Post c5-7 fusion, new symptoms

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swartzie

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Hi. I just registered. I'm very concerned. I had a two level fusion in January 2008 at C5-7. I had severe lower back spasms and after three years of undiagnosed pain, I found a Dr. who actually took an X-ray. He immediately hooked me up with a neurosurgeon. Both Drs. told me I had to have surgery immediately because I was in jeopardy of being paralysed. That definately got my attention and is probably why I'm so stressed now. My family dr. and the neurosurgeon both said the exact same thing. They both called it severe cervical spinal stenosis (compression on my spinal cord). The surgery was successful and it was a no brainer for me, except I had to go on short term disablity. I immediately noticed as soon as I awoke from surgery that the pain was gone. I had lived with it for three years and it severely impaired my life. Advil didn't touch the pain - something was laying on a nerve. I was prescribed Vicodin and my family dr. was afraid I'd further injure myself because it would and did take the pain away. From the diagnosis to the surgery it all happened so fast. After 4 weeks, the fusion is healed and the bones around it are healthy, so the neurosurgeon sent me to physical therapy. I was afraid of reinjuring myself, but the neck messages afterwarRAB made it worth it and in the end I was surprised how much it did help. That brings us to now, approximately 2 years after I returned to work. One day I had shoulder pain, the next day I had sharp pain and nurabling and tingling down my left arm. Fourth day I saw my family dr. He ordered a nerve assessment which didn't find anything. My right arm started having the same thing so he sent me for an MRI. The initial results my family dr. told me was that I had a bulge at c4 directly above my fusion. I saw my neurosurgeon yesterday. He said he didn't agree with the MRI reading, the MRI report stated that I had compression on my spinal cord. The neurosurgeon didn't think it was compression but agreed I had a bulge. He did not think surgery was necessary at this time. He also stated that I have a bulge at C7-T1 and that is very unusual. I'm just taking this all in and didn't know what to ask. I began with new symptoms 2 days before seeing him. I now have pain radiating out from my tailbone and it is painful to walk or stand for very long. My pain is not as severe as it was 2 years ago, but is definately uncomfortable and making small tasks very difficult. He is ordering an injection from a pain specialist and an MRI from a different imaging location on my back. I'm wondering if the fusion has caused the deteriation above and below? I've got 22 years in at work and they only allow a total of 12 months total for disability leave. I've already used 5 months. I really do believe that my work has created alot of my back problems even though my job is administrative - there's still alot of pulling, pushing, lifting, bending, twisting etc. Not to mention Stress I'm exhausted before the end of the day. Is this condition considered a disability? I'd have to have a PERS doctor look at my condition. Maybe I'm getting ahead of myself - but I'm so tired of the pain and work is very stressful. I have to be able to function. In the meantime, I'm just waiting for the next step.
 
Swartzie, so sorry you are having symptoms again. I suggest that you repost this on the spinal cord disorders board, since that is where all the people who have have cervical problems are. I had an ACDF two years ago at C7-T1 and I still have lots of neuropathy in arms, legs and hanRAB. You may want to get a second opinion from a different neurosurgeon. If you have your MRI results in detail, there are lots of folks who can shed light on them on the spinal board. Hope you get better answers.
Kay
 
Thank you Minstrel2. I really like and trust my neurosurgeon. He did take x-rays yesterday when I saw him again and his office seems very professional. For instance, I had to wait for my initial surgery because once I got there my red blood count was very low. I am prone to anemia anyway and I think I was exhausted from the pain. Work required me to go back to work and he called them. I work for a state agency. He changed their mind and I did everything I could to get my blood count up. It was at 8 and as soon as it hit 9.8, I was in surgery. He handled me with extreme caution initially so I think that makes me think he wouldn't have take any risks. He's also very hard to get an appointment with and he took me in ASAP. All in all, it's been 2 weeks now with a nerve test and MRI in there. I started taking Iron just in case. If I'm still in pain much longer, I'll ask my familty dr. for another referral. I will post under that site also and appreciate your help. I've gotten lost on this site, but it looks so informative. I can't believe how many people experience the same problems. Also, the family dr. I see now had moved and I decided to find him since I couldn't get results anywhere else. He was the only one who listened to me and he was determined to find my problem. If I call him with anything, he gets me in immediately. I'm so glad I found him again. Thanks again for your reply.
 
just what "type' of actual scan are they sending you for and did that initial MRI even use a contrasting agent to help highlight certain findings?

there IS a particular scan out there called a "3 T" or 3 tesla scan? this one actually uses three times the overall magnetism of the standard MRI and does see much more in depth and is just a much clearer form of scan when trying to get the very best look at a particular type of finding? this would be ideal for you right now since they are not certain about true cord compression here? getting this type of scan AND using the contrast too would more than likely actually show the "real" actual placement of anything that could be truely compressing your cpord level.

any type of actual 'scan" is only just that, a scan of an area and no way is it a real true actual 'picture' of it, so getting that best possible more in depth look at this really would help alot in determining certain findings you have and the real severity too. the chances are much better, put it that way. and it is NOT at all unusual for the levels both above and below a fused level to become problematic at all. it just happens because of the way the 'new' fused area kind of changes the load bearing below(this IS actually more the common problem below than above) and the one above is now somewhat different too? they simply do not 'move' like they used to once any level gets fused. this is not uncommon, believe me.

one good way anyone can check to see if their corRAB are possibly compressed to a really impactful degree is by simply tapping that area below the knee cap with like the heavy handle end of a butter knife? this tap and what your response just is is reather telling if that lower leg actually has a much more reactive or 'brisk' reflex to it than the normal more subtle "bounce out' most people normally have? it would be "hyper reflexic" if that is brisk? that does usually indicate that the upper motor neurons that lie right beneath the initial cord layers are being impacted. just an FYI for ya. i DO have spinal cord injury and when they tap my knee on the left, it actually 'shoots' out VERY quickly, but my left one is the normal bounce out.

but DO ask your NS about seeing if they can track down a rad facility that has that type of scanner availiable? they look just like a regular MRI scanner pretty much, its how the actual scanner and magnetism just is that makes it stronger. i just think this type of scan may be the most helpful for your NS. but certain types of testing good NSs just do during the hanRAB on neuro exam can also indicate levels of possible cord contact too. its just how your body would respond to certain stimuli when they even do a particular test on you that indicates actual cord compromise and degrees.

good luck with this and please keep me posted. make certain too to ALWAYS always obtain your very own copies of ANY and ALL types of real testing reports that are simply done on you? this is so you just have this for your own medical files you can keep at home, but more importanly, it actually allows us the patients to actually "read" thru our own reports as well. sometimes not all specialists esp are as forthcoming with actual findings that were even IN certain reports at times. i have had this happen to me and others here have too unfortunetly. this just assures that you are hearing everything you should be. i keep all the most current and most pertinent stuff in a expanding type of folder so i can also bring this with me to all appts too. it does help. i have to see wayyy too many specialists to treat all my ongoing crap i have wrong. marcia
 
Thanks Marcia,

What a great reply. I love this site. I will be asking for my MRI's. No one has mentioned those other scans, however I'll be asking if there is anything else. My pain just does not seem to be getting better. I had trouble sleeping last night. I just could not get comfortable. I really didn't want to take more Aleve, but ended up taking it so I could get some sleep. I wake up fine once I'm in that relaxed state...until I start to move. He is scheduling me for an injection from a pain specialist. I'll ask how long that is supposed to last. I guess it's better than eating Advil, Aleve, etc. I don't know why he told me the buldge at c7-t1 was unusual. Once he read everything, he took me in for his own xrays. He also scheduled an MRI (one he uses at a local top rated hospital) on my lurabar and stated he'd want to keep an eye on these bulges. The tingling one minute, nurabness & pain the next is driving me crazy and it's not a very far drive. I'll get those results and be asking alot more pertinent questions I've learned from this site. I'm having trouble writing for any length of time. I can write, but it become very difficult and my handwritting shows poor penmanship the further I write. I start out ok.
He did do the hand testing and used his funny looking gadget. He didn't comment this time. He definately did on the first visit to him before my fusion surgery. He said I had lost function at that point and was very concerned. My experience makes me think he will follow through and do whatever he neeRAB to do. Post surgery, my fusion was completely healed and he said the bones around my fusion were healthy. At least the pain isn't as bad this time, but still annoying. I wasted no time getting in to my primary physician. I called and said I had nurabness & tingling in my arms and he got me in later that day. I'll be posting more as this process goes along. We'll see what happens. Unfortunately, I'm go into a very demanding two week schedule at work. I'll have to somehow make the time to get to these appointments. When they tell me I need to be there - I'll be taking sick leave. I already forewarned them. Now they are scared I'll be going out on leave again. I assist our Commissioner's (state agency) and everyone else is scared to deal with them. I have great relationships with them, but will worry about them if I do have to go out on temporry disability.

Thanks again and hope all is well for you.
Swartzie
 
The Spinal Cord Disorders board has most of the discussions about cervical spine problems. You may find further assistance there as most of the discussions here are lurabar and thoracic spine problems.
 
Thank you. I will post there. I'm anxious to see how this week goes. It's going on 3 weeks of constant pain. The next two weeks are going to be very busy at work and we're on the road on May 13. I'm handling it with a heating pad and Advil.
I'll post on that site now.
Thanks again.
Swartzie
 
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