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  • Need Advice on Artificial Disc Replacement,, Do I or Dont I?

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    Old 10-12-2009, 04:37 PM   #1
    estella3
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    Question Need Advice on Artificial Disc Replacement,, Do I or Dont I?

    Someone please help,
    Im not sure what to do. I have moderate osteophyte formation at the C5-6 level. there is also moderate osteophyte formation at the C6-7 level with mild focal concavity involving the superior endplate of C7. The T1 and T2 vertebral bodies are of adequate height and signal. There is slight reversal of the cervical lordosis centered at the C6 level, without significant anterior subluxation or scoliosis.

    IMPRESSION:
    Broad based disc osteophyte complex at C5-6 with superimposed mild central to left paracentral disc herniation extending along the superior aspect of the C6 vertebral body. This produces posterior displacement of the cord without frank cord compression. There is mild overall narrowing of the canal and lateral recesses as well as foraminal narrowing, greater on the left that may well encroach on the left C6 nerve. There is no compromise of the C6 nerve in the foramen.

    Broad based disc osteophyte at C6-7 with a slight to mild central disc herniation contributing to mild effacement of the thecal sac. The cord is slightly displaced posteriorly but not frankly compressed. There is no significant lateral recess or foraminal narrowing.

    The C2-3, C3-4 and C4-5 discs are intact. There is slight disc bulging at
    C7-T1 and T1-2 without disc herniation or canal stenosis. No intrinsic cord abnormality. Slight reversal of the cervical lordosis centered at the C6 level. Moderate degenerative change at the C5-6 and C6-7.

    My pain is at a moderate level, some arm involvement but it ends at about my biceps. The neurosergeon wants to be an ADR of C6. He said if i dont get it done, in time i could lose function of my legs,my legs right now feel fine. I really dont know what to do. IF ANYONE HERE COULD GIVE ANY ADVICE ON THIS OR HAVE SIMILIAR BACK ISSUES, OR HAD THE ADR SURGERY, PLEASE RESPOND. ESTELLA

     
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    Old 10-12-2009, 05:39 PM   #2
    jennybyc
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    Re: Need Advice on Artificial Disc Replacement,, Do I or Dont I?

    I would get a second opinion. You have a bunch of things going on in your neck and an ADR can only be done at 1 level. What does he plan to do about all the other problems?

    I'd also recommend a second opinion because a neurosurgeon who tries to frighten you into surgery by saying you'll lose use of your legs if you don't, it not telling you the whole story. You have very mild spinal cord compression at C6 and that is what would cause you to lose the use of your legs...but not for a good long while. Your spinal cord can take compression down to 1-2 thickness or 5-6mms. It's currently not compressed at all, just slightly displaced by pressure. It may never compress your spinal cord.

    Something sounds fishy here. He's pushing you to have a surgery that still has a lot of questions about it. He hasn't addressed all the other problems in the other levels. And he's scaring you to try to get you to agree with a scenario that may never happen. RED FLAGS FLYING!!!!!!!!!!

    Get a second and third opinions if necessary. I got 3 and think everyone facing risky spinal surgery should do the same.....you could end up paralyzed if it's done wrong. Ask a lot of questions and get a lot of answers before consenting to anything. And this doc scares me! Why so pushy...makes me wonder..........

    gentle hugs...............Jenny

     
    Old 10-13-2009, 06:50 PM   #3
    estella3
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    Re: Need Advice on Artificial Disc Replacement,, Do I or Dont I?

    I dont know, i am in daily pain, and would rather have the surgery now when im younger and have the insurance to cover it than later, in fact i hear that after a certain age my inscurance wont pay for an ADR. The surgeon said he would send me to pain clinic if i wanted to give that a try, but i get the feeling, that like with therapy i tried before, it would only be temporary relief. He said that the majority of the pain will be gone with surgery, does not guarantee that it all will be gone. The main thing is replacing the C6 disc. the C7 is not as bad as the C6. I told his Phy. assist that when they do the surgery that if c7 looks bad to do that one as well, rather then having to have surgery for that one down the road.. The thing im confused about is that the doctor said that by having the CADR that it will prevent the other vertebrae from going bad, bulging, and that this will relieve pressure. But then i have read that people have read that there is a chance of the vertebrae above and below the CADR's to go bad, buldge. He didnt say anything about fusion of the spine. This was a VERY bad week for my back the stress and cold weather making it worse. I know i cant go on like this.
    ESTELLA

     
    Old 10-14-2009, 09:45 AM   #4
    jennybyc
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    Re: Need Advice on Artificial Disc Replacement,, Do I or Dont I?

    Estella...I wrote to you on another thread that you can't have 2 ADR's put in so if C7 is bad as well as C6 than there is no ADR at all.

    I still think you need a second opinion as your doc is pushing the ADR so hard. Why? It doesn't help arthritis and can only be used in 1 area..period. My understanding is that it is best used when you have a single herniated disk without much else going on. You seem to have a lot going on.

    Is there a reason you can't or don't want a second opinion? I think everyone here has had 2 or 3 opinions from other spine surgeons(be they orthopedists or neurosurgeons). It will really help you to decide what to do.

    gentle hugs.................Jenny

     
    Old 01-05-2010, 10:46 AM   #5
    algenon
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    Re: Need Advice on Artificial Disc Replacement,, Do I or Dont I?

    I have had an artificial disc replacement at C5/6 and caged fusion of C6/7 in July 2007. I was experiancing severe pain in neck and arm with pins and needles in my hand. I awoke from surgery with no symptoms at all. The drain tube was uncomfortable and my throat felt alittle sore but only for the first day.(the tube was also removed after 24 hours). I personnally would recommend A.D.R. as recovery is quicker and leaves movement between the vertibre.

     
    Old 01-05-2010, 05:56 PM   #6
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    Re: Need Advice on Artificial Disc Replacement,, Do I or Dont I?

    I agree that you need a second and possibly third opinion. Maybe see another Neurosurgeon and then an Orthopedic Spine Surgeon. I agree that your doctor, from what you've said, is pushing for the ADR. If he is he has to be willing to sit down with you and create a long term treatment plan for what he sees now and what could happen at those other levels later. If he wont then he's not looking at the whole picture. When I met with my OSS prior to my ACDF he said that since I had other cervical levels that were likely to need stabilization surgically later that meant I was not a candidate for ADR. He didn't want to do the ADR and possibly need to go back in years later and remove it due to problems above and below it.

    Also, contact your insurance company and be sure ADR is covered. There are many insurance plans that don't cover ADR (regardless of age). If that's the case then you wouldn't even have to decide if it was best for you as it would not be an option.

    Personally I had the ACDF with success and would not have wanted to pursue an ADR.
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    Rt thumb fusion '13. R&L thumb arthroplasty '12 ; RT TKR & Bilat CTS' 11. Fusions: L5-S1('87), L4-S1('93), C5-C7('06), L3-S1('10), C4-C5('13). C5-C7 foraminotomy '08

     
    Old 01-08-2010, 07:33 AM   #7
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    Re: Need Advice on Artificial Disc Replacement,, Do I or Dont I?

    Im going to chime in & encourage you to get those opinions. I wish I would have done the same. Im due for my one yr. check & will go to more then one surgeon if need be for consults as I know there will be more surgery in my future.
    kind of like your situation I had the C5-6 with possable problems with C7. My surgeon thought C7 may have a chance of avoiding surgery in the near future by removing pressure. He almost did C7 & I wish he would have but the surgery was longer then expected due to some unexpected problems found. Now Im left to wonder if my existing pain & problems are in part due to the C7, I truely believe to some degree they are.

    If it was one disc & the others in great shape I would definantly try the ADR as Ive heard good reports from others, but if there is even a possability of future problems with other discs I would stick with the fusion. I hope in the future there are other options but for now we are limited in choices.

    Another thing is you want to feel as confident as you can with the surgeon you choose. Good communication is so important, one who listens to what you are saying & addresses all your questions & concerns. Its amazing how surgeons can avoid giving a direct answer. They cant say for sure whats going to occur in the future but they can as Spine AZ stated address a long term treatment plan if it may be an issue.

    I think its hard to find a good surgeon. Many end up in pain management & alot of surgeons dont like to deal with meds associated with PM. This seems to be a huge issue for many. It would help if all doctors could work as a team for the patients best interest. Alot to consider when choosing a surgeon.
    It cant hurt to get other opinions & if anything you can walk away with a better understanding. Good luck, Sammy

     
    Old 02-20-2010, 06:01 AM   #8
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    Re: Need Advice on Artificial Disc Replacement,, Do I or Dont I?

    First let me clear up that you can get more than one ADR in the cervical spine. The FDA has approved ADR for one level but doctors can use them "Off Shelf" for muliple levels. I know because I will be getting 4 Prodisc-C in the US.

    I got a fusion at C6, and now the fusion has herniated the 2 disc above, and 2 below it. So, I need 4 Prodisc now. I am a believer because I have 3 Prodisc-L since 2004, and I am pain free from the waist down.

    I wish you luck.

     
    Old 02-20-2010, 11:02 PM   #9
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    Re: Need Advice on Artificial Disc Replacement,, Do I or Dont I?

    newbackguy - I am curious if you insurance company has agreed to pay for this multiple application?

     
    Old 02-21-2010, 05:33 AM   #10
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    Re: Need Advice on Artificial Disc Replacement,, Do I or Dont I?

    The question in the appeals process is whether they will pay for all the discs or only one. The discs are just shy of $6k each. So if I have to pay $18k for 3 discs and they pay $6k plus surgery, I will.

    The other option which they are considering is Germany with Dr. B, who did my original 3 ADRs in my Lumbar. As of now 13 out of 50(each state is independant) BC/BS pay for ADR, and several of those pay for overseas surgery because of huge savings. It's $50k in Germany for 4 Prodisc-C. Also Dr. B. is BS/BC approved. The numbers are nearly double that here.

    I reseach ADRs for 2 years before going to Dr B in Austria. All I can say is the fusion I received at C-5 C-6 worked, but within a year it destroyed my neighboring discs. All along it has only made sense to me that if something was intended to bend, it should always bend. ADR is the only choice with promising data. And if I had a choice I would go back to Germany.

    I wish you all comfort from pain.

     
    Old 02-28-2010, 05:55 AM   #11
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    Re: Need Advice on Artificial Disc Replacement,, Do I or Dont I?

    Hi Newbackguy, Can I ask you when your dr. in Ct said he would do a 4 levical cervical ADR? Was it very recently?

     
    Old 03-23-2010, 02:56 AM   #12
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    Re: Need Advice on Artificial Disc Replacement,, Do I or Dont I?

    Yes, last year, and two months ago.

     
    Old 03-31-2010, 02:49 PM   #13
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    Re: Need Advice on Artificial Disc Replacement,, Do I or Dont I?

    I am 1 month post-op prodisc-C C5/6 AND LOVING IT! C6/7 is next I hope. I am Army and have been in touch with a guy that got L3-S1 done PD-L and says he is nearly pain free after 40 days. I guess the back takes a lil longer to heal due to wt bearing. I looked him up through a friend as I am soon to ask for the PD-L for T11-S1 as many as they will do. I have yet to consult Ortho, and I know my Neuro guy only likes to do one level at a time, so I will find out what the surgeon is willing to do. I have little to no disc hight T11-L3 and L5-S1 BUT also a HX of broken vert at those levels so that may throw a wammy my way. Before my PD-C I was taking 900mg of Gabapentin TID, 100mg Tramadol QID, Percocet PRN some days 4 a day some none, and 75mg Nortriptyline at night for sleep. I am now at 100 mg Tramadol BID mostly for the LBP. Can't help you first hand about the PD-L BUT as for PD-C It has been a Sanity saver FERSHER!!.

    JMHO

    Last edited by aquaD; 04-01-2010 at 07:19 AM.

     
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