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ACDF 2014 still having issues - please see ct results

Started by ladybug5563 on 06/20/2016 1:30pm

Still having issues after ACDF 2014 please see ct scan results below. Any help/comments greatly appreciated.

EXAM: CT CERVICAL SPINE WITHOUT CONTRAST

HISTORY: Post anterior cervical discectomy and fusion. Current symptoms of sharp neck pain, tension spasm, headaches, neck numbness, numbness down right arm.

TECHNIQUE: Contiguous axial images were obtained utilizing a multislice, multidetector CT scanner. Post-processed reformations were also submitted for review.

The total DLP was 1061 mGy-cm and the total CTDI was 40 mGy. Low dose protocols were performed.

One or more of the following dose reduction techniques were used: automated exposure control, adjustment of the mA and/or kV according to patient size, use of iterative reconstruction technique.

COMPARISON: MRI cervical spine, 1/10/2014. Radiographs, cervical spine, 3/10/2015.

FINDINGS: Straightening of usual cervical lordosis. No osseous sclerotic or osseous loose lesion appreciated. The usual low attenuation visualized portions mastoid air cells. Mild hypertrophic changes C1-C2 with small spurs. On scout image, mild dextroconvex curvature thoracic spine. Anterior metal plate extends from C5 through C7, with 2 anterior screws, C5, C6, C7.

C2-C3: No significant herniation or osseous stenosis.

C3-C4: No significant herniation or osseous stenosis. Slight anterolisthesis, 1 mm.

C4-C5: Bulging disc/osteophyte, 1.6 mm. Minimal uncovertebral joint degenerative changes. Prominent anterior osteophyte with endplate changes and bone loss, superior endplate C5, anteriorly. No significant osseous canal or osseous foraminal stenosis.

C5-C6: Postoperative hardware and postoperative changes at disc space with incorporation of the osseous construct noted. Residual posterior spur, 2.2 mm, and mild residual anterior osseous encroachment of the canal. No significant osseous stenosis of the right foramen. Mild osseous narrowing left foramen.

C6-C7: Postoperative hardware and postoperative changes at disc space. Osseous construct does not appear incorporated to superior endplate of C7. The left C6 screw appears to extend below the inferior endplate of C6 to the osseous construct/C6 inferior endplate junction region. The right C6 screw extends along the inferior most extent of the vertebral body near the interface with the osseous construct. Residual posterior spur, 1.4 mm, minimally encroaches anterior canal. No significant osseous foraminal stenosis.

C7-T1: Broad-based posterior disc protrusion/osteophyte, 1.5 mm, left paramedian. Mild uncovertebral joint hypertrophy. No significant osseous canal stenosis. Mild left osseous foraminal stenosis.

T1-T2: No significant osseous canal or foraminal stenosis.

T2-T3: Bulging disc/osteophyte, 1.5 mm, minimally encroaching anterior canal. Anterior osteophyte also present. Mild to moderate disc narrowing. Facet hypertrophy bilaterally. Moderate bilateral osseous foraminal stenosis.

T3-T4: No significant osseous canal or osseous foraminal stenosis. Mild to moderate disc narrowing with endplate degeneration. Anterior osteophyte.

T4-T5: Bulging disc/osteophyte, left foraminal, 1.4 mm. Mild left foraminal stenosis. No significant osseous canal or osseous right foraminal stenosis. Mild to moderate disc narrowing with mild endplate degeneration. Anterior osteophyte.

IMPRESSION:

1. Postoperative residuals C5-C6, C6-C7, with hardware as detailed above.

2. Osseous construct at C6-C7 does not appear to be incorporated to superior endplate of C7.

3. Posterior bulging disc/osteophyte, C4-C5, C7-T1, T2-T3, T4-T5, as above.

4. Canal stenosis: Mild C5-C6; minimal C6-C7, T2-T3.

5. Foraminal stenosis: Mild left C5-C6, C7-T1; moderate bilateral T2-T3; mild left T4-T5.

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Has anyone else had any issues after ACDF? Please send results - I am still having issues and they are getting worse. I have spoken to a Neuro who says it is serious. Wants to try physical therapy and injections first to try to get ride of numbness going to thru left arm. I am going to more than likely have another surgery something going on with the disc above my fusion, and the fusion on left side has not fused and a screw not where it's supposed to be. Overall I am just in pain everyday. Does anyone have any suggestions on how to interpret this CT scan or going thru similar situation?

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