Hello all! It's been a few months since I posted and would like some help with a new MRI I just had done a few days ago. I had the C4-5 and C6-7 levels done with cadaver bones and hardware on September 5. When I woke up, the pain, tingling on the left side were gone, and eventually the numbness subsided. The C5-6 disc was bulging but not ruptured, so the surgeon did not remove it. Of course, I had the mid-back pain from shoulder to shoulder for quite some time. About 5 or six weeks after the surgery, I started experiencing some major pain on the right side. There is no numbness or tingling involved and the pain is different from what I experienced before my surgery. It's not constant and I have brief intervals without pain throughout the day. The pain involves my right shoulder blade, shoulder and my arm. The pain ranges from mild to severe. The doctor ordered another mri. I'm going to type the whole thing out. I understand the fused levels are good, but I need some input on the interpretation of C5-6.

At C4-5 there has been interval fusion. There has been significant decrease in the size of the disc osteophyte complex. Only mild canal narrowing is currently evident.

At C5-6, there is a post-fusion change. There is a diffuse disc osteophyte complex which causes mild to moderate central canal and right foraminal narrowing. The degree of central and right foraminal is unchanged from the preoperative study.

At C6-7, there are post-fusion changes. Previously seen right paracentral disc osteophyte complex is no longer evident. There is no significant canal or foraminal narrowing seen.

Impression:

Status post anterior plate and screw fusion from C-4 through C-7. The appearances of of C4-5 and C6-7 have improved. At C-5-6, there is persistent central canal narrowing with right foraminal narrowing unchanged from the pre-op study.

The reason I am asking for an explanation is because I do not see my doctor again for almost two months! He won't be in the office. Do you think I would have to have surgery again or is there some other alternative treatment that would help with the pain? I appreciate any insight from the group.

Beckel

At C5-6, there is a post-fusion change. There is a diffuse disc osteophyte complex which causes mild to moderate central canal and right foraminal narrowing. The degree of central and right foraminal is unchanged from the preoperative study.

Well I am as confused here as you possibly!?!?!

You stated that the doctor left C5-6 alone....the study says post op changes, then it ends with these are unchanged from pre op studies.....

Yes, I am slightly confused. I have the original MRI and it states:

C5-6, there is posterior disc osteophyte complex. There is mild canal stenosis. there is moderate bilateral neural forminal stenosis secondary to posterior osteophyte. The only difference I see is in the word "diffuse" added to the disc osteophyte complex and the word "moderate" added to narrowing. So it looks like the osteophte complex has spread out and the narrowing is getting worse. I asked him if he was going to remove the C5-6 disc before surgery and he said no. I am wondering if he had fused it, would I be having all this pain now?

well it is hard to answer. If the disc was healthy then it was probably in your best interest to leave it. The osteophyte or bone spurring, could have gotten worse for sure. Usually when they clip the osteophyte they do so from the anterior when the disc is removed. In order for them to get to that w/o removal of the disc is posterior.

It could most certainly be the source of pain btw. I can explain what I was told as I am C4-7 Myself, and it took two tries lol. The body senses trauma to the bone and sends signals to repair itself and then the bone starts to grow, this is how fusion is achieved. Now if there are bone spurs already present it can make them larger. Hope that helps a bit

Just to note I also experience this same type pain. Never had it like that prior to surgery. They did an MRI of my right shoulder and found out I had a torn rotator cuff....there was some etiology present as well to cause that kind of pain and I am also told that this is a normal type complaint from this kind of surgery.

Thanks Gator and it does make a lot of sense about the bone spurs getting larger. So if it actually came to the point of another surgery, they would go in from the back, correct? I didn't have this pain before surgery and if the conditions were present then, I wonder why? Maybe because they have gotten larger. You say you've had two surgeries, were they both ACDF?

Reading your post is is so similar what I been dealing with since acdf done in 7-2010 at same levels. Since surgery i been on predisone several times. Post surgery pain in right arm and shoulder--I actually thought I had a torn shoulder. I had surgery done down the street at U.H--- but it near cleveland clinic. My most recent MRI shows the nerve and C-5 Is pinched but not closed. DR doesnt feel its worth risking a revison surgery. The only thing that helps me is predisone but I have to be on it for several weeks before I see any benefit. Now Im seeing eye DR this friday because for the past 2 weeks I have horrible eye twitching every few secs and right bicep is always twiching not sure if this eye is realted to neck --hope not. I know how horrible this can be to deal with it ---Best wishes.

Well, I'm glad I'm not alone with this problem although I hate the fact that you are experiencing the same symptoms. I really think that the pain is coming from the bone spurs which have gotten bigger and cover a larger area at the C5-6 area. I am just tired of waiting for such long periods of time to schedule testing and then waiting weeks after the test to see the doctor. I really don't think getting a second opinion is a bad idea. Wish I had gone to CC in the first place. I hope you can find out what is going on with your eyes and your bicep. Thanks so much for your words of encouragement. Please let me know what the eye doc says.