Help w/CT results 3 years post ACDF

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shacker06

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Hi,

First a little background. I had an C6-7 ACDF in Septeraber, 2005, with plating and donor bone. Post surgery was great, with little or no pain.

About three months post surgery pain returned and has been getting worse. I take 8-10 50 mg Tramdol (Ultram) per day. I have tried steroid injections in the neck (in addition to steroid and nerve deadening chemicals) in lower back facet joints. Recently, the pain in my neck (no pun intended) has gotten much worse, with nights being terrible. :(

My pain management doctor ordered a CT scan after I insisted something had to be done. This is where I need the help in better understanding the findings.

First the good news, no problems at C2-C3 through C4-C5 and C7-T1.:)
Next come thee issues:
  • C5-C6: There is a 1-2 millimeter degenerative retrolisthesis, which is new. There is a mild narrowing of the disc space and small, broad-based posterior disc protusion. In addition mild effacement of the anterior aspect of the thecal sac, but no significant foraminal stenosis.
  • C6-C7: (ACDF location) Any bony fusion across the C^-C7 level appears very minimal. There are fairly well corticated sclerotic margins of the endplates and localized bony protuberances. The area most suggestive of bony fusion is seen immediately posterior to the interbody stabilization device, with a stalk that appears to extend from C6-C7 measuring 4 mm in diameter.

I think I understand some parts (like the no problems section), but would like anyone's help in better understanding any part of this write-up. Also, any suggestions on pain solutions would be great.

Thanks,
Aaron
 
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