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  • Help! More cervical spine problems after ACDF

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    Old 05-21-2006, 07:44 PM   #1
    horseygirl14
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    Help! More cervical spine problems after ACDF

    Hi everyone. I am new to this site. My husband, age 37, had an ACDF in January 2000 with great success. The fusion is solid. He's always been an active person. He was a wrestler in high school and started taking brazilian jiu jitsu after his surgery (it's a grappling art) - I am convinced this is the source of his problems now. He had some problems last year but not much showed up on his MRI. He had a fall at the gym a few months ago and has had problems on his left side since then - back, shoulder pain, tingling in his first 2 fingers. His recent MRI report showed the following.

    MRI REPORT - April 30, 2006

    The fusion at c3, c4, c5 is solid.

    There is reduced anteroposterior diameter to the spinal canal from c3 to c7 with anteroposterior flattening of the spinal cord. There is cord atrophy with focal myelomalacia posterolaterally on the right at c3-c4 and centrally at c4-c5. There is severe cord atrophy at c4-c5.

    At c5-c6 there is a large posterior osteophyte extending to the left lateral recess with ossification in the lateral recess extending inferiorly to the c6-c7 disc space. There is osteophyte formation extending into the neural foramina on the left at c5-c6 and c6-c7. The facet joints remain aligned.

    OPINION:

    Focal myelomalacia c3-c4 and c4-c5. Spinal stenosis. Left C6, C7 neural foraminal narrowing (this is the opening between the left c6,c7 vertebra where the nerves leave the spine - it is narrowed).

    Clinical correlation and confirmation with previous history suggested.


    His sports medicine dr. has him going for physiotherapy right now. He has an appointment for EMG testing this week (these same tests last fall turned up nothing). His appointment with the neurosurgeon is scheduled for June 13th. The neurosurgeon who did the first surgery is no longer practicing so we now have to see someone that we've only seen once before.

    Can anyone shed some light on his MRI report? I have looked up some terms on the internet but it's hard to decipher everything. The spinal cord atrophy especially scares me.

    Thanks for anyone's help or comments.

     
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    Old 05-22-2006, 06:58 AM   #2
    feelbad
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    Re: Help! More cervical spine problems after ACDF

    Yea,there are some rather big concerns with him and his c spine issues,I do hope that he is not in any way still doing anything that could cause this stuff to prgress.he has to be a bit more careful until some of this is actually somehow resolved.the cord atrophy and the myleomalacia would really be the biggest concerns as far as I can see,although there are some other big concerns here as well.i am wondering what is actually causing the cord to atrophy and the myelomalacia to occur?have his docs given you any real reason or indication of any sort of actual reason for this to be going on in there?if I remeber right(i did have the malacia going on inside my cord after my spinal cord surgery)this is an actual sort of granulization of spinal cord tissu?sometimes this is just present during the healing process and sometimes its not.mine eventually went away once things were finally healing properly.i do also have some rather extensive direct spinal cord damage that was left behind from the cavernoma resection done on the inside of my cord.

    Just a thought here but considering the extent and types of issues he has going on,i would really try and see if he can see a neurosurgeon who is affiliated at a good university teaching hospital if there is one fairly close by?even within a few hours drive would be worht it i think in order to really get the best opinion as to what should and shouldn't be done.you most definitely need to obtain at least one more opinon from another NS who is not affiliated in any way to the one you are seeing now,just to obtain a totally neutral opinon .

    personally,going to the U of MN for my third opinion on just what I should and should not do with regards to the cavernoma that was found in my cord,was really the best place for me.the head of the neurosurgey dept who also hasd over thirty years of experience actually is my NS and he is the one who actually did my surgery.

    I had to obtain that third opinion as the first two were totally different as far as what should be done and I needed that "tie breaker"?I just really feel that the teaching atmosphere and the fact that in most cases,the universitys really see the most extensive and the harder to treat cases so they just have a naturally higher experience rate with the more involved types of neuro issues this just makes them one of the better places for the best possible eval of a particular condition or spinal problem.

    either way though,i would not do anything as far as any surgical intervention until you have obtained at least one more opinion.i would never ever rely on just one surgeons particular feeling about any one of my many medical problems.you have no clue as to just how really knowledgeable and experienced the one and only NS you see really is,you know what I mean?and if they do not kind of stay up to date on the latest or newer types of treatments,well you as the patient really are not getting all of the options that are realistically availiable to you.

    just make sure you really check into seeing another NS to see what they have to say after you get the first eval done and that NSs impression or your hubbys overall condition and treatment options.sorry I couldn't be more specific about all that you were wanting to actually know.please keep us posted tho on what you find out.I wish you both lots of luck with this.Marcia
    __________________
    3-22-01,herniated C-6-7
    11-20-01,placement of hardware for failed fusion
    9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

     
    Old 05-22-2006, 07:34 AM   #3
    horseygirl14
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    Re: Help! More cervical spine problems after ACDF

    Thanks so much for your long reply. I really appreciate it. I have definitely been thinking about getting more than one opinion. I asked the sports medicine dr. if he needs surgery and he said no, but he's not a neurosurgeon. I really wish the neurosurgeon who did his first surgery was still available as we really liked her a lot. To complicate things as well, my hubby's family dr. closed his practice in April and he is without a family dr. at the moment although he could probably see my dr.

    We haven't seen the neurosurgeon since last fall so we haven't had his opinion on this latest MRI yet. We see him on June 13th. The wait is driving me crazy.

    We live in Canada and there are many good teaching hospitals here in Toronto so I think I will look into things a bit further in that respect.

    I will keep you posted. Thanks.

    Sherry

     
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