@rdflash0788 I do see the places you are concerned about. The circled discs are on the front side of the spinal canal. The dark is your spinal cord and the white space around it is spinal fluid. You can see that in the place between C3 and your fused levels that there is bigger fluid space on the opposite side (back) of the spinal cord. It looks like the cord is indented slightly or is bending around the disc in front, but able to move into the space to the back. At your C6/C7 level adjacent to the fusion, it is harder to tell how much space there is. There may be another slice that shows it more clearly. It does appear that there is compression coming from the back side of the spinal canal. Sometimes the MRI slice isn't lined up exactly parallel to the spine, or if there is any spine side curvature it can be off a bit and looking through the slices can give better information.

My spine imaging showed no white space at all on either side of the cord, although the neurologist said there was a little bit of space. My vertebrae were moving out of alignment by a few millimeters, and when that happened, I did have symptoms with a gait disturbance walking with a limp, and difficulty emptying my bladder. I was working with a physical therapist at the time and she would get the vertebrae realigned properly and it resolved those symptoms until the next time spasms caused vertebrae to shift and rotate and then it reoccurred. It was an intermittent problem for awhile and this is how I knew that the symptoms were related to the spinal cord getting touched or compressed slightly. I did also have pain and tingling that could be anywhere in my body and those issues shifted location when I changed the position of my spine.

Going through PT isn't a bad thing, and it may help by strengthening the core so your spine can be better supported. Insurance often requires PT before they will authorize surgery, so in that sense, it does check a requirement off the list.

In answer to your question, yes listhesis does shift the vertebrae bodies and change the shape inside of the spinal canal which may make it a bit smaller with the vertebrae shifting. Think of it like beads on a string and the beads get pulled out of alignment causing the string to touch the side of the hole inside the bead. The question is how much is it shifting and does the cord touch a disc osteophyte complex that is pushing toward the spinal cord? I know from my experience that my fluid space was gone all around the cord, so a shift of listhesis definitely caused symptoms. There was never any spinal cord damage evident on my MRI which is good. Mine was only one level affected, and yours is a bit more complex with a few levels involved and a prior surgery which can increase the symptoms. Prior to any spine surgery, I got to the point that if I bent my neck forward, I sent an electric shock down my entire body, and then it stopped when I straightened my neck again. That is positive proof of touching and compressing the spinal cord. I had bone spurs there in front that were like a knife edge that the cord was bending around. I didn't have the nerve compression in the foramen (nerve roots) that you have which adds more symptoms that are predicable for the specific nerves involved.

How much physical therapy will you be doing? Do you follow up with the surgeon after that? Are you considering other surgical opinions? You've been through cervical spine surgery before, so you must have a sense of what surgery will be like although with adding more fusions, there will be further loss of movement. Did your surgeon discuss other non fusion procedures such as a laminectomy? That would just add more space to the spinal canal. Artificial discs may not be approved for use next to an existing fusion, but that may be something to ask. It is a big decision.

Jennifer