Okay if anyone can read this and let me know if you think I need surgery please advise. I just recently had an ACDF C7-T1 on 2/20/09. Prior to that I had ACDF C6-7on 7/07 and Anterior Posterior L4-5 L5-S1 10/07. Right now I have severe pain in my neck shoulder blades, middle back, lower back, and numbness down my arms. It hurts when I take a piss or a crap, to push.
Here is todays MRI Findings
Post surgical changes are present with anterior
plate and screws at C7-T1, and interbody fusions at C6-7 and
C7-T1, better appreciated on plain films from 3/3/09. The
cervical vertebral body alignment appears anatomic. There is
mild reversal of the normal cervical lordosis in the upper
cervical spine of C3-4 which may be related to patient
positioning versus muscle spasm. The cranial cervical junction
and cervical spine cord are within normal limits.
Individual cervical levels are interrogated as follows:
C2-3: No central stenosis or foraminal narrowing.
C3-4: Endplate osseous ridging and posterior anular disc bulging
cause minimal central stenosis unchanged. Moderate right greater
than left foraminal narrowing not significantly changed.
C4-5: Posterior anular disc bulging and endplate osseous ridging
and uncinate hypertrophy, cause moderate right and mild left
foraminal narrowing unchanged. Minimal central stenosis
C5-6: Small disc bulging with osteophyte ridging without central
stenosis. Moderate right and mild left foraminal narrowing is
not significantly changed.
C6-7: Anterior fusion at this level. No central stenosis or
C7-T1: Anterior fusion at this level. No central stenosis or
T1-2: No central stenosis or foraminal narrowing.
Paravertebral soft tissues are unremarkable.
THORACIC SPINE: Thoracic vertebral body alignment is anatomic.
Marrow signal is within normal limits. No compression fractures
are seen. Schmorl's node affects the inferior endplates of T11,
T12 and superior endplate of L1. The thoracic cord demonstrates
normal caliber and signal intensity. Central disc protrusion at
T7-8 causes effacement of the ventral thecal sac and mild central
stenosis. Central/left paracentral disc protrusion at T8-9
effaces the ventral thecal sac essentially to the left and causes
mild to moderate central stenosis and may contact the ventral
thoracic cord at this level. Small anular disc bulge at T9-10
causes minimal central stenosis.
No foraminal narrowing is identified at any thoracic level.
1. Stable appearance of the cervical spine as detailed above
with anterior fusion at C6-T1. Minimal central stenosis as
detailed above. Multi level neural foraminal narrowing as
2. Disc protrusions at T7-T8 cause mild central stenosis and at
T8=9 cause mild to moderate central stenosis at T8-9. Minimal
anular disc bulging at T9-10 causes minimal central stenosis. No
thoracic foraminal narrowing identified.