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Had severe scoliosis. Had osteotomy. Suffer back pain. Cervical spinal cord signal and morphology are normal. Surgery again?

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I had severe scoliosis corrected in 2004 with instrumentation from T2 to the Sacrum. A year later I had an osteotomy done at L3 and two years after that another osteotomy done at L2 fused down to S2 and instrumented to the pelvis. I am now having quite a bit of neck pain and I was told to have an MRI of my neck done. Below are the results and I would like to have your opinion on what they mean. Is surgery in my future again?

The cervical spinal cord signal and morphology are normal. There is severe degenerative change involving the articulation between the odontoid and anterior arch of C1. The atlantoaxial facets demonstrate moderate degenerative changes as well. The craniocervical junction is unremarkable.

C2-C3 - There is mild disc desiccation. No disc herniations or spinal stenosis. There is mild facet joint arthropathy.

C3-C4 - There is mild disc desiccation. There is a small disc osteophyte complex without stenosis. There is mild facet arthropathy.

C4-C5 - There is mild disc desiccation and disc height loss. There is a circumferential disc osteophyte complex without stenosis. There is mild facet joint arthropathy.

C5-C6 - There is moderate Modic type I endplate change. There is severe disc desiccation and moderate loss of disc height. There is a circumferential disc osteophyte complex. There is mild central spinal canal stenosis. The thecal sac measures 10-11 mm. There is severe right foraminal stenosis. No left foraminal stenosis. There is minimal facet arthropathy.

C6-C7 - There is mild disc desiccation and minimal loss of disc height. There is a small 2 mm broad-based central disc protrusion. This results in mild central spinal canal narrowing. The thecal sac measures 10 mm. No foraminal stenosis. There is mild facet joint arthropathy.

C7-T1 - There is minimal disc desiccation. No disc herniations or stenosis. The facet joints are normal.

IMPRESSION:
1. Degenerative disc disease and mild scattered facet joint arthropathy involving the cervical spine as detailed above. There is mild central spinal canal stenosis at C5-C6 and C6-C7. There is severe right forminal stenosis at C5-C6. There is Modic type 1 endplate change at C5-C6.
Posted Mon, 28 Oct 2013 in Back Pain
 
 
Answered by Dr. Vaibhav Gandhi 1 hour later
Brief Answer:
Right foraminal stenosis at C5-6 is Severe

Detailed Answer:
Hello,

I have studied your case.

As per your MRI majority of changes are degenerative and may not need surgical procedure.
But at C5-6 there is severe right foraminal stenosis and this should be clinically correlated by examination.
So if you pain is localized on right side in C5 innervated area then you may need decompression surgery.
Till time you can take epidural shot and see for results.

Some medication like methylcobalamine and analgesic will reduce pain.
You may consult physiotherapist for guidance. He may start TENS ,or ultrasound which is helpful in your case.
Soft cervical collar may help you to avoid sudden irritation to nerve root.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Take care
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