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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Cervical Disc Prolapse Or Cervical Osteopath?

Dear sir, I had an instrumented anterior cervical discectomy & fusion of c3/4, c4/5 back in 2004. Examination Findings: Plain x-rays and the MRI scan of the cervical spine show an large osteophytic disc prolapse at C3/4 causing cord compression & associated with signal change within the cord. There is reversal of lordosis at this level with some CSF present behind the cord. At C4/5 there is also an osteohytic disc prolapse causing canal stenosis and complete vaffacement bof the subarachnoid space but no compression as such. There are also degenerative changes at C5/6 but not at C6/7. In extension there are 2-3mm of retro-listhesis at C3/4 & C4/5 presumably due to ligamentous laxity associated with a mark loss of disc height at those two levels. I was advised to under go surgery to decompress the canal & remove the threat to my spinal cord. It was explained to me that the main aim of this procedure is to prevent further deficits & that improvement of the current deficits cannot be guaranteed. The operation was accomplished by an anterior approach, but the sergion did not think that i was a particularly good candidate for cervical disc replacement in view of the marked loss of disc height and mild instability in extension. I was given a C3/4 and C4/5 anterior cervical discectomy and fusion using iliac crest bone graft and an anterior cervical plate. I was told the risks of this procedure, including the small risk of injury to the spinal cord, & the risk of pseudarthrosis, infection, recurrent laryngeal nerve injury, carotid and oesophagus injury & cardio-pulmonary complications. It was discussed that there is a risk of developing further degenerative changes at C5/6 level. Cervical disc replacement could perhaps be considered at this level if surgery is required in the future. Prognosis: The aim of this procedure is to prevent the development of further neurological deficit. There maybe some improvement in my current symptoms is possible, but a complete recovery is very unlikely. I had the procedure done at the end of 2004.. Things haven t been too bad with continual pain relief, but have always have had continual server pins and needles in my hands legs & feet. With continual server neck pain & continual head pain. The pain I am now getting goes from my neck down to my lower back and with me 24/7. I am unable to walk any distance with out server pain going down my legs, its getting Very stressful as I cant get the A.C.C to refer me to a specialist to see if there is something that needs to be done to make my life liveable. They say that my condition has not deteriated since my operation. I know in with the amount of pain and lack of sleep i get, my condition is very bad that just a simple walk to the local shops is so painful bringing me to tears.. Putting a long story \, what does one have to do to get further assistance from our so called medical a.c.c. I desperatley need expert help from a specialist but can t seem to get it.. As i said to my A.c.c case manager when he called the other day saying that they will be rejecting my application for there support/payments that I did once get.. I might as well be in a wooden box & won t have to suffer 24hrs a day seven days a week, year after year after year. Hope you may be able to put me in the right dirrection, as this medical stuff is over my head Regards Ian Rosevear... I m on a very limited income so maybe able to pay any free at the present time... but I do need help and assistance asap
Mon, 7 Mar 2016
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Orthopaedic Surgeon 's  Response
hello
if surgery at c3-4-5 was done with fusion and osteohyte removed then there is little chance for pain in lower legs, i may suggest for checkup for lumbar spine with a simple x ray for any osteoarthritic changes down there t o cause low back pain and radiation to legs.If c6-7 are degenerated, then it cannot produce pain in lower limbs as they supply neurologically to neck, upto shoulder and base of neck or upper back only.Your continual pain in neck upper back may be residual from cervical lesions.In all probability you may not need further surgery of neck or even lower back spine, as both these areas can be maintained with medicines, brace or collar and exercises and physical therapy which wont cost much, just a consultation and learning few exercises, buying brace for back and neck would suffice.But a consultation with an orthopedic doctor is a must to iinstitute these measures, neither long leave may be required for this.
best wishes
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What Causes Cervical Disc Prolapse Or Cervical Osteopath?

hello if surgery at c3-4-5 was done with fusion and osteohyte removed then there is little chance for pain in lower legs, i may suggest for checkup for lumbar spine with a simple x ray for any osteoarthritic changes down there t o cause low back pain and radiation to legs.If c6-7 are degenerated, then it cannot produce pain in lower limbs as they supply neurologically to neck, upto shoulder and base of neck or upper back only.Your continual pain in neck upper back may be residual from cervical lesions.In all probability you may not need further surgery of neck or even lower back spine, as both these areas can be maintained with medicines, brace or collar and exercises and physical therapy which wont cost much, just a consultation and learning few exercises, buying brace for back and neck would suffice.But a consultation with an orthopedic doctor is a must to iinstitute these measures, neither long leave may be required for this. best wishes