The Titanic
 

Hi, Thanks for reading. Any feedback would be appreciated!

I had a foraminotomy 8 months ago that removed a bone fragment that was irritating my nerves, an osteophyte, and freed up a little more room for my nerves since they were being crushed. I have been busy gathering a bone density test, an updated xray and MRI in anticipation of a cervical 2-level M6 ADR when I received the next blow—my xray indicates (that in the areas where I had surgery) “mild facet degenerative change is present.” Strangely, none of my MRI(s) have ever mentioned facet degeneration and I specifically asked the ultrasound tech to evaluate that since I am trying to rule out any contraindications. I thought that MRI(s) looked at soft tissue and would be a better diagnostic tool for facet issues than an xray that shows bone?

I have honestly felt like a dog chasing its tail :sus: with all the hopeless scenarios and today the straw broke the camel’s back, or neck, so to speak!

Isn’t it possible that my facets have mild degenerative change due to two discs collapsing on top of them? Wouldn’t restoring that height and removing the stress be a positive outcome? I had already decided not to get the Prodisc due to the fact that it allows too much movement/stress on the facets, but is ADR out of the picture all together?

My pain is usually less in the morning when I have laid perfectly still all night on an ice pack :flaming: with my nerve and sleeping pill. However, after being up for an hour or so (due to movement such as driving to work, turning my head even 10 degrees to look at my 2nd monitor, brushing my teeth, etc.) causes pain. All this time I’ve likened it to the analogy of a punching bag—it’s fine just hanging there, but the slightest movement feels like it is getting punched over and over again and it swells. I have a lump of swelling on the back of my neck/thoracic area that is less prominent than it was pre-surgery, but still there. I suppose I really thought the pain generators were my nerves because: 1)the pain moves from side to side-one minute it can be on the left and the other it’s on the right; 2)usually pulling my neck (traction) up a little feels good; 3)I have 1 ruptured disc (c5-c6) and 1 herniated (c6-c7).

What are my options? I am going to see a pain specialist to see if any diagnostic injections are recommended. I don’t want to let time pass and cause any additional damage. It’s already going on the 13th month since the pain started. I suppose I could: 1)do nothing and just writhe in pain and agony (I truly feel like a 3-legged table that is causing further damage); 2)get a fusion (so far I “refuse to fuse”); 3)get two m6(s) and have no money or insurance to treat facet issues if they occur; or 4)get facet injections and hope they relieve the pain. If facet injections do relieve the pain, does that mean that my facets are continuing to be damaged by the collapsed discs but I just can’t feel it? The epidural injection I had pre-surgery caused “a fragment to present itself” from my disc rupture, so I am apprehensive about another injection.

Oddly, last week I had 2 good days (as long as I was as still as possible). I could actually turn my neck a little and didn’t notice I was doing it. Then I decided I should do my PT stretches (just touch my chin to chest and side to side) and the swelling and pain became relentless again.

Oh, I also have muscle tightening that occurs on and off all day long with tight hard balls in my neck and shoulder area that I am constantly having to do acupressure on so it will unclench my nerves. I’ve never read anyone else mentioning this.

So much for waiting for conservative methods. Please! I need some encouragement. Some light at the end of the tunnel. A lifeline because I feel like I’m drowning! :bawling:

Ahhh, Jen - sorry you had such a bad day. Sounds like the news wasn't good today. I'll shoot you a PM. in the morning. Just got home from a birthday party, came straight in & propped myself on the sofa with pilows. Get some rest tonight...

Hi Jen, sorry you are here. I hope we can help. May I ask what the originating cause was that led you to your first surgery? Was it trauma? By the way, we also have some meaty topics on bone density and DEXA scans. You can locate them easily with the the search function.

MRI would be better at showing just about anything than an xray - I'd ask your pain dr. Doesn't mean that the person reading the MRI didn't gloss over the facets or put in a macro for the read of that part (trust me, IT HAPPENS).

i know that not everyone has the access to radiologists that i do, but i took all of my films to the musculoskeletal rads at my hospital and had them all reviewed before i did anything. yes, i'm that paranoid. pain docs and spine surgeons nearly always look at the films themselves, so they should be able to chime in.

i know nowhere near as much about cervical issues as i do lumbar - i have cervical muscle issues but nothing structural, due to hypermobility per my PT -- but what i can tell you is that you are asking the right questions!! hopefully your pain dr is good and patient and will work through those issues w/ you. hopefully you can find at least 2-3 stateside surgeons from whom you can get an honest and thoughtful opinion - even if the right thing to do isn't for them to operate on you... that they will admit it!

best of luck!!

Plan
 

Hi Richard! :clap: Thanks for the welcome. I just had a DEXA scan in case I needed ADR. I get the results in two days. Are you thinking that the DEXA scan might reveal a more accurate picture of my facets? In regards to what caused my two damaged cervical discs, initially I didn’t know, but after much retrospect, I realized it was trauma.
Laid Up Doc-Thanks for your reply as well! :jacks: I'm so jealous of your access (I didn't underline that word!) to doctors and radiologists! That's wonderful. Recently I actually asked my primary care doc if I could get an appointment with a radiologist to discuss my MRI results and he said that the reason radiologists go into that specialty is so they will not have to “interact” with patients. He did say we could request a second opinion on the MRI though. I am reluctant to have my surgeon tell me if surgery is acceptable with my facets for obvious reasons. I know what you mean by paranoid, I feel the same way. I spend everyday analyzing and researching this situation. Occasionally I get so discouraged that I think I should just get a fusion like a couple of my friends. They all had fusion within the last 4 years and are doing great! Too early to tell if they are going to have adjacent disc issues, but they are out golfing, horseback riding, etc. and I am tiptoeing around trying to cause no movement to my neck so it doesn’t blow up.
With that said, I’m going to try to move forward by focusing on my goals for this week: 1)email Dr. Clavel my MRI & xray; 2)get the results of my DEXA scan; and 3)make an appointment with the pain doctor.
I will keep y’all posted. ;)

Jen, good for you for setting goals for this week! Here's the meaty, multipage topic I referred to earlier (DEXA, osteoporosis, nutrition, etc.):

http://www.adrsupport.org/forums/f51...porosis-10179/ :look:

Also, search for facet arthritis and facet arthrosis within this community, as many topics should be of interest to you.

ct scan indicates new bulge!
 

I sent off my MRI and xray scans to a couple of different doctors for evaluation. My MRI(s) have always indicated a bulge at C5-C6 & C6-C7, and recently an xray indicated mild facet degeneration at my worst level, C5-C6. One of the surgeons I sent my scans to, Dr. Pimenta, requested a CT Scan before providing a game plan. Today I got the results of my CT scan & it had an error. In one section it indicated a bulge at C3-C4, but in the summary, it indicated a “2 mm bulge at C2-C3…” That was an error and should of read C3-C4, not C2-C3.

Interestingly the CT scan report did not show my largest bulge at C5-C6! Maybe that is because that is where I had my foraminotomy, but I still have a mild bulge there and every MRI indicates that.

Due to the obvious error and my concern over having another bulge, I asked for an explanation from the imaging company. A radiologist (he was not the one who initially interpreted my CT scan) agreed that C2-C3 was fine and that was a mistake, but that he did see a bulge at C3-C4 & C6-C7. I proceeded to tell him that I’ve had many MRI(s) (I mistakenly told him a month ago, but when I looked at the report at home, it was 10 weeks ago) and none have ever indicated a problem at C3-C4. He did not have access to my MRI scans since they were done through a different company, but indicated he would like to see them. He did tell me that an MRI is a much better picture of this kind of thing than a CT scan.

Also, I received a quote from a well-known surgeon that is spoken most highly of on this site and he gave me the quote for the 2 levels I was aware of, so wouldn’t he have seen C3-C4 if it had a bulge as well? Another UK surgeon that is highly spoken of did not mention the bulge from my MRI either.

Movement hurts me and I do everything I can to stay as still as possible. Even to the point of not shaking hands, not riding in the car much, not pushing a shopping cart because it’s too jarring, etc. I pretty much go to work and come home and lay down with my ice pack, so how can I possibly have another bulge? I have felt like my neck is unstable since my surgery..

I’m scrambling for answers. I don’t know how long it will be before I get an “addendum” report to my CT scan. Isn’t it unusual to have a bulge at a non-consecutive level?

I don’t think CT scans indicate something that isn’t there… I have had MRI(s) at two different places over the last 15 months and neither have ever mentioned disease at C3-C4. I suppose it’s possible that a new bulge surfaced in the last 10 weeks. If any of you think differently, please encourage me and prayers are always welcome!

Thanks.

Jen,

While it is disconcerting to see these types of careless errors made by medical professionals, try not to be too concerned about this particular one. The surgeons that you send the report to will probably not read it anyway. They will instead look at the images themselves. I would think that they would be less likely to make the same errors.

Good luck, Jeff

Hi Jen,

Thinking of you this morning & hoping you are closer to finding your solution. You mentioned in your above post about knots & accupressure; do you think it is muscle spasms? I get them so bad sometimes you can see the muscles jerking through my clothing...

Hang in there, I know you find the right doctor, I just know it!:)

Hey Jen, tried to answer your PM this evening but you box is full!!