[canwin67]

Hi, my name is Candace. I've had neck problems for over 20 years because of a car wreck that gave me a severe case of whiplash.
Last year I was rear-ended again which reinjured my neck. I suffered for months in pain before I finally broke down and went to the ER thinking they would give me steroids and pain meds and send me on my way. The pain seared from my neck and down my left arm making it feel like it was on fire and my pinky and ring finger were completely numb. I was in complete agony. They sent me for ex-rays, a CT scan and an MRI. To my surprise, the MRI showed multiple levels of damage and it was decided that I would have a posterior laminectomy at C7-T1. The surgery went well and when I awoke, I was thrilled to find the searing pain gone although my fingers were still numb and my hand was still weak.

At the time I did not have insurance, so I didn't do any physical therapy and only had one post-op visit with the neurologist and that was to remove the staples. I recovered pretty well and soon went back to work but the numbness and weakness persisted and my neck remained achy.
A week ago I was carrying a load of laundry, didn't see one of my daughter's toys on the floor and I tripped landing with the brunt of the impact on my chin which caused me to hyperextend my neck. The pain was instantaneous and massive. This time I was only able to stand it a day or two before I was back in the ER, begging for some kind of relief and terrified that I had somehow "broken" the surgery.

They ran the same tests again (ex-rays, CT scan, and MRI with and without contrast) and immediately checked me into the hospital. The attending physician said I have the c-spine of an 80 yr old woman (I'm 45) and immediately got neurology involved. It ended up being the same neuro as before and this time he wants to do an anterior fusion of three levels that would include donor marrow and hardware. The neurologist was getting ready to go on a three week vacation so since I have insurance now, he set me up with a pain management doc, a Miami J collar that I'm to wear at all times and an appointment to see him when he gets back into town.
After I got out of the hospital, I went to the pain management doc who suggested three left transforaminal epidural steroid injections at c4-5, c5-6, and c6-7 at 5k a pop. The injections gave me a very small amount of pain relief and for now he is managing my pain with percoset, zanaflex and lyrics. Of course he wants to do another round of injections, this time going in at the back of my neck. The neck pain and the shooting pain down both of my arms is so bad that I'm willing to try anything...especially since the neuro won't be back for a couple of weeks.
Since I didn't have insurance the last time around, I got very minimal care and really knew next to nothing about my test results and the extent of my injuries.

Thankfully this time, I've got insurance and was able to get the MRI results and copies of all the doctors reports which I have to be honest...they sound pretty terrifying.
If you don't mind, I am going to share the MRI report in the hopes that I can get a little advice and maybe some piece of mind. Here goes, OK?

The c1-2 relationship is within normal limits.
At c2-3, mild disc space narrowing is noted with broad-based posterior disc osteophyte complex greater to the left than to the right. This produces moderate encroachment of the left c2-3 foramen. No pathological enhancement.
At c3-4, there is broad-bases annular bulge with disc osteophyte complex formation bilaterally resulting in moderate to severe bilateral foraminal stenosis without evidence of herniation. No evidence of pathological enhancement.
At c4-5, the disc space is relatively well preserved but there is moderate left posterolateral disc osteophyte complex formation producing moderate to severe left foraminal stenosis at c4-5. No evidence of acute herniation. The left side of the spinal cord appears to be flattened at this level though the CSF space can still be seen anterior to the cord.
At c5-6 there is marked disc space narrowing and anterior osteophyte formation as well as endplate degenerative changes. Broad-based disc osteophyte complex formation is present slightly greater to the right than to the left. The right foraminal stenosis is severe and the left foraminal stenosis is moderate to severe. There is indentation of the spinal cord secondary to central disc osteophyte complex. The cervical cord appears slightly flattened.
At c6-7, the disc space is moderately narrowed with moderate broad-based disc osteophyte complex formation producing cord flattening and bilateral foraminal stenosis. No evidence of pathological enhancement.
At c7-t1, there is focal left posterolateral annular bulge and high signal in the posterior annulus raising the possibility of acute annular tear. The focal disc protrusion produces left c7-t1 foraminal stenosis and some displacement of the cervical cord to the right of midline. No evidence of pathological enhancement.
The t1-2 level is unremarkable.

There do appear to be postoperative changes in the left posterior spinal soft tissues. The lamina and spinous processes remain intact.
Impression:
1. Severe multilevel cervical degenerative disc disease with a very similar pattern compared to July 2012.
2. There are areas of cervical cord flattening at c5-6 and c6-7.
3. Multilevel foraminal stenosis with specific levels described above.
4. Left posterolateral disc profusion at c7-t1 with possible acute annual tear.
5. No marrow abnormality detected except for the endplate degenerative changes at c5-6.

So that's the whole report. What concerns me the most is impression #1. If it's a very similar pattern to my last MRI, it makes me wonder why the neuro didnt perform the fusion last year that he wants to do now. It worries me and makes me think I should find a different neurologist. The other scary part if this MRI is the evidence of the spinal cord flattening. what does that even mean? I'm terrified that I'm going to move the wrong way and end up paralyzed.

I'm sorry if I'm being a drama queen but I am very frightened. I'm divorced and take care of my aging and ailing mother. If something were to happen to me, I don't know how we would make it.
If you made it this far, thank you so very much for reading. I apologize that my very first post is so long. If you have any advice or words of encouragement, I would greatly appreciate hearing from you.
Thanks again,
Candace

[glenntaj]

--though I am sorry for the spinal issues that have brought you here (which do sound extensive).

I am not as much of an expert on the surgical implications of your report as a number of people on our spinal forum would be (if you haven't seen that yet, the link is http://neurotalk.psychcentral.com/forum22.html), but is does sound as if you need more than one neurological consult, and certainly more than one surgical neurological consult (and yes, it would have been helpful to have the earlier reports to get some idea of the reasoning behind the type of surgical procedure chosen for you the first time.

Do click on over to the spinal forum and get the opinions of some of the people there who have been through cervical issues and surgeries.

[canwin67]

glenntaj, thank you so much and thanks for the link! I will definitely check it out.

[Darlene]

Candace,

It is great to have you come and be with us. You will fine a great number of dear friends to listen when you are in need of ears. Please, just let us know how we can help you out. You will find out we are supportive and relaxing place.

Sorry to hear of the pain you are going through. Looks like glenntaj has given you a wonderful place for some answers.

Please keep us up to date on your situation. Again welcome, looking forward to seeing you around. My thoughts and prayers are with you.