Hi there,
I am hoping for some insight into my situation and even some advice on my MRI results. I had ACDF surgery (C5-6/6-7) in Feb 2102. My neurosurgeon stated that there were other cervical levels showing concern which most likely would require additional surgery but that only 2 levels would be fused hoping to alleviate most of the symptoms.
Here I am 2 years later with pain and symptoms that are actually worse than before surgery.There was a brief time frame after my MRI in 2/13 which per my surgeon showed nothing wrong, that I somehow chose not to acknowledge the symptoms - kinda mind over matter. That way of dealing with the pain only worked for so long. The pain is now becoming debilitating and having a very negative impact on my life. I am an otherwise healthy 31 year old female.
I had a recent MRI showing a disc bulging at c2-3 and c3-4- grade 2. This report states that there does not appear to be cord impingement at either level. C6-7 shows "Uncinate spurring"
Here is the info: MRI 1/2014
C3-C4: Grade 1 diffuse bulging disc/marginal osteophyte complex, with left greater than right facet hypertrophy. No significant cord impingement or central canal compromise. Mild left foraminal narrowing without definite neural compromise.
C3-C4: Grade 1 diffuse bulging disc/marginal osteophyte complex, with left greater than right facet hypertrophy. No significant cord impingement or central canal compromise. Mild left foraminal narrowing without definite neural compromise.
IMPRESSION: 1. Stable appearance of the cervical spine compared with the previous examination. 2. Status post anterior cervical decompression with fusion C5-6 and C6-7 with fixation hardware in place and no interval change at these levels. There remains mild to moderate foraminal narrowing bilaterally at C6-7. 3. Redemonstration of slight retrolisthesis C4 on C5, but without significant stenosis or foraminal narrowing. 4. Mild unchanged left foraminal narrowing at C3-4. Associated left-sided facet hypertrophy at C3-4 and C2-3.[/I]Also identified a cystic mass: Visualized paraspinous structures: There is a cystic structure involving the floor of the mouth in the midline anteriorly, possibly representing a thyroglossal duct cyst but not completely characterized by this study

My previous MRI from Feb 2013 shows
C3-4 Minor diffuse bulging disc and facet disease producing left foraminal stenosis.
C4-5 Diffuse grade 1 bulging disc produces mild spinal stenosis with residual canal diameter of 8-8.5mm. A borderline and mild left foraminal stenosis is associated.
C5-6 Anterior plate and screw fixation and mild right unicate hypertrophy produces a mild right foraminal stenosis.
C6-7 Anterior plate screw fixation and mild unicate hypertrophy produces bilateral foraminal stenosis. Spinal canal is mildly narrowed with residual central canal diameter or 9mm.
Findings: Sagittal scans demonstrate interval interbody susion with anterior plate and screw fixation c5-6 and c6-7 associated with resolution of spinal stenosis at these levels. There is interval appearance of a grade 1 retrolisthesus at c4-5 associated with mild kyphotic deformity associated with grade 1 bulging disc producing spinal stenosis. Diffuse bulding disc is present at c3-4 without significant stenosis. Mild multilevel facet disease and minor unicate hypertrophy is again noted. Relatively congenitally short pedicles are noted throughout the spine producing congenital spinal stenosis. Oblique sagittal foraminal scans demonstrate unicate hypertrophy and mild facet disease producing mild left C3-4, right C5-6 and bilateral C6-7 foraminal stenosis.

Again... my surgeon's response to the findings per his MA is that everything on the MRI looks great! He would not allow me to schedule an appointment with him. I explained again how I am feeling... and asked why there are persistent symptoms, yet nothing is wrong? I was told that she would ask him to call me. I have yet to hear from him. Now I am no Dr… but it appears to me that I am not dreaming up the issues associated with my neck. This is the same surgeon that explained a potential need for future surgery. There was no mention or advisement regarding the mass identified in the MRI.
MRI 11/2011
C3-4 Central disc bulging effacing the ventral aspect of the thecal sac with contact of the cord noted. Findings are slightly more evident than on the prior examination (yes I had an MRI in 2/2010)
C4-5 Disc bulging slightly asymmetrical to the left is again seen. Contact of the cord without distortion is seen. Findings are slightly increased since the prior examination. Minimal bilateral neural foraminal compromise persists.
I have done everything suggested by my GP - injections, PT, heat/ice, rest, meditation etc. You name it and most likely I have tried it. I am somewhat losing hope that I will ever come back from this. My symptoms include pain and numbness that radiates down my arm, the top part of my back and up the base of my skull. My employer and parents seem to think that I am malingering and that I need to just suck it up. I realize that my situation could always be worse and I am fortunate that I am otherwise relatively healthy but the pain and numbness have become unmanageable, especially since I choose to not use narcotics.

Is there anyone that can provide me with feedback on my MRI findings and response from my surgeon? If the results are in fact normal- then perhaps there is something else going on.

Does anyone know what impact ACFD surgery has to the cervical levels above and below the fusion? I also wondering if it is possible to have inconsistent findings on MRI's and the reasoning (other than different radiologist interpretation) with one of my MRI's showing disc compression being evident at C3-4 and C5-6 and then another MRI showing no cord compression.
Thank you and my apologies for the long entry.

Welcome to Neuro Talk. None of us are doctors, but we sure listen to each other and pick up a lot of information on this site. I have had two cervical fusions and I do know how much these spine issues hurt. Often the surgery prevents further trouble. It doesn't always take away the pain.

Your 2014 MRI, at C3-4, you only have Mild issues. There is no cord impingement or central canal compression. When the cord is compressed, that is what they worry about.
Where you were fused before, would be my guess, is why you still are experiencing pain. At C5-7 where your hardware is, there is still mild to moderate narrowing. Your surgeon most likely did the best he could do with those vertebra. You healed OK in that area. The issue is, not everyone gets the best pain relief from that procedure.
Unless the others above fail, and you herniate compressing the cord, most neuro surgeons won't do much about it.
It would be a good idea to take the MRI to another neuro surgeon, or orthopedic surgeon for a second opinion.

Jo*Mar, is one of our moderators, and she may be able to tell you a bit more than I can. I would try PT, maybe even acupuncture.
I have had two spinal fusions. Now C3-7. I go to PT regularly, as much as I can each year. I also do the Japanese acupuncture, which has already helped me a bit. I do have pain killers, if and when I over do the activities. I also do what PT I can do at home.

Do not hurry to try to get more surgery. You would lose more mobility being fused further. I do have issues with driving. To look over my shoulder at traffic, I have to undo the seat belt and actually turn around. Pain for me is by degrees, and I keep it under control.

Have you seen a pain specialist? The one I go to thinks outside the box and was trained at Harvard in acupuncture. She also is the one who prescribes meds. when I need them. This type of doctor I see is called a physiatrist. Maybe call around to see if there is one in your area who treats for pain. Try all therapies.

There is another kind of shot or infusion called Ketamine. Sometimes pain specialists are trained with this. I had this done between my surgeries. It worked for 4 -5- months and gave great pain relief. ( It did not hurt to get the infusion)

If you are not sure who to see for help, ask your primary care physician for his recommendation of what you can do.
I will be here if you ever need to talk. I know it is scary to have these problems. I hope there will be some relief for you. Don't give up.
Ginnie

Hi and I am sorry you are still have issues with your neck.

One thing that does stand out to me based on your MRI report and your current symptoms is the Moderate foraminal narrowing noted at C6/7 bilaterally and also on left side of C3/4 this foraminal narrowing or stenosis is the little openings that the nerves run through. With your symptoms it sounds like you have some type of nerve compression. Like Ginnie suggested I would find the most reputable Physiastrist in your area who can work with you through all non-operable treatment options before any further surgery is considered. Please remember that just because you had previous injections in the past that they might not have been specifically for this type of issue so injecting for that purpose might just do the trick. A massage therapist who can work on your neck will also do wonders to keep muscle tension from causing or worsening these symptoms.

I had what is called a laminectomy/foraminotomy a little over a year ago for C3/4 and C6/7 where they go in from the back side of the neck and essentially drill the holes back open and I've been happy ever since. 3 doctors wanted to fuse me but I finally found one who considered my lifestyle, age, etc., and offered to do this procedure for me instead. I've since learned not many doctors will do this procedure and instead go strait to fusion.. that wasn't for me.

Personally I would seek out several other opinions from the top Nuerosurgeons in your area recommended by the best physiatrist!!

I wish you the best,
Tessa