Post ACDF 2-LEVEL Surgery MRI RESULTS

Hello everyone,

I'm new to this site, but have a couple of questions and would like feedback/opinions. I had a 2 level ACDF surgery in 2015. Since then I have had multiple MRI's, which all state the same thing. Could someone please explain the findings.


C5-6: Endplate spurring is noted most pronounced at the right subarticular zone producing mild cord flattening. The AP diameter of the spinal canal is mild stenotic A.-9 mm. Mild-to-moderate right foraminal stenosis is noted. The left foramen is mildly narrowed.

C6-7: Subarticular endplate spurring is noted. The midline diameter of the canal is mildly stenotic at 9 mm. Slight cord flattening worse on the right. Extensive right foraminal stenosis is again seen. The left foramen is at least moderately stenotic.

These are the 2 levels that were operated on and I have to most likely have to have a second surgery due to the pain and loss of feeling in the hand. Any input would be greatly appreciated.

Thanks

Hello straydog,

All 3 of the MRI's basically say the same as above. I have seen a couple of Neurosurgeons who have stated either they would not have preformed the first surgery since there was no severe cord damage or potential. The other Neurosurgeon stated he will need to go through the back of the neck. The first surgeon basically said "you know you have a lot of arthritis" and that was basically it. He as well was a neurosurgeon. I guess with the little research that I have done and knowing that the first surgery only took the doctor a hour and 17 minutes makes me wonder what did he really do. The problem now is that I have to try to get the Department of Veteran Affairs to pay for a second surgery. I also thought that with a diskectomy they are supposed to clean out the disc material as well as remove the bone spurs. Maybe it is a different procedure for VA Patients.

I actually have copies of everything. You will probably laugh at the post-op report. I had a P.A. at Eglin look at it and start laughing. Of course he was not laughing at me, but said that he can pin point 3 items that were not done during the surgery. Here is the info from the post-op report.

Operative detail: The patient was brought to OR. General anesthesia was administered. The patient was placed supine on the operative table. Cervical area was sterilely prepped and draped. Transverse cervical incision was made. Dissection was carried down through subcutaneous tissue. Platysma was divided. Blunt dissection was used to identify the prevertebral space. Prevertebral fascia and longus coli muscles were dissected laterally. Self-retaining retractor was placed. Fluoroscopy was used to confirm localization. Diskectomy was then preformed at C5-6 and C6-7 in the following fashion:
Distraction was placed across the disc space. Diskectomy was preformed with curettes and rongeurs. Anterior and posterior osteophytes and endplates were drilled with a Midas RX drill. Posterior longitudinal ligaament was opened and bilateral foraminotomies were preformed. At this point, the Dura and nerve roots were well-decompressed at C5-6 and C6-7 levels. Two iliac crest allograft was then shaped and fit into the inner spaces at C5-6 and C6-7 under fluoroscopic guidance. An anterior cervical plate was placed, 2 screws each in C5, C6, C7 under fluoroscopic guidance and locked. Wounds irrigated and hemostasis was obtained. The wound was closed using 2-0 vicryl in platysma, 3-0 vicryl subcutaneously and derabond on the skin. There were no obvious intraoperative complications.

That is the complete post-op report. I can already figure a couple of things that might should be removed.

I just posted the Post-op report above. The symptoms actually became worse more burning in shoulder blades also now when I eat every time I have the first bite get stuck in my throat so either it is coming back up or I will have a severe case of hiccups. Also loss of feeling in my right hand as well as weakness. I have had a epidural shot in the neck and that just aggravated the shoulder blades with a burning sensation. The original surgeon said I have a lot of arthritis in my neck and that was it. He didn't even have a follow-up appt after 6 months to see if the fusion took. Trust me I have not been back to him.

I agree and understand not going back to him!

You might find it helpful to read newmanmaple's comments. He is also using the Veteran's Administration. He gives his MRI results and it mentions his previous surgeries.

Billy, I am stumped about your recent MRI not mentioning your surgery. If you looked at newmanmaple's report his surgery is discussed.

I would not go back to the original surgeon either. Is there no one at the VA that you can take a copy of your records to & discuss some of this? I know they often refer out for specialist. There has to be something that can be done. Do you have any other insurance besides using the VA?

Take care.

Hello Whitebeard,

I have had multiple MRI's and CT-Scan myelogram. All basically indicate the samething. The original surgeon was a outside surgeon that the VA paid. The swallowing issue has been ongoing since the surgery (2 years ago). I was hoping as you stated for the nerves to relax. I did have a modified swallow test which the speech pathologist stated that my muscle that contracts to open the esophagus is bumping into the metal plate. Of course when I explained to her that I need her to document that she of course didn't. Anyway I'm at this point very skepitical of any surgeons locally and as you really do not trust the VA with healthcare needs. I guess the thing that was a big player other than the numbness and pain was the scare tatic that if i was involved in a fender bender I could have been paralyzed from the neck down. Well I wonder if I'm still in that same position.

I wanted to thank everyone for the input. Also I guess I will eventually have a second surgery just not really comfortable with the concept of trusting someone to cut open my neck again after the first go. No feeling in the right hand is starting to get aggravating so I'm sure I will overcome the trust issue soon.