ADR imaging and the M6 C cervical disc

[Jarrod]

Hello,

Wanted advice on MRI imaging of the m6c disc. I had a cervical MRI to make sure the canal stenosis was taken care of but the scan showed distortion in the neuroforamenal openings at all three levels. Is there a special MRI or scan that I can have to show the nerves are not compromised after my surgery. Dr. wants me to get at Myleo ct, but that is like $7000.00 dollars and Im not sure that BCBS of Florida will agree to cover that as I had surgery in Barcelona Spain. Im having some post op numbness and lower shoulder blade ache below the area of the c7-T1 disc I had replaced. Any advice is greatly appreciated. Im worried that maybe the nerves are still be compromised and this is why i still have some pre surgery symptoms. So I figure I will just make sure so i can stop worrying myself to death.

Jarrod

[annapurna]

The CT myleogram is the gold standard technique. There are possibilities but they tend to (1) be very dependant on the equipment and radiologist and (2) work better for the lumbar where everything is simply bigger. One thing, myleography is dangerous. This is another area to find a good person who's confident with his/her technique and pay for that expertise rather than go for a low cost, high risk option. I don't know how risky it can get but the technique can cause short-term excrutiating headaches and potentially even lead to long-term pain problems.

[catelynnw3]

Hi Jarrod,

It seems that a CT myelogram is your best bet if you want to know exactly what's going on in there. You should ask your primary doctor to submit the request to your insurance company to find out if it's even an option for you to consider. If they agree to cover it, then you should definitely weigh the risks vs. benefits. I'm not sure of another test that would give you the answers you want/need.

Wishing you the best,
Cathy

[Jarrod]

Catelyn,

Not sure what to do yet, some days are good and some I'm just achey all day in my shoulder-blade area. I talked to mark and he said in so Cali. He can have a myleo ct for about 1800.00, so I asked him if he knew of anywhere on the east coast for a better price, since I am in fl. My hand is better than before, it just has a mind of it's own and sometimes the fingers are barely numb and other times they are fully numb and activity does not activate the numbness. Also when I cough or sneeze I don't get that electric sensation down my arm as much, it is less intense, so this I'm thinking it is the nerve calming down still, ( I pray it is). But the shoulder blade ache flares up about 2-3 times a day, so I'm stumped on if it's nerve or muscle. When I herniated my c7-t1 my whole left shoulder .blade was swollen about 4 inchs out, so maybe it's just the muscles re- traumatized in the same area from surgery.

Dr. Clavel said it could take up to a year for me to feel normal again and I hate complaining because I kno there are so many others out there that are way worse off than I am, so I ask questions to self diagnose my symptoms. Three levels is alot for the body to recover from, and I kno I tend to be a slow healer from previous shoulder surgeries, so icky takes 9-12 months to heal then I will gladley wait it out. So if you have any posts that you read about slow healers please let me know I will gladley read them. I wish I knew if it was muscular or nerve pain that I am having. Thanks for the response, I really appreciate the help .
Also anyone kno how insurance works with ADR out of pocket, will they possibly cover a myleo ct due to artifact interference due to ADR. Not sure how my gp wi submit or ask for the need for the myleo ct. I have bcbs of Florida.

Thank you guys, especially catelyn and all others who respond with interest.

Sincerely Jarrod

[catelynnw3]

Considering how bad you injured your shoulder and that you've had previous shoulder surgeries ~ is there a possibility that the pain isn't from the ADR surgery at all? Was it there before your surgery? Maybe you could go to a Sports Medicine doctor or even a Physical Therapist who may be able to help you pinpoint where your pain is coming from. They will often move you in different ways and ask lots of questions to try to figure out the source of your problem.

I don't consider you to be complaining ~ if there's something more you can do to help yourself ~ you should seek answers and then do it. That's what this forum is for.

As far as insurance covering tests after out-of-pocket ADR surgery, I haven't had any problem with BCBS covering my pre-op testing (which was done in the U.S. & ordered by my Primary doctor). I also didn't have a problem with them covering my three month post-op x-rays which I had recently. I noticed on the report that the Clinical Indication says "Neck pain with history of disc space surgery". I assume that's what my Primary doctor told my insurance company so they'd cover the x-rays although I didn't mention any pain. Since you do have pain, your insurance company doesn't know for sure if it is from your surgery, so they should cover further testing to properly diagnose.

[catelynnw3]

Hi Jarrod,

I was thinking... If you do decide to get the CT Myelogram done, I would ask Dr. Clavel if you should pre-medicate prior to the test. Typically it is recommended to pre-medicate (with antibiotics) prior to a dental appointment for up to two years after ADR surgery. I would think that injecting dye into the spinal canal would warrant at least the same precautions. I could be wrong, but I'd err on the side of caution.

Cathy

[Jarrod]

Hi all,

Well I'm headin to the neurologist tomorrow to set up a EMG and a possible myleo ct of the cervical spine and upper thoracic spine. I've had enough and I have to make sure that the nerves at the operated levels are not being compressed by possible leftover disc material that is on the sides of my ADR's. They leave some disc in for spine stability, that's what my surgeon said. I think that the muscles in my hand are getting smaller in between my wrist and pinky finger and my thumb and index finger too. Also when I put my head down in a flex position the back ache and forearm irritability come together as one. Want to get to the nerves if there being compromised so that permanent damage does not happen. Very depressed and looking for answers, feeling like my family is tired of hearing about my issues and this crappy attitude I've been having. Not myself and looking for some answers and releif, holding that I did not waste 40,000 in the meantime. I still have faith in my surgeon as he was very good and reassuring to me that it takes time. Hopeing everyday to wake up and have these symptoms start to diminish, and pray that I am a slow healer instead of an unsuccessful ADR surgery.

Anyone had these tests done and can the EMG test tell where the nerve is being compressed or pinched.I feel like somewhere in my upper back the nerve is being trapped so I hope the EmG is helpful in this as the myleo ct is very invasive. I hope these symptoms are not something I will have for the rest of my life as I was a very athletic and outgoing person who seems to have lost that zest I use to have before this nightmare happened!!! Thank you all for listening!!

Jarrod

[jss]

Jarrod,

I hate that you're still having issues. I don't know if this information will do you any good, but it is another data point.

I had M6's at C3/4 and C6/7 17 months ago, and fusions at C4/5 and C5/6 years before. I'm 100%, but still have some sensory issues at times. My left hand is still mostly numb. When I go for a run, within the first mile my left hand goes almost completely numb. If I run more than 20 miles or do something especially strenuous, like dig out a tree stump, I'm subject to have spasms in my neck, left trapezious, or left radiobrachialis for five or six days. I've never had a post-surgical check up since leaving Barcelona, but as far as I can tell, everything is Ok. I've accepted that I almost certainly have permanent nerve damage and that my residual symptoms are from that.

Here's to hoping that you'll find everything Ok from the myelogram. Please keep us updated.

Good luck, Jeff

[annapurna]

An EMG can tell you which nerve is getting pinched but only if they test enough and spend enough time on it. Basically, if you get out the door in less than an hour, question your results. Laura's two full-body tests took about 3-4 hours but that was checking cervical and lumbar for issues. EMG isn't very pleasant. Expect the needles to hurt but there really isn't any way to do the test right without them. The CT myleogram has it's risks, as you've mentioned but the two together should give you a reasonable idea of where your problem stems from.

Don't be surprised, though, that the two suggest that the nerve is being irritated some distance from where you feel it. If you search on referred pain here or elsewhere, you'll see what can happen when a nerve is pinched and that leads to an apparent pain some distance away because that's the area the nerve ennervates.

[Jarrod]

Annapurna,
Can u elaborate on the enervation of a nerve. My c7/t1 was herniated verybad on the left nerve root and is it possible that maybe that the nerve was impinged lower down due to the swelling and trauma from the injury. I'm not sure I understand how it works and what is ennervation exactly. I'm trying to figure out this so that I can talk to the neurologist. I thought that if the pressure was released from the nerve root then most likely the symptoms would resolve and function would return gradually to the affected side ( espicaaly if caughtsooner than later) so how long should it rake for the hand muscles to return to a somewhat normal state and how due I get the nerve freed up if it is impinged further down than the c7/t1 area. You seem very knowledge about this so I'd like ur opinion.

Jeff ur always so helpful and I thank you for ur imput always.

Jarrod