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  • aprokop
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    Post count: 22

    Dr. Corenman,

    I had a ACDF on level 5/6 in January of 2018. This week I had an MRI and it indicated that I have a significant bone spur on my 5 disc area. This is the same place that I had my fusion in January of this year. What are my options? I’m guessing this is why I’m having some pain and difficulty in my recovery. Can they grow that fast because I assume my surgeon would have taken the spur out when he did the surgery? Can I have a surgery that shaves off the bone spur without redoing my fusion? Are there any options that don’t involve surgery?

    Thanks,
    Andy

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Bone spurs that are present some time after an ACDF fusion at the same level at C5-6 (not at the level above as “spur on the 5 disc area” could mean C4-5 or C5-6 where you had your previous surgery) has two potential causes. I will assume you are talking about your previous disc surgery level at C5-6.

    One is a missed bone spur that surgery for some reason did not fully remove. It is unusual that a residual bone spur is missed but possible. If you had a period of some good relief after surgery but then the symptoms returned, this scenario is unlikely. However, if you had a period where you never felt like you had temporary relief, then either the spur was not fully removed or this level was not the cause of your initial arm pain in the first place. Another possibility is that you took opioid pain medicine for this period of temporary relief and when you stopped this opioid, your pain returned.

    The other possibility is that you have a pseudoarthrosis (non-fusion) and this lack of fusion is causing motion and a recurrent bone spur.

    If you have a solid fusion, then a posterior foraminotomy can be performed to open up the foramen and give you some relief. See: https://neckandback.com/treatments/posterior-cervical-foramenotomy/. If however you have a pseudoarthrosis, then you would need a revision from the front (a redo ACDF) to correct this bone spur compression.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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