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i do not understand the results of my CT/myelogram!

MelWMMelW Posts: 426
edited 06/11/2012 - 8:41 AM in Neck Pain: Cervical
I am so confused. My surgeon says there is nothing else he can do but he did not explain any of my results and when I tried to ask questions he did not give me any direct answers.

Can any of this be the cause of all of my pain? And is there anything that can be done? I have searched the internet and can not come up with too many answers to the results of my CT. I have an appointment with an ortho spine specialist but it may be up to a month before he can get me in to get a second opinion but I am seriously scared of being in pain forever or a doctor telling me I need surgery again and it makes me worse than I already am. Help!


Minimal multilevel ventral thecal sac deformity without myelographic evidence of cord compression
C7-T1: Uncinate hypertrophy without significant foraminal comprise or exiting impingement

C6-7: This is the level below the fusion. No herniation, central canal narrowing or significant foraminal comprise. Minimal uncinate hypertrophy without facet joint arthropathy.

C5-6: Surgical changes as described above. Subtle osteophytic spur without herniation, canal narrowing or cord compression. Minimal uninate hypertrophy without foraminal stenosis or exiting nerve root impingement.

C4-5: This is the level above the fusion. Mild degenerative spondylosis results in subtle effacement of the ventral subarachnoid space. No herniation, canal narrowing or cord compression. Uncinate hypertrophy results in minimal foraminal stenosis without focal exiting impingement. The facet joints appear intact.

C3-4: Mild loss of disc height with minimal osteophytic spurring and spondylosis. Effacement of the ventral subarachnoid without AP canal narrowing or cord compression. Uncinate hypertrophy results in minimal foraminal stenosis without exiting impingement. No significant facet joint arthropathy.

1. Surgical changes with anterior cervical discectomy and interbody fusion at C5-6 with graft endplate interface incorporation and likley fusion.
2. Mild multilevel osteophytic spurring and spondylosis without significant herniation, bony canal stenosis or cord compression.
3. Uncinate hypertrophy results in mild multilevel foraminal stenosis without focal exiting nerve root impingement.


  • Hi Mel,

    I think it is important that you talk to a doctor as to what these things mean on the scan. Do you have a primary doctor who can explain these things to you. I can tell you what some of the terminology means but that doesn't really mean anything. "Hypertrophy means excessive growth. The joint becomes larger due to the grinding forces that it is subjected to when the shock-absorbing discs have degenerated, i.e. worn out. The grinding and movement induce bone and connective tissue growth, and fluid may accumulate in the joint". From the looks of it they are saying nothing is on the nerve roots and there is no stenosis present. Keep in mind the CT/myelogram gets a good look at the cord and it relationship to the soft tissue around it. I do hope the ortho that you see will have some answers for you. Have you by chance had a EPI since surgery. We have had a few that is all it took following surgery to move them in the right path. I think the surgeon released you as from a surgical stand point there wasn't much he/she could do. That doesn't mean that you still don't have issues and there isn't something that can be done, just he don't have the answers. Anyway keep us posted on what happens. Take care.
  • Thank you for your response Tamtam. I feel so lost right now. I am glad the doctor told me he does not know what is going on if he doesn't know but at the same time it is very frustrating to hear them say that. This entire ordeal has made me very insecure about myself. I am constantly feeling I am a burdon to others even though I do not let anyone know what is going on. I try to act like I am fine but apparently I do not put on a good act because everyone is always asking me what is wrong. I keep thinking, how in gods name is my husband going to live with me always in pain. He always asks what is wrong or if there is anything he can do to help and it kills him to see me cry and he can not do anything about it. I am sure everyone with chronic pain goes through a lot of these emotions, I am just having a hard time coping. Not to mention I have gained 15 lbs since all of this because I can not exercise the way I used to. Okay I am done rambling. It is just that everyone on this forum can actually relate so I know you all understand. Okay now I am really done :)

    So is going to an orthopedic spine specialist the right thing to do?

    I keep being told that a neuro deals with the nerves and a ortho deals more with bone. Is this correct? I have done research but nothing says this 100 percent. My other fear is if the doctor for some reason suggest surgery, am I going to end up in more pain and worse off than I am now??? I almost wonder if this is it, do I leave it alone and learn to deal with the pain I am in and just manage it and learn to live with it???
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  • Mel,

    You need to try and relax a bit. Surgery may not even be something that is needed at this point and time. LIke I said it could be just some injections that are needed. Now in my experience I really think it takes up to a year to fully heal from this surgery and some even longer. But getting a fresh set of eyes won't hurt either. My take on chronic pain is it is a process. It works just as though you have lost someone. Everyone is at different places in the process. As time goes on you will find different ways to deal with it. You may want to check your local area for support groups that deal with chronic pain, possibly through your local hospital. If you are googling those things in your myelogram be sure to use the words and cervical spine in conjunction with them. Sometimes I think dealing with things we cope better if we understand. Keep in mind at this point and time in life anyone who has a myelogram it is going to show something due to the age of the spine and normal wear and tear. But like I say I am no medical professional, just a proficient goggler. Also you may want to check out the link in the FAQ section preparing to meet with a spine surgeon. I only say this so you can formulate some questions and be fully prepared for that meeting. Since you are going in as a new patient i would assume the meeting will be longer the first go around since he is not familiar with you. Please be sure and not say anything negative against your previous surgeon, that will serve no purpose and may make the new person skiddish in helping you. Focus on what you do know and ask questions directly related to the pain itself. But above all else be prepared. I am just telling you all of this, based on my experience and I want to see you get to the reason why you are in so much pain.

    You have a good theory as to how the surgeons should work but it depends on the training of the surgeon and what if any other surgeries they do.
    You know we are always here and we do understand so vent away if you need to. Sometimes getting it off your chest does help ease the pain. Take care and keep us posted.
  • I would never talk negatively about my neuro, he is a good doc, he just can not figure out what is going on. I think all of the numbess that I am having again is what is freaking me out.

    My PT lady is trying traction this week but said if it does not go away she wants me to see a surgeon again.

    I will be fine. I think I just have moments of freaking out :)

    I will be seeing the ortho soon and have an appointment with the chronic pain doc in about a month so hopefully I can get some answers, or pain relief, here soon.
  • Hey Mel,

    I was just thinking of something else that may help. One was that myelogram followed with a ct. Another thing be sure to take the actual films with you to the ortho surgeon. The surgeons I use don't use the reports at all but the actual films they basically read themselves. Another option you may want to try and utilize is seeing about taking those films to a independent radiologist and see if they are read any different. The place that did this myelogram have they done films of your neck prior? I am just speculating of course but I have seen if the films are taken in the same facilities they are using prior images to much to gauge by. Just some other options for you. I am glad to see you are going to a chronic pain doctor as well. They will focus more on the soft tissue damage you may have. I personally have a surgeon, primary and them my pm doc. My primary orchestrates it all and my overall health The surgeon focuses on the structural issues and the pm doc is managing my meds for pain and any injections I may benefit from. All in all I think you are taking all the right approaches and being as proactive as you can in your health care. Hopefully it will all pay off for you and you get some results. Just bites living like that and waiting it out. Hope the time passes soon for you.
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  • The docs I was seeing were my neuro and a PM. The neuro said he could do nothing else and there was nothing he could do surgically. And the PM told me he can not do any more injections or another ryzotimy, as he has done everything he can for the time being.

    Yes my myelogram was followed by a CT scan. And I have thought about calling the imaging center to see if the doc would take a look and see if he sees anything, but I was unsure if they would do that. All of the xrays or other type of imaging was done at the hospital or at another facility but I have films and reports for everything I have had done.
    could it be that you have this & it is what is causing all the pain
  • i was also told by 2 neuros & 4 pts that "we cant help you & dont know why or how long you'll be in pain". one surgeon even set a surgery date. i said will this make the pain in shoulder area go away & he said "no, this is just a preventative measure in case im in an accident in the future, my neck wont get hurt". he was going to put in screws, etc at c4-5,5-6,6-7! after googling my symptoms, (see link below) i came up with this result for my pain! why couldn't anyone have told me this a year ago - maybe it would've made my recovery just a little more freggin bearable!!! just knowing that sooner or later the pain will go away. it's not like i didn't ask!!!

    04/09 posterior cervical foraminotomy c4-5 & c6-7
    moderate foraminal stenosis due to uncoarthasis on the left at c6-7 and bilaterally c5-6.
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