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    What does my MRI scan report indicate?

Posted on Fri, 6 Oct 2017 in Brain and Spine
Question: Thank you for your time.
What would cause changes to area where I had acdf one year later. Feels like I am going backwards in treatment verses forward. I have pretty severe neck pain and developed occipital and trigeminal neuralgia and left sided burning forarm and hand pain. Some right arm burning has retuned.(I do not have dental issues or tmj)
A week ago I had facet block in c2-3-4-5 and trigeminal pain subsided but neck pain continues.
Pre ACDF last year I had neck and severe right sided nerve pain in arm which resolved with operation. The operation removed a right sided herniation, osteophyte complexes, and I had moderate bilateral c7 neural foraminal encroachment, spinal stenosis I have congenital narrowing of neural foramina at c6-7.
The newest MRI impression says:
1."there are post operative changes to an acdf c6-c7.
2. Broad based osteophyte c6-c7 results in flattening of the central thecal sac, but no cord impingment. There is left neural foraminal narrowing at c-6 -c7 secondary to uncovertebral and articular facet joint degeneration.
3. There are minimal disc bulges c4-5 and c5-c6 without cord impingement

Anyway the new MRI may be abit benign but the chronic pain is a bit frustrating though continuing pt and various injections. Been to my primary care for muscle spasm nerve impingement due to neck pain. Thanks, XXXXXXX
Answered by Dr. Neeraj Kumar 9 hours later
Brief Answer:
Take treatment as advised

Detailed Answer:
I have gone through your question and understand your concern.
The mri shows root compression at C6-7 level. The other findings are benign.
You should continue pain killers with muscle relaxant.
Pain modulator drugs like pregabalin or gabapentin or amitriptyline or duloxetine can be added and increased gradually for optimal response.
Physiotherapy can be started once the pain subsides.
No need of surgery at present.
Hope you found the answer helpful.
Do get back to me for further information.
Dr N Kumar
Above answer was peer-reviewed by : Dr. Yogesh D
Follow up: Dr. Neeraj Kumar 22 hours later
Thank you. I am unable to take medicine such as lyrica and neurontin as I have had a bad reaction from them. I do take topomax, lamictal and lithium for cluster headache. Unfortunately though they are sometimes prescribed for nerve issues they haven't helped with my neck pain. I am not on pain medicine except for ibuprofen. My main question was, my apologies if it wasn't clear- was why would there be changes at the acdf site so soon after surgery. The mri showed a broad based osteophyte at c6_7 (the location of my acdf) So the donor cadaver bone can develop into a bone spur/osteophyte? I just figure that having the disc and bone spurs removed I should not expect to be seeing them so soon. Thanks again for your time.
Answered by Dr. Neeraj Kumar 13 hours later
Brief Answer:
Get Mri reviewed again

Detailed Answer:
The osteophyte is not new and may be present earlier too.
The imaging needs to be reviewed.
The pain will decrease with time.
Low dose trial of drugs like pregabalin or gabapentin can be tried again.
Physiotherapy under guidance should be done.
Wishing you good health and early recovery.
Discuss with the treating neurosurgeon too.
Dr N Kumar

Above answer was peer-reviewed by : Dr. Vaishalee Punj
Answered by
Dr. Neeraj Kumar


Practicing since :2006

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