Hi, I'm new to this forum and I have had a C-Spine Fusion 1/2013 of C4, 5 & 6. The surgeon didn't do all of what needed to be fixed. I have a burning pain in my Thoracic area about mid level. I have hyper reflexes in my legs for almost the past yr...it's worse in my left leg and weakening. It buckled underneath me the other day and I landed on my butt. I've had several different tests done and have been getting corticosole steroid facet injections and epidurals in my neck and back for about 3 yrs. There are new findings...I'm including a few pages of MRI findings...some of them are a bit conflicting, some show what others don't. It just depends on the radiologist reading them. Anyway, if anyone has had any of this stuff or knows what action might be suggested or could just share their insight on any of this it would be greatly appreciated. Thank you in advance.


LUMBAR MRI, X-RAYS AND CERVICAL X-RAYS 11/15/13

Exam Description: Low Back Pain and radiculitis.
Technique: MRI Hitachi Oasis high field 1.2T Open MRI system. T2 FSE Sagittal, T1 FSE Sagittal, T2 FSE axial (angle),

FINDINGS: of LUMBAR MRI 11/15/13
ALIGNMENT: Minor Retrolisthesis at L5-S1
COMPRESSION DEFORMITY: None
DISC SPACES: Mild to moderate degrees of narrowing with relative sparing at L4-L5.
CONUS MEDULLARIS: Terminates at the lower L1 level with a grossly unremarkable appearance.
MARROW SIGNAL: No gross marrow edema.

DISC DEGENERATION:
At L5-S1: There is minor disc osteophyte ridge formation.
At L4-5: There is diffuse disc bulge with right foraminal/lateral annular tear.
At L3-4: There is diffuse disc bulge.
At L2-3: There is minor disc bulge.
At L1-2: No focal herniation is noted.

CANAL STENOSIS: No gross canal stenosis.
FACET JOINTS; Moderate degrees of degeneration at L3-4 and L4-5. Extraspinal synovial cyst formation at the right L4-5 level.
NEURAL FORAMINA: Minor neural foraminal narrowing at L4-5, Moderate to Severe left and mild right foraminal narrowing at L5-S1.
PARASPINAL SOFT TISSUE: No gross mass effect.

IMPRESSION:
1. Disc osteophyte ridging at L5-S1 with multilevel disc bulge with right foraminal/lateral annular tear at L4-5.
2. Left foraminal narrowing at L5-S1. Correlation for possible L5 radiculopathy.
3. No compression fracture or high-grade canal stenosis.
4. Moderately severe facet degeneration at L3-4 and L4-5 levels.

LUMBAR X-RAY FINDINGS 11/15/13
DISC SPACES: Minor narrowing at L3-4. Moderate narrowing at L5-S1.
FLEXION AND EXTENSION VIEWS: Borderline increase in angular and anterior posterior translation at L3-4 with associated traction osteophyte formation. Mild increase in angular translation at L2-3.

FACET JOINTS: Mild-to-moderate degeneration at L4-5 and L5-S1.

IMPRESSION:
1. Mildly increased angular and anterior posterior translation with traction osteophyte at the L3-4 level suggesting ongoing motion and instability. Increased angular translation also present at L2-3.
2. No compression deformity or displaced fracture fragment.
3. Moderate disc degeneration at L5-S1. Lower lumbar mild to moderate facet degeneration.
4. No compression deformity or displaced fracture fragment noted.

CERVICAL X-RAY

EXAM DESCRIPTION: X-RAY CERVICAL SPINE 5 VIEWS

TECHNIQUE: Frontal, lateral, transoral odontoid, flexion, and extension views.

FINDINGS:
POSTPROCEDURAL CHANGE: Status post plate and screw anterior cervical discectomy fusion across the C4-C6 levels.
Hardware: Grossly intact appearance with no dominant periscrew lucency.
ALIGNMENT: Grossly unchanged.
DISC SPACES: Minor disc osteophyte ridge formation at C4-3. Moderate disc space narrowing with disc osteophyte ridge formation at C6-7 as previously noted.
TRANSORAL ODONTOID VIEW: Odontoid process grossly intact.
PREVERTEBRAL SOFT TISSUES: Normal thickness
CERVICOCRANIAL ALIGNMENT: Grossly unremarkable.
FLEXION AND EXTENSION VIEWS: Limited range of motion. No abnormal angular or anterior posterior translation to suggest frank instability.

FINDINGS: Stable alignment and appearance of hardware when compared to July 2013 study. Moderate disc degeneration at C6-7. Moderate disc space narrowing with disc osteophyte ridge formation at C6-7. Minor disc osteophyte ridge formation at C4-3.

THORACIC MRI FINDINGS:

Clinical History: Cervical spinal stenosis, evaluate for cord impingement. Patient describes worsening chronic neck and bilateral shoulder pain as well as mid and low back pain. Mid back feels like a burning across back to spine.

Comparison MRI Cervical spine 8/14/13 and 11/20/12.

Technique: Hitachi Oasis High field 1.2T open MRI system. Quality of study is diagnostic. Multiplanar multisequence MRI Imaging of the Thoracic spine was performed.

FINDINGS: There is trace anterolisthesis of T10 on T11. Sagittal alignment is otherwise maintained.

Disc desiccation is present from T1 through T5 and from T8 through T11. Focal fat/vertebral body hemangioma is noted within the left side of the T6 vertebral body. Bone marrow signal is otherwise homogenous and there is no worrisome marrow signal or bone marrow edema.

The central spinal canal is widely patent and there is no evidence of central spinal canal stenosis. There is no abnormal signal within the cord.

There are mild hypertrophic changes at T10-11 with perhaps mild bilateral neural foraminal narrowing, right greater than left, without evidence of definite neural compromise. This is best appreciated on the sagittal sequences. Mild facet arthropathy is also noted at T11-12 with patent neural foramina.

The paravertebral soft tissues and visualized retroperitoneum are within normal limits.

IMPRESSION: No evidence of central spinal canal stenosis or abnormal signal with the cord within the thoracic spine. Other than some focal degenerative changes at T10-11 where there is trace anterolisthesis producing minor bilateral neural foraminal narrowing, the neural foramina are otherwise widely patent.

CERVICAL MRI 11/20/12 BEFORE CERVICAL FUSION

At L3-L4 disc there is a mild bulge slightly greater to the left side that indents the ventral thecal sac and narrows the inferior neural foramina in conjunction with mild facet disease.

At L4-L5 disc there is a broad mild disc bulge which flattens the ventral aspect of the thecal sac producing minimal canal narrowing inferior neural foraminal narrowing.

At L5-S1 there is a broad disc bulge which remains in the epidural fat extending out laterally produces mild inferior right and left neural foraminal narrowing as described above.

Impression: Multilevel mild degenerative disc disease produces relatively minimal canal narrowing but up to mild neural foraminal narrowing as described above.

Multiple sequences were obtained in the sagittal and axial planes. Images obtained demonstrate an anterolisthesis of approximately 3 mm of C4 anteriorly on C5. There is approximately 2 mm Retrolisthesis of C6 posteriorly on C7 and a 1-2 mm anterolisthesis of T1 anteriorly on T2. The visualized portions posterior fossa demonstrates no focal signal abnormalities. At the C4-C5 level there is some faint signal change in the cord suggesting early edema. There is no significant abnormality at the C2-C3 or C3-C4 disc levels.

At the C4-5 disc level there is facet degenerative change, anterolisthesis of C4 anteriorly on C5, a broad disc protrusion, which flattens the ventral cord, displaces it posteriorly, producing a moderate canal Stenosis and degenerative change of the uncovertebral joints producing some minimal neural foraminal narrowing.

At the C5-C6 disc level there is an asymmetric disc protrusion greater to the ventral left canal on the right. It minimally encroaches upon the ventral left can and left canal and left lateral recess. Degenerative changes in the facet joint produce mild left neural foraminal narrowing.

Date of MRI: 11/20/2012

Findings: multiple signals were obtained in the sagittal and axial planes. Images obtained demonstrate normal alignment and marrow signal of the lumbar vertebral bodies. There are signal changes in the S2 vertebra compatible with probable hemangioma. Conus medullaris terminates normally at the lower aspects of the L1 vertebral body. No abnormal signal is identified in the visualized portions of spinal cord, conus medullaris or cauda equina.

Review of the disc spaces demonstrates no significant abnormality of T12-L1, L1-L2, or L2-L3 disc level.

At the L3-L4 disc level there is a mild bulge slightly greater to the left side than right which minimally indents the ventral thecal sac and the minimally narrows the inferior neural foramina in conjunction with mild facet disease.

At the L4-L5 disc level there is a broad mild disc bulge which mildly flattens the ventral aspect of the thecal sac producing minimal canal narrowing and minimal inferior neural foraminal narrowing.

At the L5-S1 level there is a broad minimal disc bulge which remains in the epidural fat extending out laterally produces mild inferior right and left neural foraminal narrowing as described above.

Now A DIFFERENT Report of the CERVICAL SPINE/NECK (This report gives dimensions, etc.)

Findings: Multiple sequences were obtained in the sagittal and axial planes. Images obtained demonstrate an anterolisthesis of approximately 3 mm of C4 anteriorly on C5. There is approximately 2 mm Retrolisthesis of C6 posteriorly on C7 and a 1-2 mm anterolisthesis of T1 anteriorly on T2. The visualized portions posterior fossa demonstrates no focal signal abnormalities. At he C4-C5 level there is some faint signal change in the cord suggesting early edema. There is no significant abnormality at the C2-C3 or C3-C4 disc levels.

At the C4-5 disc level there is facet degenerative change, anterolisthesis of C4 anteriorly on C5, a broad disc protrusion, which flattens the ventral cord, displaces it posteriorly, producing a moderate canal Stenosis and degenerative change of the uncovertebral joints producing some minimal neural foraminal narrowing.

At the C5-C6 disc level there is an asymmetric disc protrusion greater to the ventral left canal on the right. It minimally encroaches upon the ventral left can and left canal and left lateral recess. Degenerative changes in the facet joint produce mild left neural foraminal narrowing.

At the C6-C7 level there is a broad mild disc protrusion, which minimally flattens the ventral aspect of thecal sac. The disc extends out laterally and produces moderate left and mild right neural foraminal narrowing.

At the C7-T1 and T1-T2 levels no significant abnormality is seen.

IMPRESSION: Degenerative disc disease and hypertrophic changes producing significant canal Stenosis at the C4-C5 level. Hypertrophic degenerative changes of disc disease producing neural foraminal narrowing up to the moderate level.

Salem Hospital 11/27/13: SPEC CT SCAN/BONE SCAN W/INJECTION:

Limited Bone Scan of the Thoracic and Lumbar Spine and Pelvis with Spect Imaging
INDICATION: Patient with Pain
FINDINGS: The patient was injected with approx 25 mCi of Tc-99m labeled MDP with planar and SPECT Imaging of the thoracic and lumbar portions of the spine performed.
There is diffuse nonspecific spondylotic change within the thoracic spine.

Within the lumbar spine there is focal moderate tracer accumulation localizing to the right L3-4 and the Left L4-5 facet joints consistent with changes of facet arthropathy. Examination is otherwise unremarkable.

(Note to self – Dr. Jose Novoa is the worst radiologist there is with many complaints to several different surgeons from many patients).

If anyone has any suggestions on what the dr might recommend, I would be very grateful to hear about any of them. I like to do a lot of research but there's so many things to research so if anyone can put some of it in laments terms and suggest what a few recommendations might be that would be awesome.

I bolded some of the main terms and findings , i hope that helps for your information & searching.