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Herniated disc, history of C5-6 ACDF. Took cortisone injection for neck and shoulder pain and numbness in fingers. What does MRI showed?

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Spine Surgeon
Practicing since : 1998
Answered : 116 Questions
Hi. I am a 35 year old female with a history of C5-6 ACDF in 2006. I herniated a disc (no known action caused it) in 2005, and had severe neck pain, right arm pain, right hand tingling, and some right finger numbness. I tried physical therapy, cortisone injections, traction, etc but finally had surgery in 2006 and felt much better for a few years. Over the past few years I have experienced off and on neck pain likely attributed to either a bulging disc or a bone spur post surgery, and a cortisone injection would help.
In the past 2 months I have had constant moderate-severe neck pain, right back of the shoulder pain, right arm pain, right hand tingling and some right finger numbness again. I can also feel the pain in my left arm and hand. I have tried gabapentin and muscle relaxers, but they don't help much. I can't take NSAIDs because they could cause my Crohn's to flare up.
I went to my Physical Med and Rehab doctor, and he ordered a new MRI. I don't see him again until next week but would love to get any feedback on some of the images from my MRI (see attached file). Thanks!
Posted Fri, 17 May 2013 in Bones, Muscles and Joints
Answered by Dr. S K Mishra 1 hour later
Thanks for your query.

Now it is seven years since you were operated. It is not uncommon to see disc prolapse adjacent to operated /fused level 8-12 years after first surgery. Reason is simple the motion at fused level is gone and its function is taken by adjacent disc making it to work extra so therefore prone for prolapse. Your MRI shows disc prolapse at C6-7.

You should put cervical collar immediately in addition to gabapentin and muscle relaxants. If your pain remains troublesome despite all conservative measures you may again require surgery.

But this time you have one extra option of artificial cervical disc after discectomy. This preserves motion, there is early mobilization and the risk of adjacent disc prolapse in future is very less.

Hope I was able to answer your query.
Above answer was peer-reviewed by
Follow-up: Herniated disc, history of C5-6 ACDF. Took cortisone injection for neck and shoulder pain and numbness in fingers. What does MRI showed? 30 minutes later
Thank you so much for your reply. Is it possible to have an artificial cervical disc placed (C6-7) even though I already have a fusion in the level above (C5-6)?
Answered by Dr. S K Mishra 8 hours later
Yes artificial cervical disc placement can be done adjacent to fused segment. Hope you recover soon. Thank you.
Above answer was peer-reviewed by
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