Need HOPE - after neck ACDF C4-C7, now have another disc herniation within 9 months!!

Hello fellow spine fusion patients,
I just got my cervical MRI without contrast report, Friday evening and can't talk to my doctor till Monday. I had ACDF C4-C7 9 months ago. I know no one on here are doctors, but I'm hoping someone can give me some hope or positive possibilities. I have been crying hard ever since I saw this MRI report because:
1. It looks like I may have disc herniation material left behind on my spine where I was fused.
2. My surgeon told me I will probably never need spinal surgery again (despite the statistics that say otherwise). My C7-T1 were unremarkable and now somewhere in the last year since my pre-surgery MRI I have: "a small disc herniation, neuroforaminal narrowing at C7-T1 with possible involvement of exiting C8 nerve roots. Correlate with exam." I know I have C8 pain from my neck down through to my hands on both sides. I only had two episodes were I may have injured it. One, was a sharp whiplash jolt I had as a passenger in the car 4/2015, after my MRI last year, but before my surgery. Two, I hit a huge pothole 3 weeks ago in the fog and felt horrible C8 pain after.

Has anyone out there had an MRI of their fusion site and have had the radiologist make comments like:
"residual disc at C5-C6 with effacement and slight flattening of the ventral thecal sac and cord, without cord compression"
Well, which is it, cord compression or not? Is this possibly stating that my surgeon left some of the disc herniation pieces behind pressing on my cord? Is there a good reason if it is? Or is the radiologist possibly referring to the "dent" left from where the disc herniation was. I have been told our spinal cords are like plastic straws. Once they are crushed there is usually a permanent dent left behind even after the piece that is pressing is removed.

Also at C4-C5 the comment is "Disc spacer at this level. Small left lateral disc with left neuroforaminal narrowing but no definitive exiting nerve root impingement."
I thought the fusion surgery was to remove all bone spurs and discs completely so there wouldn't be any narrowing.
At the C6-C7 it states no disc herniation which is where I had a severe one before the surgery. It was also severe at C5-C6 and moderate at C4-C5.

Can anyone tell me if it reads like disc material was left behind or if it is just the residual damage done from when their were discs there? Also, has anyone herniated next to their fusion so fast and it has healed back? Or they never needed more fusion? I wish there was something encouraging to hear. I know we all come here mostly because things aren't going well and if they are we wouldn't be on here, but I hope someone has some good news. I was at least hoping to last another 10 to 20 years without more fusion surgery! Ugh!! What can I do to protect myself from further damage? How do you strengthen through doing physical therapy when the smallest accident can cause trouble?

Thank you for any positive information you may have to offer!


  • SongJinSSongJin Arizona Posts: 245
    edited 02/28/2016 - 4:46 AM
    Hi Faith, 

    I'm facing an ACDF in the next ten days myself (if I can't get my insurance to push through an ADR instead), and I'm also worried about my other discs going in the future. So if anyone on here has any info about how long they lasted before they needed another fusion...I'd be interested too. My C5/6 disc is toast and has to be removed, but C3/4, C4/5, and C6/7 are already bulging for me, and I'm so worried that a fusion at C5/6 will just mean more surgery on those other levels. 

    Obviously I can't interpret your MRI either, but what I can say is that there has been considerable debate about the interpretation of my MRIs. I've had two MRIs at two different facilities within the last six months, and I've had several surgeons and other orthopedic professionals give their impressions of my images. Although there's not been anything outrageously different between the interpretations, I'd say there has been significant debate! Significant enough that one of my surgeons (who is a professor of neuroradiology) is trying to get a radiologist to amend his report so that I can qualify for the ADR.

    I guess what I'm saying is...don't panic yet? After you talk with your doctor, if the interpretation still seems suspect, maybe see if you can take it elsewhere for another opinion? And make sure they're actually looking at the MRI itself, not just the report. I've sat there with two different surgeons literally showing me my MRI and saying they do or don't see something else that another professional saw. At one point I had one surgeon saying he definitely saw a small tumor at T1 (momentary freakout), and then another surgeon saying he couldn't see anything there at all.

    I also can't stand waiting for answers. Isn't it the worst when you get news on Friday and know that you can't do a dang thing about it until Monday? Hang in there, and I'm hoping you get good news next week! 
  • SongJinSSongJin Arizona Posts: 245
    oh and i forgot to mention that whether or not i had spinal cord compression was one of my issues too. i made a post about it with the actual details, although even more debate happened since then. ultimately it was determined that i definitely have significant spinal cord compression, and sometimes the radiologist can misinterpret the image. i also get the feeling that the inconsistent terminology that radiologists use can scew someone's opinion (like if you're talking to another doctor that's ready the report, but not actually looking at the mri itself).
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  • HualaniHualani Big Ilsland HawaiiPosts: 56
    SongJin and Faith 981
    Count me in te mix. My ACDF is in 2 days.
    Im going to be honest  Faith981 if you find my other posts Im having same fears. My ACDF is for C7-T1 yet my pain and the worst looking pressure on the spinal chord (not Foraminal) is from C4-5, C5 so thats where the plate will be screwed on and placing additional pressure! How is this going to help?
    Also the first MRI the NS totally disagreed with both  the findings and the summary. I didnt question him as I  know the machine is so old and the interpretive MD so controversial there are many Doctors int e capital city tat wont deal with that radiological clinic at all (wont even talk to them)
    SO next MRIs I had done in Honolulu at the main hospital (Queens center), and yes te results were different in interpretation. I dont read MRI's but I do research online and ten try to compare my own picture with what Im reading so I can ask questions of my NS doctor.
    I am so messed up by headache cycles and loss of arm and hand function and now lately voice problems not to mention the direct pain from te neck...I know I must do something. although My NS is considered the best I wish I had better feelings about the level of the ACDF...
    So are you also reading that many need additional surgery after the first?
    I dont want to get into that.
    I am an optimist by nature but I also cant keep missing work and not having managed pain either.
    help me out.
    Where the heck is  C8?
    Im told after C7 is T1?
    is the description wrong?>
    All the best.
  • Hi SongJin,
    I'm sorry to hear what your going through. I tried for four months to get ADR too and just couldn't get it to happen for me. plus I couldn't wait any longer. On a positive note, I have had bulges and they have healed and disappeared from my MRI's, so it is possible you could heal and strengthen your neck so the other segments don't get "Adjacent Segment Disease." On government health websites I've seen that with a 3 level fusion you are less likely to need more fusions because there aren't any levels left to fuse! Ha. Maybe they don't count the T1 giving out and count it as a thoracic only fusion, despite it being next to my other 3 levels fused.
    Hi Hualani,
    I thought the same thing about the C8. The C8 apparently is the nerve root that is between the C7-T1 vertebrae.

    Best to you both.
  • SongJinSSongJin Arizona Posts: 245
    LOL Faith, I love how having all the vertebrae fused reduces the chances of needing another fusion. Funny how that works when there's nothing else left to fuse....

    I've got 7 more days to win this ADR appeal, or it's fusion time for me too :( I'm scared! 
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