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    Old 02-17-2011, 02:53 PM   #1
    kujo85
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    Question Help with CT Scan Report

    I need help understanding my report. I'm seeing my Surgeon on Wednesday and i'd like to have an understanding of my report before i see him. If anyone can help me i would be eternally grateful. Thanks in advance...

    Report:
    CT SCAN OF THE CERVICAL SPINE WITH CONTRAST STATUS POST MYELOGRAM WITH 3D RECONSTRUCTIONS (INDEPENDENT WORKSTATION):

    Impression:
    1) At C5-6 and C6-7 levels, there has been an anterior fusion procedure. There are a few small areas of bridging bone, as described. However, a majority of the disk space does remain visualized.

    2) Uncovertebral osteophyte formation resulting in moderate to severe degree of foraminal stenosis bilaterally at C5-6 and moderately at C6-7.

    3) Satisfactory appearance of artificial disk at C4-5.

    4) Congenitally small spinal canal. There has been no interval change when compared to recently performed MRI of 01/26/11.

    5) Moderate right foraminal stenosis at C3-4 with truncation of the nerve root sleeve on CT myelographic images.

    Findings:
    The course and caliber of the cervical spinal cord is normal. The canal is congenitally small measuring just over 9 mm at the level of C4. Visualized portions of the intracranial structures and orbits are normal. The paraspinal soft tissues demonstrate mild enlargement of the palantine tonsils with tonsilliths, most consistent with inflammatory change. Visualized portions of the lung apices are free of disease.

    The intervertebral disks are as follows:
    Occiput-C2: The occipitoatlantoaxial articulation is intact.

    C2-3: The intervertebral disk, neural foramina, and facets are normal.

    C3-4: The intervertebral disk is of normal height. There is bilateral uncovertebral osteophyte formation, right greater than left, resulting in moderate right foraminal stenosis. The right-sided nerve root sleeve is
    slightly truncated. There is mild congenital spinal stenosis.

    C4-5: The patient is status post artificial disk placement anteriorly. There is metallic artifact related to the artificial disk and given this proviso, there is no compromise of the central canal. There is uncovertebral osteophyte formation, left greater than right, resulting in a mild degree of left foraminal stenosis.

    C5-6: The patient is status post anterior fusion procedure with screw and plate fixation and graft placement. The posterior and lateral margins of the fusion have significant lucency extending through at these levels. However, at the anterior margin of the fusion just posterior to the plate, there are areas of solid and bridging bone. There is uncovertebral osteophyte formation bilaterally resulting in a moderate to severe degree of foraminal stenosis. The patient has mild congenital spinal stenosis.

    C6-7: The patient is status post anterior fusion procedure at this level with graft and plate fixation. There is significant lucency about the posterior and lateral margins of the graft. However, anteriorly and just apposed to the plate, there are a few areas of solid bridging bone. There is uncovertebral osteophyte formation and moderate degree of bilateral foraminal stenosis. There is mild congenital spinal stenosis.

    C7-T1: The intervertebral disk, neural foramina, and facets are normal.

     
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    Old 02-19-2011, 09:51 AM   #2
    jennybyc
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    Re: Help with CT Scan Report

    Okay...so it appears you had an ACDF at C5-6, C6-7. the first thing the report says is that they can see the disk space and only small areas of bone bridging from the bone that was supposed to fuse the area...in other words, the fusion is dissolving or has been absorbed. And from the statement below that, they never opened up the foramina where your spinal nerves exit to the body and now they are blocked to a severe level(at C5-6) meaning you need to have them opened up before they kill the spinal nerves. Nerve and spinal cord compression is rated by minimal, mild, moderate and severe. You have moderate compression at C6-7 of those same spinal nerves(the nerves that peel off the spinal cord and go out to the body).

    Your ADR looks good.

    But at C3-4, you again have a foramina blocked to a moderate degree meaning you have moderate nerve compression on the right side.

    BTW...foramina means "opening" and it is the hole in the bone that lets the nerves out to the body.

    You also were born with a small spinal canal.

    They can do surgery to open these foramina(foraminotomy) and they can also do surgery to open the spinal canal and enlarge it without further fusion(called a laminoplasty). I had both done from the back of my neck. You may not need the laminoplasty if the canal is not encroaching on the cord.

    Hope this helps and if you have more questions, I'll be around.

    Jenny(fused C3 to T1)

     
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    Old 02-19-2011, 12:09 PM   #3
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    Re: Help with CT Scan Report

    Thank you Jenny for the response. How's your pain now with the surgeries? I had a really rough time with my first one when they went through the front. I still have problems swallowing. I'm hesitant to do it all again, but the headaches and my pain now make it difficult to function. I'm also not happy about being on pain killers and muscle relaxers all the time either. It's difficult to decide what to do. My pain management doctor isn't very understanding either. I just don't know where to go from here.

     
    Old 02-19-2011, 02:34 PM   #4
    jennybyc
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    Re: Help with CT Scan Report

    It really does sound like you need those foramina opened up and that alone should bring your pain levels way down. That compression on those nerves can be very painful but if you start to feel more numb than hurting, then you know it's really time for surgery. Numb means the nerve is dying. I thought it was getting better when it slowly stopped hurting...wrong. I was becoming paralyzed form the neck down.

    My case is different from anyone here. I started with a brand new surgery to reduce the compression on my cord(the laminoplasty I mentioned) and then 3 months later, broke 3 vertebrae and dislocated 5. So it was back into surgery for a 6 vertebrae fusion from the back(my first one was from the back too). And then I capped the experience by almost dying 4 days after surgery when I stopped breathing repeatedly. Ended up with minor brain damage as well.

    It's been a long haul but I am not in pain management and take no pain meds except ibuprofen or Tylenol although I do take a muscle relaxer now as I have new bone spurs inside my fusion where they can't get to them and they are digging into my cord and nerves again. I use it only at bedtime. I am however, retired on SSDI. They had no idea if I would get the brain function back and when.....I couldn't read or write by hand so that makes working a bit impossible. Still have trouble typing. Some fingers on my left hand do as they please! I have recovered from the resulting paralysis...at least 95% of it.....but will always have residual problems like lax joints from nerve damage to the joints on the left side.

    Now my doc is watching my lumbar spine as well, as it is showing some strange problems along with my annual neck MRI to see how bad the bone spurs are. Once a bad spine, always a bad spine. Pays to have a good spine doc. I hope I never see the inside of his OR again(but I probably will).

    hugs............Jenny

     
    Old 02-21-2011, 10:45 PM   #5
    kujo85
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    Re: Help with CT Scan Report

    Oh Jenny, that sounds like such a nightmare. I hope you never see the inside of an OR again too. How long ago did all this happen? I'll be thinking good thoughts for you.

    Thank you so much for responding to me and helping me with my CT Scan. I really appreciate the help. It's really good of you to come on here and share your experience.

     
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