7mm spinal cord stenosis

Posted by sb4ca @sb4ca, Oct 8, 2022

I had an ACDF for C5-7 in March of this year. Exactly a month later I needed revision surgery because a screw was out of place. The day after I was discharged I learned I had both MRSA and regular staff infection within the bone which required a PICC line and 6 weeks of IV antibiotics. Early September I had a big increase in neck pain which my primary was concerned about MRSA coming back. My surgeon just ordered an MRI and CT. The MRI report has now come back and I have severe cord compression causing central canal cord compression to an estimated 7mm. I also am showing new bone marrow edema at the offending C3-4. This on top of advanced neural foraminal stenosis, advanced hypertrophy including the liagentum flavum and large bone spurs. This is almost entirely new from the MRI just prior to my surgery. My surgeon said this is extremely rare as usually its years before the discs right before and after the fusion are affected. Not skipping a disc altogether. Has anyone experienced something like this so soon after surgery? I mean how does this even happen???

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@sb4ca I am a cervical spine surgery patient too. You have been through a lot and a lot of changes in a short time.

We discussed artificial disc vs fusion here on Connect in this comment from December 2021 where you noticed what looked like a problem with C3-C4
https://connect.mayoclinic.org/comment/665202/
Was this discussed with your surgeon at that time or prior to your surgery? Did he think it didn't look bad enough to address?

Prior to my fusion at C5-C6, I had MRIs done 9 months apart, and it that time, the amount of bone spurs doubled so it surrounded the extruded disc. I was worried about reactions to foreign materials, so my fusion was done only with a bone graft and no hardware. I stayed in a neck brace for 3 months.

Is it possible there is still infection at the surgical site? Another thing that comes to my mind would be to question if you could be having an immune response to implanted surgical materials. There is a lab in Chicago that tests for immune responses called Orthopedic Analysis https://www.orthopedicanalysis.com/

I know from personal experience with the removal of dental work, and surgical titanium plates from my ankle (from a fracture) that these were causing issues for me, and my health improved afterward. I had chronic hives until I had the titanium removed from my ankle.

Has your surgeon discussed a possible immune reaction? Are you scheduled for another procedure?

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Hi Jennifer and thank you for your response,
I re-read what I'd previously said. Prior to the surgery this year, I had several cat scans and the last one showed that both 5/6 and 6/7 were compromised. My surgeon did not want to do several levels at the same time and apparently felt the compression at 3/4 wasn't as urgent. He also double checked where my symptoms were and tailored the surgery accordantly. You had brought up TOS and in 2021 I did see my neurologist and brought it up but he said it was not TOS. I have some type of polyradiculopthy with demyelinating processes that affects all limbs. I just saw him last week and told him I could now feel balance issues (which in Spring last year he told me it was getting worse though I hadn't noticed it) I have issues with very slow conduction, etc., that the EMG testing shows. This year, I showed him the image of the MRI that was just done and he said doing any testing would be a waste of time because he would not be able to tell what was the causation considering the compression would also produce abnormal results. He was definitely distressed about the image. Also with immune response to metal, Ive never had problems that could be traced to that. But further, I have abnormally low IgG, particularly in the subclasses. I don't believe I could mount such a massive attack but anything is possible. The new edema in 3/4 is concerning to me as it definitely could be infection but that happens with severe arthritis as well. In September I did have a blood test-CRP-which was elevated but not as bad as when I did have MRSA. I chocked this up to the big increase in inflammation when I had a sudden change of pain. The ESR was normal. I'm having a cat scan today and have a telephone appointment with my surgeon mid-week. As I said, the MRI report was not available when I saw him but he typically reads the imaging himself. So we'll see what he says.

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@sb4ca

Hi Jennifer and thank you for your response,
I re-read what I'd previously said. Prior to the surgery this year, I had several cat scans and the last one showed that both 5/6 and 6/7 were compromised. My surgeon did not want to do several levels at the same time and apparently felt the compression at 3/4 wasn't as urgent. He also double checked where my symptoms were and tailored the surgery accordantly. You had brought up TOS and in 2021 I did see my neurologist and brought it up but he said it was not TOS. I have some type of polyradiculopthy with demyelinating processes that affects all limbs. I just saw him last week and told him I could now feel balance issues (which in Spring last year he told me it was getting worse though I hadn't noticed it) I have issues with very slow conduction, etc., that the EMG testing shows. This year, I showed him the image of the MRI that was just done and he said doing any testing would be a waste of time because he would not be able to tell what was the causation considering the compression would also produce abnormal results. He was definitely distressed about the image. Also with immune response to metal, Ive never had problems that could be traced to that. But further, I have abnormally low IgG, particularly in the subclasses. I don't believe I could mount such a massive attack but anything is possible. The new edema in 3/4 is concerning to me as it definitely could be infection but that happens with severe arthritis as well. In September I did have a blood test-CRP-which was elevated but not as bad as when I did have MRSA. I chocked this up to the big increase in inflammation when I had a sudden change of pain. The ESR was normal. I'm having a cat scan today and have a telephone appointment with my surgeon mid-week. As I said, the MRI report was not available when I saw him but he typically reads the imaging himself. So we'll see what he says.

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@sb4ca I can see why your doctor is distressed about that image because it shows some serious compression of the spinal cord at C3-C4, and this is your current image if I understand? I noticed a mottled appearance in the vertebrae bones. Was that the edema you are talking about? Do you have a comparison image of C3-C4 from before your first surgery? I would be interesting to see how much it changed if it did change. I'm glad you are addressing this, but sorry that you're may be going through more surgery.

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Hi again my friend, I do have the previous MRI that was taken right before surgery. I also included the report that addresses the compression at 3/4.

At C3-4, there is a persistent 2 mm anterior subluxation of C4 below C3, with advanced disc degeneration and posterolateral vertebral body osteophytes much larger on the right side. There is also posterior facet moderate to advanced hypertrophy with ligamentum flavum hypertrophy. The anterior and posterior thecal sac defects cause a reduction in central canal diameter to an estimated 7 mm, a moderate to advanced AP central canal stenosis. Cord compression is present. Neural foraminal stenosis is advanced on the right and mild to moderate on the left. The right foraminal stenosis has increased since 2/14/2022. Since 2/14/2022, development of venous congestion/bone edema in the C3 and the C4 vertebral bodies.

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I have the same thing that you are going through but I had a Mobi C implant put in my neck. And when I started having complications my surgeon fired me and now nobody will help me it's like a huge boys club and nobody wants to admit that something bad happened feel like my whole life is ruined. I only found out about my stuff because I got my record they were telling me everything was just fine no I think I will just have to wait to die because nobody will do anything for me besides short antibiotics here and there...

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@ambermsmith1986

Hello, Amber. Welcome to Connect. I am a cervical spine fusion patient, but I did research a lot about artificial discs when I was making the choice. I have also experienced surgeons who didn't want me as a patient and surgeons who missed a diagnosis and then were too embarrassed to have me as their patient.

If you have a physical problem that can be corrected with a revision, it may be worth getting an opinion elsewhere at another facility unrelated to where you were treated. I would be careful about complaining about a surgeon and naming them when speaking with another doctor. Surgeons do go to conferences and may know others in their field who are practicing elsewhere. They probably have access to records anyway.

Can you tell me more about what the issues are that you learned after obtaining your records?

REPLY
@jenniferhunter

@sb4ca I am a cervical spine surgery patient too. You have been through a lot and a lot of changes in a short time.

We discussed artificial disc vs fusion here on Connect in this comment from December 2021 where you noticed what looked like a problem with C3-C4
https://connect.mayoclinic.org/comment/665202/
Was this discussed with your surgeon at that time or prior to your surgery? Did he think it didn't look bad enough to address?

Prior to my fusion at C5-C6, I had MRIs done 9 months apart, and it that time, the amount of bone spurs doubled so it surrounded the extruded disc. I was worried about reactions to foreign materials, so my fusion was done only with a bone graft and no hardware. I stayed in a neck brace for 3 months.

Is it possible there is still infection at the surgical site? Another thing that comes to my mind would be to question if you could be having an immune response to implanted surgical materials. There is a lab in Chicago that tests for immune responses called Orthopedic Analysis https://www.orthopedicanalysis.com/

I know from personal experience with the removal of dental work, and surgical titanium plates from my ankle (from a fracture) that these were causing issues for me, and my health improved afterward. I had chronic hives until I had the titanium removed from my ankle.

Has your surgeon discussed a possible immune reaction? Are you scheduled for another procedure?

Jump to this post

I have the same thing happened to me my body has completely fused all the way around the disc but I am being told that and is not possible to have in a reaction to these implants because they are Cobalt chromium although they do contain nickel and other Trace metal alloys they don't mention that though. The surgeon also told me that there are no allergy receptors in your spinal canal therefore although I have metal allergies it's not possible to have a metal allergic reaction to an implanted device because those receptors are only found on the skin. I know all of that information is inaccurate the community here is so small that all of the surgeons know each other although I refuse to speak bad about the surgeon and I will not even mention his name I tell them it's not important because I do not want anybody to assume that I am stating he was a bad surgeon or did a bad job therefore I just don't say his name but it hasn't helped me at all I have literally deteriorated my spine is now collapsing on top of each other and deteriorating that was 34 years old when I fell and I had an amazing life now I can't even work and I've lost my home and I can't get these people to understand that I need this disc removed immediately I've been fired by almost every one of my providers and nobody helps me these implant should be illegal..

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@jenniferhunter

@ambermsmith1986

Hello, Amber. Welcome to Connect. I am a cervical spine fusion patient, but I did research a lot about artificial discs when I was making the choice. I have also experienced surgeons who didn't want me as a patient and surgeons who missed a diagnosis and then were too embarrassed to have me as their patient.

If you have a physical problem that can be corrected with a revision, it may be worth getting an opinion elsewhere at another facility unrelated to where you were treated. I would be careful about complaining about a surgeon and naming them when speaking with another doctor. Surgeons do go to conferences and may know others in their field who are practicing elsewhere. They probably have access to records anyway.

Can you tell me more about what the issues are that you learned after obtaining your records?

Jump to this post

After my next trigger I woke up with severe pain which could be expected up after having a surgery however the pain never went away It persisted and got worse and approximately 4 months later I had the most excusiating back pain that you have ever imagined I began to get very sick and had no idea what the hell was going on I had a sinus track that developed in my chest that required two surgeries as well The sign is tracked persist but nobody has tried to figure out where it is coming from. And then multiple cultures one of a blood hematoma that came back as fine golden magnet My providers do not run sensitivity testing and basically tell me I don't have an infection even when I pretty much went septic although they didn't tell me that I knew from my blood work and from the fever in the inability to move everybody kept telling me I was fine and that the disc was in perfect spot and it had spontaneously fused which was not expected but it was okay and I was fine after reading my record I read that I have severe compression on my spinal cord and that my spinal cord is still flat I learned that the artificial disc had extruded itself and was contacting the spinal cord. I have no spinal cord fluid in the front of my spinal cord or the right side my spinal cord is completely flattened spinal canal narrows to under 7 mm where the artificial disc is I was also told that I could not be allergic to it because there's no allergy receptors in your spinal canal and that the metals in this implant are not the metals I'm allergic to which is inaccurate because I am allergic to nickel palladium basically metal alloys. Which this artificial disc contains as we know it contains at least 10% nickel and with the amount of warning letters sent to Zimmer from FDA regarding sanitation of these devices in the manufacturing processes I can't imagine that there are truthful in all of the materials used and how sanitary these implants are have a massive infection and I just basically wait to die everybody knows everybody where I live there is no second opinion is they always tell the next surgeon because they can access your records and see everything you don't have to tell them who your surgeon is so no rule that whoever put the implant and has to be the one to take it out the surgeon refused to even see me he fired me after I saw the second opinion when he told me there was nothing wrong and I knew there was his wife worked for the clinic I went to receive my second opinion from although I did not know that a week later I was fired and my life has been a living hell since there's too many problems to even mention this isn't fair and people should not have to live like this

REPLY
@ambermsmith1986

After my next trigger I woke up with severe pain which could be expected up after having a surgery however the pain never went away It persisted and got worse and approximately 4 months later I had the most excusiating back pain that you have ever imagined I began to get very sick and had no idea what the hell was going on I had a sinus track that developed in my chest that required two surgeries as well The sign is tracked persist but nobody has tried to figure out where it is coming from. And then multiple cultures one of a blood hematoma that came back as fine golden magnet My providers do not run sensitivity testing and basically tell me I don't have an infection even when I pretty much went septic although they didn't tell me that I knew from my blood work and from the fever in the inability to move everybody kept telling me I was fine and that the disc was in perfect spot and it had spontaneously fused which was not expected but it was okay and I was fine after reading my record I read that I have severe compression on my spinal cord and that my spinal cord is still flat I learned that the artificial disc had extruded itself and was contacting the spinal cord. I have no spinal cord fluid in the front of my spinal cord or the right side my spinal cord is completely flattened spinal canal narrows to under 7 mm where the artificial disc is I was also told that I could not be allergic to it because there's no allergy receptors in your spinal canal and that the metals in this implant are not the metals I'm allergic to which is inaccurate because I am allergic to nickel palladium basically metal alloys. Which this artificial disc contains as we know it contains at least 10% nickel and with the amount of warning letters sent to Zimmer from FDA regarding sanitation of these devices in the manufacturing processes I can't imagine that there are truthful in all of the materials used and how sanitary these implants are have a massive infection and I just basically wait to die everybody knows everybody where I live there is no second opinion is they always tell the next surgeon because they can access your records and see everything you don't have to tell them who your surgeon is so no rule that whoever put the implant and has to be the one to take it out the surgeon refused to even see me he fired me after I saw the second opinion when he told me there was nothing wrong and I knew there was his wife worked for the clinic I went to receive my second opinion from although I did not know that a week later I was fired and my life has been a living hell since there's too many problems to even mention this isn't fair and people should not have to live like this

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Sorry for the typos I used voice text and should have edited before posting.

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@sb4ca

Hi again my friend, I do have the previous MRI that was taken right before surgery. I also included the report that addresses the compression at 3/4.

At C3-4, there is a persistent 2 mm anterior subluxation of C4 below C3, with advanced disc degeneration and posterolateral vertebral body osteophytes much larger on the right side. There is also posterior facet moderate to advanced hypertrophy with ligamentum flavum hypertrophy. The anterior and posterior thecal sac defects cause a reduction in central canal diameter to an estimated 7 mm, a moderate to advanced AP central canal stenosis. Cord compression is present. Neural foraminal stenosis is advanced on the right and mild to moderate on the left. The right foraminal stenosis has increased since 2/14/2022. Since 2/14/2022, development of venous congestion/bone edema in the C3 and the C4 vertebral bodies.

Jump to this post

That is what mine pretty much looked like but I was told that it was a herniated disc it absolutely was not.. that image resembles an image or imaging that I had seen during all of my research recently if you look at the lower end of the spinal canal you see the gray lines to the right of your spinal cord could resemble abscess or pus in your spinal canal maybe? I'm definitely not a doctor but I will find the imaging and post it for you.

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