Dr Abhijeet,
Hello again.. I called my surgeons office and spoke to his PA, his assistant. They still are saying I am fused...Why would the radiologist say I am only 90 percent fused? My surgeons assistant tells me not to listen to him and that he is not a neck surgeon. I feel like I am being medically neglected on my surgeons side. They refuse to listen to my symptoms and tell me that the radilogist is wrong... I have seeked a 2nd opinion for Friday with a neurosurgeon.. Will he be able to tell if I am fused from my CD? I am so frustrated.. I want to get to the bottom of this.. If I am only 90 percent fused like the radioligist said if that is true, do I still have time to fuse completely/?? I really dont want to have a 2nd surgery.. And why would one vertebrae fuse and not the other?? Do you have any suggestions I might ask the neurosurgeon..? I also see the pain management doctor next week....for an evaluation.. Thanks again.
Hello.
Sorry for the delay in responding. Symptoms of pseudoarthrosis can be the same as those before surgery.
N. Mutoh et al observed that ".....Symptoms resulted from abnormal mobility, cord compression due to posterior slip or rotation of the upper vertebral body, kyphotic deformity or a problem at the adjacent level........." This suggests why pseudoarthrosis produces symptoms.
There is a very good article on pseudoarthrosis. The link is as follows-
http://www.medscape.com/viewarticle/448387_4
The article mentions the need to identify the pseudoarthrosis. Of particular relevance is this extract,"......... In patients with recurrent or persistent neck pain, however, pseudoarthrosis should be considered as a likely etiology..........."
There is also a good article on how pseudoarthrosis due to ACDF can be managed. The link is - http://www.ncbi.nlm.nih.gov/pubmed/1440001
It mentions a need for a posterior approach surgery to manage pseudoarthrosis secondary to ACDF.
In your case, pseudoarthrosis may be present. Try to get the CT scan reviewed for this purpose again.
Regards
Dr Abhijeet,
Hello again.. I wish I could send you the Ct scan report. Well anyways, I looked at the CD for the first time today. I wanted to find the area that wasnt completely fused and I found it.. It is clearly noticable on the Ct scan report. It is on the right side of the neck where I am having all my problems.. What are the chances of it fusing completely?. I saw where it is not connected at all.. Do I still have hope for it to fuse? I never had left sided neck pain before or after the surgery.. The intense burning pain started 6 weeks after the surgery and that was probably when I was trying to fuse. What are the symtoms of pseudoarthrosis? Is revision surgery the only option to fix the problem? And is 90 percent fusion not good and would this be causing all the pain...Please let me know what you think before I see the new doctor on Friday... Thank you again.
Hello again..
I am so appreciative of your knowledge. I know there is something wrong and I cant get my surgeon to be honest with me. He is a highly respected physician here and everyone I speak to in the medical profession knows him.. I am not looking for any trouble, I just want to find out the cause of my pain. My question to you is, How can this pseudoarthrosis be diagnosed. What tests need to be run in order to diagnose it? Please help.. I have an appt with a 2nd opinion with a neurosurgeon next Friday.. I would kindly appreciate any information you can give me.. Also how does pseudoarthrosis happen? Is it because I used a cadaver bone?? I am just searching for answers DR Abhijeet.. THank you..
Hi.
"Could this be pseudoarthrosis?" is the question now. When the vertebrae are intended to fuse, but do not do so, they are still mobile to a small extent. This is called pseudoarthrosis (false joint). A pseudoarthrosis makes the spine unstable.
Often the neurological examination is normal in a pseudoarthrosis. A revision surgery can be done to correct the pseudoarthrosis and fuse the vertebrae again.
Regards