Hi Everyone,
Today I had the CT guided left C7/T1 T1/T2 T2/3 facet joint steroid injections at a Melbourne Radiology Clinic.
The procedure was over in 15 minutes and had to wait 20 minutes after the procedure for observation.
The Doctor that performed the procedure was excellent. He told me that I was being injected with a mix of lidocaine and steroid.
Initially I felt that the pain abated by 50%, but when I went back home the pain increased again.
Currently it is more than 9 hours since the procedure and the pain is at 8 out of 10 consistently.
Maybe I should wait a few more days if it settles down.
I did notice the main pain is originating some 4 cm above the injection sites and spreading downwards in an aggressive way therefore I don't what is happening above is overwhelming the whole area below making it hard for me to judge if the injected area has improved or not.
I went back to re-read the MRI reports and worried about the following points:
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C4/5: Disc osteophyte complex and buckling of the ligamentum flavum causing mild to moderate canal
stenosis with severe right neural compressive foraminal stenosis. Moderate left foraminal stenosis.
C5/6: Disc osteophyte complex and buckling of the ligamentum flavum causing mild canal stenosis with
severe left neural compressive foraminal stenosis.
C6/7: Uncovertebral disc osteophyte complex is larger on the right with severe right neural compressive
foraminal stenosis. Moderate left foraminal narrowing.
C7/T1: Moderate left and mild right facet degeneration with 2mm anterolisthesis. No canal or foraminal
stenosis.
They above buckling of the ligamentum flavum was not present in the Aug 2022 MRI. Therefore what has happened for me to get worse?
I have been extremely careful with my movements and my activities.
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In particular:
1) buckling of the ligamentum flavum causing mild to moderate canal
stenosis with severe right neural compressive foraminal stenosis
2) C6/7: Uncovertebral disc osteophyte complex is larger
3) C7/T1: Moderate left and mild right facet degeneration with 2mm anterolisthesis
I read that:
1) The "buckling of the ligamentum flavum" may cause compression of the central canal
2) The C6/C7 large osteophyte complex could be pinching the nerves
3) The C7/T1 2mm anterolisthesis is a slight slipping of the upper vertebra in front of the one below
This is worrisome to me because it makes me think that I may have a serious problem.
Can this be fixed with surgery? Can they just grind down the bone spurs? Or will I need a fusion ultimately?
This can be food for thought for Jennifer @jenniferhunter 😊
Thanks again
Best regards
Alfred
Alfred, @ab6540183
For bone spurs inside the central canal, the surgeon needs to be able to get in there and I believe that they do grind them off with a special tool. The usual path is by removing a bad disc, then removing the bone spurs and damaged disc in the canal, and then grinding the end plates (surfaces) of the vertebrae to be flat to prepare them for the fusion. In my surgery, only a bone disc spacer was used made of donor bone that is milled to the right size and shape and had a space to seed the removed bone spurs. Sometimes cages are used made of plastic or titanium metal. I would think that your surgeon would likely offer you a fusion. In order to used artificial discs, there needs to be enough stability to the spine or you would not be a candidate.
I think you are now understanding the seriousness of your condition. I'm glad that you are now looking at educational videos to learn about various spine procedures. Write down your questions to ask your surgeon. Make sure to ask why a procedure is preferred over another as it pertains specifically to your case. In other words, what makes you a candidate for a procedure or what disqualifies you? I think they sometimes remove the Ligamentum Flavum, but you'll need to ask that question. When there is spine damage, you compensate with different movements. Perhaps possibly this is why the ligament is affected now? The statistics on ligament issues affects the Asian population at greater rates than people of other races.
The progression of spine disease is usually degenerative when you loose stability of maintaining vertebrae in the proper alignment, and with discs that collapse. There isn't a way to save a collapsed disc, and if it is left alone, the spine can start to fuse itself around it which may not be in a good alignment. That's why it is important to make a good decision as to what will give you the best outcome. The doctors may have done the facet injections to rule it out as the major problem because if that had fixed all your pain, they could claim that all the stenosis is not causing the pain.
The designations of "moderate" or "severe" when talking about stenosis have to do with an actual measurement from the imaging as compared to a normal measurement. They have a range they define as severe which you have. I do not think they can make excuses for not helping you with surgery when your report says severe compression on nerves. This can cause permanent damage, and the sooner it is decompressed with surgery, the sooner you can begin healing and recovery. Surgery is always a compromise, and you loose spine movement with fusions, but when you compare that with the symptoms you have now, it is an easier choice to make. I had surgery when my report said I had "mild" compression of the spinal cord. I feel that you are an urgent case, and you need to keep asking questions about this until the doctors agree to help you.
Jennifer