Anyone ACDF without plating?
Had ACDF with plating (c5-t1) in 1998. DDD advanced at c3-4 and c4-5. Presently, four docs (2 orthopedic spine specialists, 1 neurosurgeon, and family doctor) tell me I should have 2-level ACDF c3-5. They recommend removing existing plate in order to plate c3-5. I've been to a fifth doc, another neurosurgeon, who recommends doing only one level (c4-5) without plating. That approach eliminates need to remove previous plate. Here's my question: has anyone had ACDF without plating, particulalry at level directly above fused level? What was your experience? There are some new appliances that eliminate the need to remove existing plate; however, not approved for two levels. The need for surgery is clear to me. I have significant neurological deficit caused by spinal cord flattening, e.g. clonus, myelopathy, hand spasm, leg spasm, and other clever tricks. My personal debate is which approach accept. I'm meeting with the orthopedic spine specialist this Thursday for more input into his recommendation. Anyone have comments?