Neurosurgery Expert Forum
Help! How serious is Grade I Anterolisthesis of C7-T1???
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Help! How serious is Grade I Anterolisthesis of C7-T1???

My MRI of 2/4/10 shows a NEW finding of "Grade I anterolisthesis of C7 and T1 by 3 mm". What would the correct treatment be? Conservative or Surgical?
      PMH: formerly a Radiology Medical Transcriptionist,19 years.  My Neurosurgeon performed ACDF C5-6 C6-7 with bone graft harvested from my right hip BUT without plating in 1/1993 which was VERY SUCCESSFUL!
    In 8/2000, my niece quickly turned my head so I could see a whale's tail come up in the water on a whale watch boat while on vacation. I felt a POP and I could NOT move my neck!  Three months later, In 12/2000, I had ACDF C4/5 + RE-FUSE of C6-7 with cadaver bone graft and new plating.
    In 2/2002, my right hand locked & throbbed while transcribing. Cortisone did not help! I had CT Repair on 2/21/02. Eventually,ended up disabled.  I can't work b/c I am considered a Workers Comp RISK!
    Since shoulder surgery 11/3/09, pain has worsened in my neck, shoulder, trapezius, biceps and triceps. I was told to keep taking 600 mg of Ibuprofen 3X/day which put me in the ER last weekend with BP 165/90, short of breath, pressure in chest / pectoral area.  EKG and cardiac enzymes revealed NO heart attack.  I was told it was only ANXIETY and a PULLED MUSCLE from P.T.and given RXs for Xanax and Flerexil. Post-ER, MRI ordered to dx pain and occipital headaches.  PCP stopped P.T. for 2 weeks!  I REFUSED the meds which only MASK the problem/pain generator!  ROM is very limited with persistent pain and weakness with ADL.  I tend to guard and If I push my limits, I am set back 3-4 days til pain is tolerable!   However, I am grateful notto be in a wheelchair yet!  
    I can't see Neurosurgeon til 3/22!   Please let me know the next step? I apologize for this lengthy post.
Warmest regards & blessings,  Diane  (-:
    
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623823_tn?1357420257
Diane, Sleep with a large Soft cervical Collar.
I cant feel free with my advices through an internet, your case necessitates a CT-scan
2 Comments
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1201849_tn?1266680323
Hi Dr. Chahine,
     I don't think my reply to your answer posted, so here I go again.  I was able to get in sooner to see my Neurosurgeon on Monday, Feb. 22nd.  He showed me my MRI films and the C7-T1 slippage plus degenerative and spondylitic changes from C3-7.  He confirmed that I was doing well until Physical Therapy for my right shoulder surgery on 11/3/09.  
     He said the motorized cervical traction and strengthening exercises aggravated and acutely developed cervical pain, headaches, radiating down my right arm and into my 4th and 5th fingers causing decreased grip strength.  Physical Therapy has been stopped until he re-examines me on April 5th because strong traction should NOT be applied to patients with acute sprains, fusions or spinal joint instability!!  He recommended soft cervical collar (as you did) plus rest, moist heat, Ibuprofen and Flexeril until my symptoms improve.  He does not recommend surgical intervention at this time.  I am sooo relieved!!!
     Dr. Chahine, with your excellent skills and experience, do you feel that I still need a CT scan or even a Myelogram???   Do you feel the slippage at C7-T1 will get worse since I have spinal joint instability and multi-level fusions???
     Thank you sooo much for taking time to answer my questions and for being so blessed with amazing skills and intuition.  God bless you!
Warmest wishes & blessings always, Diane :o)
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