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Old 02-02-2007, 09:53 AM   #1
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Options offered

Hi, All!
Had my appt with the neurosurgeon yesterday, asked TONS of questions, and now am more confused.
I asked if a non-fusion option was possible for me, and he stated that it definitely was. He acknowledged that it is a much slower recovery, since it is done from the back and they have to cut through the muscle, but said that since I am young (relatively!) and active, I should do fine. He admitted that the ACDF causes the risk of ruptures above or below the fusion later on, but shares that I will likely have that risk anyway, since my back seems to be prone to disk issues.
He also shared that one of his partners was part of the board that send the artifical disk to the FDA, where it is in the approval process. He promised to call him and get his take on when it will be available, and if it would be a good option.
I have a second MRI scheduled for next Wed. Not sure why. My first one was very clear, with the spinal cord twisting (they said "torqueing") to get around the rupture. He said he wants to see if there have been any changes.
Has anyone had the posterior, non-fusion surgery? Are you glad you did, or would it make more sense to go ahead and do the ACDF with donor bone and titanium? I did great with a non-fusion on my L5-S1, but this is very different.
Any advice or suggestions anyone can share to help me decide will be GREATLY appreciated!!
Thanks for being there!
Treva

 
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Old 02-07-2007, 04:49 AM   #2
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Qtant36 HB User
Re: Options offered

Treva--did you get an answer yet about possible disc replacements in the neck yet? Very curious to hear what you find out. I'm off to the Cleveland Clinic on the 23rd, and that is one of my first questions....

 
Old 02-07-2007, 05:05 AM   #3
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Re: Options offered

I had a C4-C7 laminectomy - no fusion, surgery was from the rear. Yes, there was difficulty at first because of the large muscles being cut but it really wasn't bad. I also choose this over ACDF because of the fear of longer term problems at adjacent levels. Because of the number of levels, artificial disk wasn't even a consideration for me.

 
Old 02-07-2007, 07:08 AM   #4
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Re: Options offered

i am just wondering what they,or how they expect to alleviate the actual compression without doing a fusion?did he state how they woud be able to actually relieve that compression without actually removing the ruptured disc that is causing actual torqueing of your cord?i am just trying to picture this in my head as coming from the back(were having difficultys in that area).what are their plans coming from the back to try and relieve this without a fusion?it would just seem to be somewhat safer and much easier for the surgeon to do a straightforward ACDF,you know what i mean?i am just wondering if they have fully explained everything to you as how they can accomplish this from the back?i myself,would really be curious to know.

i do know that your recovery time will most definitely be longer going from the back vs the front,it is that muscle thing that rears its ugly head thats all.if i were you,i would have someone come with me to the next appt and have the surgeon fully explain both options to you and also the risks and benefits.getting a fusion surgery really dosen't limit your actual range of motion too much at all.i was actually rather suprised at the range i still have with my c 6-7 being plated and screwed.and any fusion surgery will generally displace the load and will pose some higher risks,that just comes with the territory,but you need to look at what you are currently dealing with having your cord compressed the way it is too.make certain to find out exactly how many posterior approaches this surgeon has done with cord compression as severe as yours before doing anything from the back.you just need to make sure this surgeon really knows his stuff,thats all.

if this was a straight forward herniation without the torqueing of your cord going on,this would be a different story,but that cord compression just brings things up a notch as far as risks.you need to be certain what you are doing really is the best possible thing for you,for now and in the long run.i do believe the surgeon sending you for that new MRI is looking for any more compression of your cord,or any possible changes of the way that disc is sitting.before my cavernoma was removed from within my cord,geez,i was sent for like five seperate MRIs mostly because of sudden changes in my neuro status everytime it bled.they just really need to know for sure what it is they will be dealing with.just what types of symptoms are you currently having?

just make sure that everything pertaining to both possible procedures is fully and completely explained to you before consenting to either of them.but something does most definitely need to be done to relieve that compression soon.please keep us posted on anything new.good luck with this,marcia
__________________
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 02-07-2007, 07:36 AM   #5
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monarog HB User
Re: Options offered

TrevaM...
I too would like to know what kind of symptoms you're are having. I have yet to discuss my most recent MRI with my NS - see him in 3 weeks. But I do know I have some amount of cord compression at C6-7. It's informative to me to hear what symptoms others are experiencing...or maybe it's just the "misery loves company" thing. Thanks.

 
Old 02-07-2007, 02:45 PM   #6
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Re: Options offered

the non fusion procedure I had done was through the FRONT of the neck. it was done endoscopically. they removed the nucleus of the discs that were causing the nerve compression, lasered the tears shut, then injected a gel made of my platelets back into the disc to pump it back up.

the surgery was due to herniations at c5-6 and c6-7.

read my post NON FUSION OPTION...

in my case going through the back was never discussed...

good luck

bw

 
Old 02-07-2007, 03:10 PM   #7
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Qtant36 HB User
Re: Options offered

BW67, how did they get your own plateletes if I may ask? Also, did you have cord compression? What were your symptoms?

 
Old 02-07-2007, 07:49 PM   #8
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bw67 HB User
Re: Options offered

they drew blood and used a machine that separated out the platelets...

no sprinal cord compression, but the herniations were compressing the nerves that go down my right arm, causing unbearable pain. some minor neck pain but it was the arm pain that made me do the surgery...

bw

Last edited by bw67; 02-07-2007 at 07:50 PM.

 
Old 02-08-2007, 05:16 AM   #9
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Qtant36 HB User
Re: Options offered

BW67, do you know if the surgeon you went too in Florida can do the surgery with cord compression? I think you said you were the one that went to Florida and saw Dr. Reuter? If not sorry, I have read so much lately and can't keep it all straight...

 
Old 02-08-2007, 05:44 PM   #10
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TrevaM HB User
Re: Options offered

Hi, all!
Sorry it has taken me so long to answer back. I've been off line for a couple of days.
My surgeon did the surgery on my L5-S1 about 10 years ago, and did not fuse then, either. The way he explains it, the disc, after a rupture, will actually seal itself off. You still have a bit of cushion between the vertebrae from the remaining disc (although nowhere like the original) and if you can remove the portion causing the cord compression, you do not necessarily have to fuse the vertebrae. I know it worked like a charm for me the last time, so asked if that type of a procedure was possible for the C5-6 area. He did share that the recovery takes longer. However, if you think about wearing a collar and waiting months for the fusion to occur, that seems like a long recovery, too. He acknowledged that the adjacent disc theory is correct, but also shared that my discs are going to be very likely to continue degenerating as they have been, and I may fuse naturally as the years pass, so he didn't want me freaking out about the fusion part of it. I just feel that if he can go in and remove the part causing the pressure, and leave as much alone as possible, I might be better off.
Symptom-wise, I have pain in my right arm that tends to come and go. When it gets to my hand, it tends to go into the back of the hand and not into the thumb like it is "supposed to." I have a lot of pain and popping in my shoulder, and we confirmed that I have bursitis and tendonitis in the shoulder, but no rotator cuff tear. I have lots of pain between my shoulder blades, also. It's tolerable. I haven't slept well in a long time, due to waking due to discomfort, but finally consented to LorTabs at bedtime, and am sleeping much better. I only use Darvocet during the day. I have to admit, though, that I have an incredibly high pain tolerance, so my stubborness and unwillingness to admit I'm in pain might be in play here.
Had the second MRI done yesterday, and MD has tried to call me twice today, but I've been in meetings and didn't get out until the office was closed. Will call them in the am and see what I can find out.
Thanks for everyone's input. I just want to do the least possible to be functional and active again.

 
Old 02-08-2007, 06:49 PM   #11
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bw67 HB User
Re: Options offered

qtant36-

I'm not sure precisely what Dr. Reuter can and can't do. My suggestion would be for you to contact them and have them address your specific situation.

I know, in my case, there was a charge- I think $200- for me to have them review my MRI's, Xrays, etc. For me it was a cost I was willing to pay to find a non fusion option. Not everyone will feel like it's worth it, but it was money well spent to me...

I'm really slammed right now with work, a new baby and a two year old, so I'm not able to get on the board as often as I used to. I tried to spell out my situation as best as I could in my post NON FUSION OPTION. I will continue to try and help when I can, but I think at this point you're really better off contacting Dr. Reuter's facility directly if you're interested in their services. They were excellent in reviewing my case and answering any questions I had.

Best of luck

bw

 
Old 02-09-2007, 04:26 AM   #12
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Re: Options offered

I would have to agree that if you could spend 200.00 and get another seperate opinion it would really be money well spent for you in the long run.getting more than one opinion on any surgery espescially in the spinal area,really IS a good idea.different neuros and other surgeons just have so many different levels of experience.i had three seperate neurosurgeons give me like three totally differeing opinions on my spinal cord surgery.

this just gives you better options and overall info enough to really make the best informed choices for your health.good luck,Marcia
__________________
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
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