires a referral. Any suggestions? Maybe show the report to my family doc and ask for a referral that way?
Doesn't seem like there's much you can do, if you are stuck within that system. If it's just a matter of going to another city, you might consider it. As for showing the report to your GP, you need a better report, first....
My ROM is good. Keep in mind that I've only had one single-level ACDF, and that was on one of the less important disks (C3-4). The second operation was a foraminotomy, which has no effect on ROM, and the third was a laminoplasty, which is designed to preserve ROM...
I had my latest pain management procedure on 11/13/12. Before going under, I talked to the doc, explaining my concern about the not more than 8mm width of the canal at C3-4 and C3-5 (from the CT) and the impingement on the canal in that area (from the MRI). He agreed that I should be concerned but said if I were to have another fusion, I would probobaly need another in 5 years. I told him I was not advocating surgery, but again expressed my concern about the impingement. Then he asked if I had talked to my NS yet. I told him he requires a referral so he said he would put a note in my chart. Hopefully, I guess that means I will see the NS soon.
Saw my NS today (12/4/12) and he said we needed to fix the problems, or at least some of them. On 17 Dec, I have an ACDF of C3-4 and C4-5, removal of some of the osteophytes I have causing some of the compromise to the canal, plus removal of the old hardware from my earlier C5-6,7 ACDF. Spacers will be put in place with a mix of ground up bone from my spinous process and BMP, then some rods and screws to hold it all together. The deal should take abou 2 hours and I may or may not have to stay overnight. Las time I did this, the bone spurs had put a hole in the sheath surrounding the cord causing leak of CSF, and the doc had to glue it shut. Anyway, I had to lay flat of my back for hours and they kept me overnight. Hopefully, this time will be better.
Good luck with all that. I think it's remarkable that they'd even consider making something so extensive an outpatient procedure. Please keep us updated on the hospital stay and the recovery...
I had my surgery on 12/17/12 - ACDF C3-4, 4-5, removal of several bone spurs, and removal of the hardware from my ACDF 5-6,7 from 2005. Surgery went well, very little pain post op on Monday. Was encouraged to walk around the hall as much as I desired. Later that night, though, I started leaking what turned out to be CSF from my incision. The next morning the neurosurgeon put in some more sutures and staples and put me flat on my back for 24 hours to seal the leak. He told me that several of the bone spurs didn't just puncture the dura, they were growing into it. So, he had to disect them out and put an artificial sheath around the dura to repair the damage. It will absorb into the natural dura over time. I came home Wednesday morning and am doing pretty well.
So glad you are doing well and the CSF leak closed off on its own. It is always encouraging to hear of successful surgeries and experiences with our Drs and healthcare system! Hope your recovery is quick and your pain is relieved!
I had my surgery on 12/17/12 - ACDF C3-4, 4-5, removal of several bone spurs, and removal of the hardware from my ACDF 5-6,7 from 2005. Surgery went well, very little pain post op on Monday. Was encouraged to walk around the hall as much as I desired. Later that night, though, I started leaking what turned out to be CSF from my incision. The next morning the neurosurgeon put in some more sutures and staples and put me flat on my back for 24 hours to seal the leak. He told me that several of the bone spurs didn't just puncture the dura, they were growing into it. So, he had to disect them out and put an artificial sheath around the dura to repair the damage. It will absorb into the natural dura over time. I came home Wednesday morning and am doing pretty well.
Dear xcobra, Hi. Wow, you poor thing! Im glad that you were finally diagnosed correctly & that the NS found the leak & fixed all the problems with your neck. I had CSF leaks after LL ×2 & my original injury, repaired with fat and fascial grafts. Hope you are recovering as quickly as possible & are doing well. Would you mind explaining about the artificial graft or sheath that was put on your dura? Im quite interested, hope this isnt an inconveniece so soon post op. Thank you, gmak
gmak - I wish I could give you more info, but that's what the doc told me. During my C5,6,7 fusion in 2005, I also had a leak caused by a spur, but the doc was able to use "medical super glue" to close the hole. Back in my room, I had to lay flat for 12 hours or so. That's what was surprising this time. Everything I've been told about this current surgery would suggest to me that I would have the same "flat of my back" routine to follow; instead I was encouraged to walk the halls as much as I desired. I went back for my post-op visit on 27 Dec and the doc left all the sutures and staples in. He also withdrew 52cc of fluid from around the incision (which puffed up again over night as he said it might). I see him again on the 10th. I hope he doesn't put me in for a blood patch or whatever; I have no idea what the options open are - maybe just more rest.
gmak - I wish I could give you more info, but that's what the doc told me. During my C5,6,7 fusion in 2005, I also had a leak caused by a spur, but the doc was able to use "medical super glue" to close the hole. Back in my room, I had to lay flat for 12 hours or so. That's what was surprising this time. Everything I've been told about this current surgery would suggest to me that I would have the same "flat of my back" routine to follow; instead I was encouraged to walk the halls as much as I desired. I went back for my post-op visit on 27 Dec and the doc left all the sutures and staples in. He also withdrew 52cc of fluid from around the incision (which puffed up again over night as he said it might). I see him again on the 10th. I hope he doesn't put me in for a blood patch or whatever; I have no idea what the options open are - maybe just more rest.
hi cobra' Wow, Im so sorry to hear that that leak may still exist. I had to do the "lay down " thing for 3 months 3 times! i hope that it goes away by itself, absorbs etc. is it still puffy? Hope all goes well at dr. Please let us know how you are. thanks
gmak - yes, still puffy and starting to leak again, though not too adly. I can feel it on the dressing, though.
Hi xcobra, Im really sorry! I would call the dr this am for dr recommendation. I had to go to hospital right away when my dressing got wet, my dr said it was a meningitis risk! Please let us know your progress, praying for you.
gmak - I saw the doc on Thursday. He withdrew another 50cc from around my incision and removed my staples. I told him I had been seeping around the incision and he didn't like that and asked if I had been exerting myself any. I told him I had had some severe coughing fits and the seeping started right after. I go back to see him Tuesday. If I am leaking bad enough he will put me in the hospital and insert a drain. The dressing he put on does not feel wet, so hopefully there won't be any more drainage. The right side of my neck has started to hurt rather sharply in the last couple of days, too.
gmak - I saw the doc on Thursday. He withdrew another 50cc from around my incision and removed my staples. I told him I had been seeping around the incision and he didn't like that and asked if I had been exerting myself any. I told him I had had some severe coughing fits and the seeping started right after. I go back to see him Tuesday. If I am leaking bad enough he will put me in the hospital and insert a drain. The dressing he put on does not feel wet, so hopefully there won't be any more drainage. The right side of my neck has started to hurt rather sharply in the last couple of days, too.
Hi cobra, Im so glad that you posted an update, I have been worried & prayiing for you. My goodness, i know what you are going through & this reminds me of that horrible time. I am So Sorry that this is happening! I always had to have another surgery to patch the leak. One of my friends had a leak & it resolved on its own, but we prayed so much I think it was a miracle. I will continue to pray, I hope it has stopped on its own. I wore a pressure dressing & had to lay flat only up for the bathroom. I even had to bathe in bed. I got really good @ eating laying horizontal!Lol I had so much help & I hope that your family & friends are helping you. I will be looking for your update on tuesday. Thanks for the update, surely it will stop!
gmak - I saw the doc on Thursday. He withdrew another 50cc from around my incision and removed my staples. I told him I had been seeping around the incision and he didn't like that and asked if I had been exerting myself any. I told him I had had some severe coughing fits and the seeping started right after. I go back to see him Tuesday. If I am leaking bad enough he will put me in the hospital and insert a drain. The dressing he put on does not feel wet, so hopefully there won't be any more drainage. The right side of my neck has started to hurt rather sharply in the last couple of days, too.
Hi cobra, Ive been wondering what the dr said last tuesday & i hope that the leak has resolved!
, just increased constipation 
. Oh and increased difficulty in swallowing. Since neither the recent CT or the MRI noted any of my fusion instrumentation or an osteophyte pressing against my esophagus, I guess there is another reason.
