| Re: Trying to understand CT scan report
When you have a disk/osteophyte complex, the vertebrae on either side of the disk are growing bone spurs where they interface with the disk. The disk itself may have been pushed backward, too. The disk and the osteophytes are intruding into the spinal canal, creating a narrowing (stenosis) and even going so far as to press on the cord.
The report doesn't mention it, but the severe canal narrowing may be because your canal is too narrow to start out with (congenital canal stenosis). If this is the case, then anything intruding into the canal has a greater and more immediate effect.
At each level, a nerve leaves the spinal cord to the left and the right. (e.g. the C4 nerve leaves from the C3-4 level). As the nerve leaves the cord, it passes through a bony hole called the foramen. A disk/osteophyte complex, or osteophytes growing off the facet joints, can narrow the foraminal opening (stenosis) and impinge upon the nerve. If your stenosis is rated "severe" by the radiologist, then this is probably happening.
Your surgical alternatives could be:
- Have a bi-level ACDF - at C5-6 and C6-7 - where the surgeon comes in from in front, removes the disk (and, I suppose, the osteophytes also), replaces it with a donor bone, and clamps the whole thing together. This is the traditional cervical spinal operation.
- I think this ACDF would most likely have to be followed by "foraminotomies", where the surgeon comes in diagonally from behind and shaves the osteophytes off the facets. This would remove the impingements on the peripheral nerves where they head off into your neck, shoulder and arms. Looks like you might need this all the way from C3 to C7. You have a LOT of osteophytes.
- An alternative might be surgery called a "laminoplasty". If you actually are suffering from congenital canal stenosis, then you can gain a lot more space in your spinal canal by swinging open the lamina (bones on the back of the spine) and putting donor bone and titanium plates to hold them open. This might be a more global solution. It would not fix the disk/osteophytes, but would allow the spinal cord to move backward, away from them. Foraminotomies could be done in the same operation to relieve the foraminal stenosis.
Laminoplasties are not yet common in North America, although they have been done for decades in Japan. They require an experienced and skillful surgeon to deal with the muscles behind the spine. And, of course, you have to be a candidate.
Please keep in mind that this is all from an interested but semi-informed amateur, and only intended to put you in a better position to talk intelligently with the surgeon.
And you REALLY should get at least two opinions.
Let us know what the NS says, please (and on this thread)...
Last edited by WebDozer; 01-23-2012 at 07:33 PM.
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