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Spinal Roundtable Discuss Newly disgnosed DDD - facing C4-C5-C6 fusion in the General Discussion forums; After having numbness and tingling, my neurologist diagnosed me with DDD and stenosis, and referred me to a neurosurgeon. The ...

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  #1  
Old 07-30-2007, 09:09 PM
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After having numbness and tingling, my neurologist diagnosed me with DDD and stenosis, and referred me to a neurosurgeon.

The surgeon's first recommendation was a two-level fusion. I expressed unhappiness at that, as I've heard bad things about fusion (if ADR fails, you can get fusion, but not the other way around). He then suggested an alternative procedure, an open-door laminoplasty, to give the spinal cord more room and give me a few more years until the FDA approves mutil-level cervical ADR. This sounds like the best FDA-approved, insurance-covered treatment I can get. I'm going to get a 2nd opinion and see what that doctor says as well.

So, I'm faced with three choices
1. Fusion - ick. I like being able to swivel my neck, and don't want to have more joints fused later on because of this fusion (and my doc says that will probably happen if I get the fusion)
2. Laminoplasty (paid for by insurance).
Pros: Will allow spinal cord relief, ease symptoms (I have myelopathy as well)
Covered by insurance
Cons: Painful recovery due to anterior approach
Will need a more permanent fix 5+ years from now (multilevel ADR or fusion) - this just postpones that surgery
3. Two-level ADR in Europe
Pros: Better range of motion than fusion
Doesn't cause adjascent joints to fail
Less painful than laminoplasty
Cons: Can't get it done in US (unless part of a study, then 50-50 chance of getting fusion anyway)
ADR doesn't have long-term data. Possibility of another operation in the future to replace disc or fusion.

I'm lucky, I'm not in any pain. Aside from weakness in my right hand and leg, and tingling in my hand, I have no real symptoms. But I've seen that MRI - my spinal cord has zero room in those two joints, so something's gotta be done about it. ADR seems to have the most options.

I've seen people talking abut Dr. Bertagnoli's clinic, and I've also seen stuff about the Stenum clinic. Any pros/cons to either place?

I'd appreciate any feedback/comments on the above.

Thanks!
__________________
C5-C6/C6-C7 Cervical spondylosis with stenosis, resulting in parathesia and myelopathy
July 2007 Diagnosed
November 2007 Prodisc-C ADR both levels
Janurary 2008 Doing well, not pain, full range of motion, not even a bad scar
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  #2  
Old 07-31-2007, 03:47 AM
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Bertagnoli - can be very difficult to get in touch with them. My biased opinion is that he'd be in the top ten spine surgeon list no matter how you sorted it but I admit to a bias for him. Communications is my biggest gripe but I have to point out that there has been at least one story posted here that questioned his decision to operate.

Stenum - led to some very strongly held opinions. Some on the forum have defended the work done there, some have posted horror stories of work done there and the incredibly poor outcomes. You can't go from stories to statistics but it seems like for every defender there's an attacker so it would suggest no better than 50% chance of excellent results.
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Laura - L5S1 Charitee
C5/6 and 6/7 Prodisc C
Facet problems L4-S1
Knee, Shoulder, Toe, Finger, Elbow Problems

Jim - no spine problem but lots of other fun medical challenges

"There are many Annapurnas in the lives of men" Maurice Herzog
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Old 07-31-2007, 07:07 AM
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I belive that you will increase your chances of success if you stay away from Stenum. What takes Zeegers or Bertagnoli 4 hours takes Stenum 1.5 hours. Originally, when I was misinformed, I thought shorter was better. However, this is definitely not the case. The reason it takes them 4 hours is that they do a thorough job of decompression and take their time to do it right.
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Rob Wilson
2/06 L4/5, L5/S1 ADR Stenum Hospital - Iliac vein cut w/ occlusion of iliac vein and hematoma
12/06 thru 8/07 Laser Spine Institute - 6 surgeries on L3/4 both sides, L4/5 both sides, L5/S1 both sides

4/08 Bonati Institute - redo of L5/S1 right
8/08 Bonati Institute - redo of L5/S1 left
12/08 Bonati Institute - redo of L4/5 right and left

9/09 Piriformis surgery to remove piriformis muscle causing sciatica
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Old 08-02-2007, 07:26 PM
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Laminoplasty is not anterior approach--it's posterior and goes through more muscle, hence more painful.

I am in a similar situation with problems at C3-7, but with only two discs being looked at for ADR.

Bertagnoli has the best reputation for ADR. Zeegers is close. In Los Angeles, the best are Delamarter, Regan, Lauryssen. I don't know about Oregon. All of the LA doctors are doing clinical trials with Dr. Regan's study being 2/3 ADR and 1/3 fusion.
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--------------------------------------------
First injured C4-7 in 9-95.
Had CED (MISS) at those levels 1-00 and regained my life.
New injury + re-injury C3-7 in 8-06, initially causing "claw hand."
Latest MRI shows: 4.5mm disc protrusion,
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