2 years POST ACDF New CT Myleogram Desperately Help

2 years POST ACDF New CT Myleogram Desperately Help

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tamter
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Last seen: 4 years 3 months ago
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Joined: 12/18/2008 - 10:34am
2 years POST ACDF New CT Myleogram Desperately Help

Ok just got back from my Ct Myleogram and here it is doesn't seem good.
Surgical changes include c5-6-7 ACDF with high denisty cages in the intervening discs. Botoh cages re confluent with adjacent superior endplaes There are som lucencies demarcating the cages from the adjacent superior endplates of 6 & 7 There is no excursion at C5-6 on the flexion extension view, but motion persists at c6-7. There are no ventral defects demonstrated at 5,6, or 6-7 but CT demonstrattes 1-2 mm right paracentralright c6 rootlets proximal to the foramen. thee is also a more diffuse hard disc at 6-7 toward the right foramen. the right 6-7 root sleeves fill less distally thant the left on both the myelogram and on ct. If there are coresponding radiculopathies this may be significant. Thee is reisidual ossifcication on the posterior longitudinal ligament at 5-6 which just reaches the dural sac there is no associated stenosis. Shallor ventral extradural defects are present on the myleogram at 3-4 and 4-5 CT demonstrates a 2 mm diffuse disc protrusion with spondylosis and ossification kn the posterior longitudinal ligament resulting inmild ventral dural deformity without spinal cord impingement. the residual midsagittal dural diameter is about 11 mm There is mild right uncinate prominence at c3-4 without significatn foraminal stenosis.
At c5-5 ther is anterior spondylosis at a central 2-3 mm focal disc protursion which reaches and probably slightly retro displaces the spinal cord The risidual midsagittal dural diameter is about 8 mm There is also ossification in the posterior longitudinal ligament contributing to the ventraldefect at c4-5 There is mild left uncinate prominence at C4-5 withough significant foraminal stenosis.

There may be some annular bulging at c2-3 on ct Ossification is present in the posterior longitudinal ligament at c3, c4, c5 ,6 and c7. Cervical root sleeves other wise fill out normally and symmetrically.

conclusion C5 6 7 ACDF is noted with persisting motion at C6-7 There is residual or recurrent hard disc proximal to the right foramen indenting the dural sac at c5-6. Residual or recurrent hard disc is also narrowing the right foramen and indenting the dural sac at c6-7. The right c6 and 7 roost sleeves fill less than the left. Ossificataion persists in the posterior longitudinal ligament at c 5, 6, 7.

A 2-3 mm central disc protursion at c4-5 reaches and probably slightly retrodisplace the spinal cord leaving 8 mm residual midsagittal dural diameter. There is also a central 2 mm combined disc protrusion with spondylosis at c3-4 withoughspinal cord impingement. Mild uncinate prominence is noted on the right at c3-4 and on the left at
C4-5

Ossification is present in the posterior longitudinal ligament at c3 thru c-7. There is disc bulging without stenosis at c2-c3

My neurolgist is concerned about my fusion not taking at the 6-7 which I think that is what is meant by the report that says
c5-6=7 is noted with persisting motion at 6-7 this is the area he was worried about not being fused and with screw loosening. And also he was wondering if I had diagnosed a calcified ligament and I am assuming this is what the Ossification mentioned is. By all the report looks like i maybe doomed. I just really worried about fusion 6-7 not taking and loose. When I asked him before the CT if it was a clacificated ligament what was that treatment he said that would be discussed if this is what it was. Does anyone know what that treatment is and is it surgical? From what I am reading this report appears that I am pretty messed Up... And comments on all this PLEASE HELP!!!!!!!!1

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straker
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Last seen: 3 years 6 months ago
Title: Member
Joined: 06/27/2008 - 6:22am
i am sorry to see that

you are in a mess and i wish that i could help you .but this site is a patient led system and even though you have provided plenty of medical information .i doubt than any of us are qualified to give you the answers that you seek .we can support you and give our personal opinions but i guess that you are looking for more than that ..or am i wrong? there are many on here with a vast amount of experience under there belts and i may be wrong and someone may be able to give you more that just friendly support .i am Farley knowledgeable myself but it would be wrong of me to give you any information that you may act on and that the information i gave you could cause you more harm than good .i know that the moderators don't like patients with only there own personal experience giving other advice .i think we have a few doctors on hand but you would have to contact one of the moderators to be sure .my advice is for you to meet with your doctor and get him/her to explain your report to you .good luck
STRAKER

tamter
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Last seen: 4 years 3 months ago
Title: Member
Joined: 12/18/2008 - 10:34am
Straker, totally understand

Straker, totally understand and I do have a follow up with my Neuro tomorrow.. I was just wondering if anyone has had a problem with the OPLL I think it is called. And what did they experience is there conservative treatment they tried.. I know I feel like I am a mess. And I wonder if the all this could mean that I am not fused I know that was one of my dr concerns and also with the OPLL and this is something new that I have developed so wonder what others have experienced with this. Thanks again for the kind words..

optimist
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Last seen: 1 year 2 months ago
Title: Member
Joined: 06/20/2008 - 3:32pm
thoughts

I have been told by some surgeons that when there is lucency around hardware, as mentioned around the cages, that usually implies there is not a solid fusion and this has allowed the hardware to move. Hope the surgeon offers some thoughts too.

candle99
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Last seen: 2 years 4 months ago
Title: Member
Joined: 07/03/2008 - 9:27am
I had lucency around my screws and not fused

Hi, just relating myself to your MRI report about the lucency. I had a CT scan that somehow took all the slices of the bones going down and showed just the bones and hardware and I had lucency around all my screws that were supposed to be holding the plate onto C4 thru C6. I decided to change surgeons after a second opinion. I had to have more surgery to add posterior screws/rods in for stablization. It has helped with my neck pain quite a bit. I'm still have shoulder blade and mid back pain a month and a half later. Plus still using the fentanyl patches 25mcg/hr and hydrocodone for breakthrough pain.

I hope you get a really good explanation from your surgeon and what your options are. My new doctor has made a plan with me for what he can do for me if I want to go forward. Good luck.

krista.sanchez
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Last seen: 3 years 3 months ago
Title: Member
Joined: 05/18/2011 - 8:10pm
This October will be 10

This October will be 10 years since I had C2-C5 done and honestly I never felt better until I took a year and 1/2 completely off from work 6 years after surgery. Now the are getting ready to do some in my lumbar and I fully believe that if I don't rush back to work like last time and allow proper healing it should take a lot less time. PS, until i did take that time off I was on 50mcg Fentanyl Patch every 48 hours with percocet for breakthrough pain along with neurontin and zanaflez and a local lidocaine patch and afterward the time off was able to completely go off any pain meds until this new development. Please allow the proper healing!!!!

Joydancer
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Last seen: 6 months 6 hours ago
Title: Member
Joined: 08/01/2009 - 10:15pm
Myelogram - Assessment

tamter wrote:
Ok just got back from my Ct Myleogram and here it is doesn't seem good.
Surgical changes include c5-6-7 ACDF with high denisty cages in the intervening discs. Botoh cages re confluent with adjacent superior endplaes There are som lucencies demarcating the cages from the adjacent superior endplates of 6 & 7 There is no excursion at C5-6 on the flexion extension view, but motion persists at c6-7. There are no ventral defects demonstrated at 5,6, or 6-7 but CT demonstrattes 1-2 mm right paracentralright c6 rootlets proximal to the foramen. thee is also a more diffuse hard disc at 6-7 toward the right foramen. the right 6-7 root sleeves fill less distally thant the left on both the myelogram and on ct. If there are coresponding radiculopathies this may be significant. Thee is reisidual ossifcication on the posterior longitudinal ligament at 5-6 which just reaches the dural sac there is no associated stenosis. Shallor ventral extradural defects are present on the myleogram at 3-4 and 4-5 CT demonstrates a 2 mm diffuse disc protrusion with spondylosis and ossification kn the posterior longitudinal ligament resulting inmild ventral dural deformity without spinal cord impingement. the residual midsagittal dural diameter is about 11 mm There is mild right uncinate prominence at c3-4 without significatn foraminal stenosis.
At c5-5 ther is anterior spondylosis at a central 2-3 mm focal disc protursion which reaches and probably slightly retro displaces the spinal cord The risidual midsagittal dural diameter is about 8 mm There is also ossification in the posterior longitudinal ligament contributing to the ventraldefect at c4-5 There is mild left uncinate prominence at C4-5 withough significant foraminal stenosis.

There may be some annular bulging at c2-3 on ct Ossification is present in the posterior longitudinal ligament at c3, c4, c5 ,6 and c7. Cervical root sleeves other wise fill out normally and symmetrically.

conclusion C5 6 7 ACDF is noted with persisting motion at C6-7 There is residual or recurrent hard disc proximal to the right foramen indenting the dural sac at c5-6. Residual or recurrent hard disc is also narrowing the right foramen and indenting the dural sac at c6-7. The right c6 and 7 roost sleeves fill less than the left. Ossificataion persists in the posterior longitudinal ligament at c 5, 6, 7.

A 2-3 mm central disc protursion at c4-5 reaches and probably slightly retrodisplace the spinal cord leaving 8 mm residual midsagittal dural diameter. There is also a central 2 mm combined disc protrusion with spondylosis at c3-4 withoughspinal cord impingement. Mild uncinate prominence is noted on the right at c3-4 and on the left at
C4-5

Ossification is present in the posterior longitudinal ligament at c3 thru c-7. There is disc bulging without stenosis at c2-c3

My neurolgist is concerned about my fusion not taking at the 6-7 which I think that is what is meant by the report that says
c5-6=7 is noted with persisting motion at 6-7 this is the area he was worried about not being fused and with screw loosening. And also he was wondering if I had diagnosed a calcified ligament and I am assuming this is what the Ossification mentioned is. By all the report looks like i maybe doomed. I just really worried about fusion 6-7 not taking and loose. When I asked him before the CT if it was a clacificated ligament what was that treatment he said that would be discussed if this is what it was. Does anyone know what that treatment is and is it surgical? From what I am reading this report appears that I am pretty messed Up... And comments on all this PLEASE HELP!!!!!!!!1

Tamter, hope you are able to review your Myelogram more fully with your neurologist; and if not with a good spinal surgeon.

I have had ACDF on C-3/4.4/5,5/6 with bone implant (no hardware) successful fusion 17 yrs ago. I have ongoing DDD in remaining 2 levels in my C-Spine, causing nerve compression of two levels of nerve roots, as well have beginning changes of thecal sac deformity (narrowing by scoliosis and osteophyte ridging) on previous ACDF levels.

So I can relate to what you have going on.

What symptoms have you been experiencing with the unfused level and other degenerating levels? Have you had symptoms of neuropathy in arms/hands?

You are young and to have so many levels (all ?) degenerating in C-Spine. Were you involved in trauma injuries, ie. motor vehicle accidents?

I have had issues early in life 20;s began DDD because of deformity at 2 top levels, affecting the other 5 and needing surgery when I was 45. I have issues on all levels of C-Spine, similar to you, but different surgery.

I have had advanced DDD for past 5 yrs C=5 thru C-7 into T-1/2 and with progressive radiculopathy and past year because of nerve compression causing nerve damage and muscle atrophy in left lower arm/hand/fingers I am definitely candidate for surgery + have surgeon assessmests going on re: prognosis of reversing left arm & preventing right (mildly compromised). I also have issues at C-2/3 congenital deformed hemi-vertebrae and tethered on one side, where I have hyper-angled movement; which right now is not as much of a problem as lower levels.

I am not familiar with OPLL but I looked it up on
here's a link to pub-med publication; very resourceful site, which may help explain what it is and how medical field approaches treatment/conditions caused by OPLL.

http://www.ncbi.nlm.nih.gov/pubmed/17688057

Glad you are here on Spine Health, there are many of us that have multiple levels of C-Spine and advanced degeneration and conditions. Some have had surgeries, others have pending.

Stay in touch, hope you are able to get some good support from your neurologist and/or cervical spine surgeons.

Janelle