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Excruciating chronic left side neck pain plus lumbar issues

Spine Health | Last Active: Nov 18, 2023 | Replies (360)
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@ab6540183

Hi Jennifer @jenniferhunter

How are you?

I have been reading your very informative ADR vs fusion posts.

I remember that you said the ADR can have problems (calcification and screws) as well as fusion (Adjacent segment disease).

Obviously it will be up to my neurosurgeon to decide if he will do surgery or not. If he does decide to go ahead with it, he will have to take into consideration my specific, unique condition's factors before he will select one type of surgery or the other.

In my latest cervical spine MRI dated 28 of Jan 2023 the report states the following:

Approximately 2mm retrolisthesis of C4 on C5 and 1.5mm retrolisthesis
of the C5 on C6 vertebral body noted.

C5/6: Spondylolisthesis and uncovering of the intervertebral disc in
conjunction with discophytic lipping associated with mild spinal canal
narrowing along with moderate left neural foraminal narrowing seen
impinging the exiting left C6 nerve root. Mild right neural foraminal
narrowing contacting the exiting right C6 nerve root also noted.

I am no expert, but does it mean that I may need a fusion from C4 to C6?
If so would I lose flexibility? Probably a YES?

I couldn't help noticing that there are some areas pretty close to my cervical spinal cord?
How serious is this?
Some times when I slightly bend I feel pain in the neck then leg and foot for a few seconds before it stops.

I have attached 2 images: Cervical and top of upper thoracic.

What do you think?

Thank you.

Best regards

Alfred

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Replies to "Hi Jennifer @jenniferhunter How are you? I have been reading your very informative ADR vs fusion..."
Jennifer, Volunteer Mentor | @jenniferhunter | Feb 14, 2023

@ab6540183
Good morning Alfred,
In my surgical case, my retrolisthesis was 2mm at C5/C6. My surgeon said he could do an artificial disc there or a fusion, but that I was not the best candidate for ADR because of the slipping. At 4mm of retrolisthesis a patient would be disqualified from a clinical trial for ADR.

From your image, I can see that you do still have fluid space around your spinal cord where you have marked the red arrows to indicate the bulging or herniated discs and the enlarged ligamentum flavum that extend toward the spinal cord. The fluid space in white. The reason you are having symptoms on flexing is because it's like bending a rubber hose with a rope inside which makes fluid space a bit more narrow when you do that. The spinal cord is like the rope that has to move within the space when you bend, and is probably contacting the discs or ligament and generating the symptoms. I had a similar thing when I could bend or turn my head and produce symptoms.

My fluid space was completely gone on imaging, although a neurologist said there probably was still a little bit of space that wasn't visible, but I got to the point where I could flex my neck forward and send an electric shock down my entire body. I was on the surgery list at that time just a couple weeks before my procedure.

If C4 through C6 are fused, you'll loose some flexibility. I have only C5/C6 fused and my range of motion for turning my head is normal. Head turning is mostly C1 & C2, with some help from C3 & C4. If your C4 is fused to C5 and C6, you might loose a little bit of head turning range, but how much is a question for your surgeon. You may not have that range now because of muscle spasms. I cannot touch my chin to my chest anymore, but it is very close.

I hope that information helps.

Jennifer

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