2 yrs Post ACDF Problems Recent CT Myelogram HELP!!!

[montanamae]

Ok just got back from my Ct Myleogram and here it is doesn't seem good.
Surgical changes include c5-6-7 ACDF with high denisty cages in the intervening discs. Botoh cages re confluent with adjacent superior endplaes There are som lucencies demarcating the cages from the adjacent superior endplates of 6 & 7 There is no excursion at C5-6 on the flexion extension view, but motion persists at c6-7. There are no ventral defects demonstrated at 5,6, or 6-7 but CT demonstrattes 1-2 mm right paracentralright c6 rootlets proximal to the foramen. thee is also a more diffuse hard disc at 6-7 toward the right foramen. the right 6-7 root sleeves fill less distally thant the left on both the myelogram and on ct. If there are coresponding radiculopathies this may be significant. Thee is reisidual ossifcication on the posterior longitudinal ligament at 5-6 which just reaches the dural sac there is no associated stenosis. Shallor ventral extradural defects are present on the myleogram at 3-4 and 4-5 CT demonstrates a 2 mm diffuse disc protrusion with spondylosis and ossification kn the posterior longitudinal ligament resulting inmild ventral dural deformity without spinal cord impingement. the residual midsagittal dural diameter is about 11 mm There is mild right uncinate prominence at c3-4 without significatn foraminal stenosis.
At c5-5 ther is anterior spondylosis at a central 2-3 mm focal disc protursion which reaches and probably slightly retro displaces the spinal cord The risidual midsagittal dural diameter is about 8 mm There is also ossification in the posterior longitudinal ligament contributing to the ventraldefect at c4-5 There is mild left uncinate prominence at C4-5 withough significant foraminal stenosis.

There may be some annular bulging at c2-3 on ct Ossification is present in the posterior longitudinal ligament at c3, c4, c5 ,6 and c7. Cervical root sleeves other wise fill out normally and symmetrically.

conclusion C5 6 7 ACDF is noted with persisting motion at C6-7 There is residual or recurrent hard disc proximal to the right foramen indenting the dural sac at c5-6. Residual or recurrent hard disc is also narrowing the right foramen and indenting the dural sac at c6-7. The right c6 and 7 roost sleeves fill less than the left. Ossificataion persists in the posterior longitudinal ligament at c 5, 6, 7.

A 2-3 mm central disc protursion at c4-5 reaches and probably slightly retrodisplace the spinal cord leaving 8 mm residual midsagittal dural diameter. There is also a central 2 mm combined disc protrusion with spondylosis at c3-4 withoughspinal cord impingement. Mild uncinate prominence is noted on the right at c3-4 and on the left at
C4-5

Ossification is present in the posterior longitudinal ligament at c3 thru c-7. There is disc bulging without stenosis at c2-c3

My neurolgist is concerned about my fusion not taking at the 6-7 which I think that is what is meant by the report that says
c5-6=7 is noted with persisting motion at 6-7 this is the area he was worried about not being fused and with screw loosening. And also he was wondering if I had diagnosed a calcified ligament and I am assuming this is what the Ossification mentioned is. By all the report looks like i maybe doomed. I just really worried about fusion 6-7 not taking and loose. When I asked him before the CT if it was a clacificated ligament what was that treatment he said that would be discussed if this is what it was. Does anyone know what that treatment is and is it surgical? From what I am reading this report appears that I am pretty messed Up... And comments on all this PLEASE HELP!!!!!!!!1

[Kalvin]

I have to have another ACDF sometime this year myself, so I kind of know what you're going through. Strong people sometimes get overwhelmed too. I hope everything works out for you and that you finally get relief from your awful pain.

Take Care

[montanamae]

Thank Kalvin my ACDF was in 2008 I do have pain in my arms and neck and my fine motor skills seem to effected I have problems putting jewerly on and the in the mornings my hands shake.  I had  a EMG/Nc test and it showed some nerve deteriation not bad but some.  My neck also gets stuck and then pops it is very weird feeling.  One  time when it happened after it popped I actually seen stars.  I know my situation is not hopeless I am a very strong person but of course don't want to go through this.  And I am very active and this is my favorite time of year we are fixing to open our pool and hate to think that I won't be able to swim right off.  thanks for your response.

[Kalvin]

Your not doomed, don't even think that. A lot of things in your report don’t even cause symptoms. How much pain are you in and how long has it been since you had those levels fused?

Conservative treatment of Ossification of the posterior longitudinal ligament usually involves wearing a cervical collar or continuous traction. The later would probably be contraindicated in your case because of your fusions. From what I understand, if the OPLL isn’t causing symptoms, you leave it alone. And while you have ossification at C3-7 I don’t see anything on your MRI about cord compression. They need to figure out whether or not its actually causing any problems.  If you do have to have surgery for this there are a variety of procedures that they use, sometimes they remove it and other times they thin it out.

You didn’t say anything in your post about your pain level, that is a very important factor in all this. You know, it might be necessary for them to go in there and redo C6-7 and take care of a couple of the other problems you have, but by no means is your situation hopeless.

Take Care