I had emergency surgery on my neck in July and the neurosurgeon perform anterior cervical diskectomy on C4-5, C5-6, anthrodesis, C4-5, C5-6, then a fusion from C4 through C6 using allograft and plating, and finally Microscopic dissection. Since the surgery I did well for the first 4 months and then the Dr. released me to go back to work. I ended up with the intense migraines returning, neck locking up etc., and the neurosurgeon closed practice and moved to Texas, his co-partner decided to retire. My personal physician took me out of work after 45 days and we just received the MRI results. It stated mild to moderate anterior CSF effacement at C5-6. My physician does not understand what this means as far as the continued pain or what the future holds for this and is trying to find me a new neurosurgeon. Does anybody know what I can expect from this? I already am suffering severe neck, shoulder, hand and killer migraines, so as you can see pain is a "constant" and I would really just like to know what else I can expect in the future or is there another surgery that I will have to have? Any and all feedeback is greatly appreciated. Thanks.
Welcome to the Back and Neck Community. Members are here to provide assistance to individuals experiencing symptoms related to possible abnormal conditions of the spine. Advice given is non-professional and is primarily based on personal experiences.
From your post it appears that you had an anterior cervical discectomy and fusion from C4-C6 using bone graft and titanium plating. Microscopic dissection would have been done at another level (either C3-4 or C6-7) because with a fusion all of the disc material is removed to place the donor graft. It would be helpful for you to get copies of your medical records and the surgical report to give to your next treating neurosurgeon so that there is no discrepancy or misunderstanding regarding the surgery performed in July.
After a fusion procedure, the adjacent discs are at risk for degeneration as they took up the stress previously apportioned to the discs that are now replaced by fused bone.
It is sometimes necessary to perform additional surgery on these adjacent discs if symptoms of pain and other neurological symptoms occur.
Your MRI report indicates that there is mild to moderate CSF effacement at the C5-6 level. CSF effacement means that something has extended into the spinal canal (through which the spinal cord travels) and is pressing on the meninges (outer covering of the spinal cord) and is causing displacement of the cerebrospinal fluid which protects the cord. This CSF effacement and meningeal distortion is probably the cause of your migraines and neck pain.
If you were fused at this level, there would not be any disc material to press against the CSF in the spinal canal. It might indicate that the area did not completely fuse (called pseudoarthrosis) and some of the bone graft may have shifted to cause the problem noted on the MRI. This can only be confirmed by having your MRI interpreted by a skilled neurosurgeon and I am hoping your personal physician is able to find a specialist who can assist you further.
It is very important for you to get a neurosurgical consult to review the clinical findings of the MRI and discuss the treatment options available for you. This may include another surgery to assess the status of the fusion and perform additional repair as indicated.
Please post again with your progress and with any additional questions/concerns you may have.
I am postop ACDF C4-C7 in the early stages of recovery and hoping that my fusion proceeds uneventfully. Only time will tell if I will be facing similar concerns that are confronting you.
Best wishes -----
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