Surgery for C1-C6 Anterior-Posterior Fusion????

[arlenee]

My name is Linda and I had surgery in Jan of 2000 with c1-c6 laminectomy, decompression, bovine graft, craniotomy and duraplasty. In 2002, I had an Anterior Posterior Disectomy for c5 and c6. Now I have Progressive Kyphosis from the multiple laminectomies in 2000.
My new surgeon wants to do an Anterior Posterior fusion for the complete cervical. I am going to get more opinions, of course. It is because of the progressive kyphosis that he wants to do this surgery, not because of a noticeable deformity or horrible pain. What is your opinion on this? I live in FL. I hear this is a rare surgery and there are a handful of surgeons that do both procedures at one time. Is there another way of taking care of this problem? Physical therapy? Anything? How successful is this surgery? Can you recommend another surgeon to look at me? I know that I will need the best of the best. Please help me in this matter as much as possible.
Thank you very much for any input on this matter.
kyphosis Anterior Posterior fusion

[paulam310]

I was in complete kyphosis before I had my 3 level cervical adr, but the doctors would not have done the surgery simply based on a kyphotic neck. They look for intolerable pain. I do not think that a military or kyphotic neck is all that uncommon but it is when you become debilitated that the issue becomes more crucial. There must be other issues besides kyphosis which they are looking at. I would recommend sending your MRI to my surgeon, Dr. Delamarter, he is the only surgeon that has performed 3 level cervical prodisc in this country, I believe he also performed a 4 level in the neck.

[arlenee]

Thank you for your input Paula. As you know, progressive kyphotic deformities caused from laminectomies, can eventually cause neurological problems. Because of the degree and the amount of time that the neck started being kyphotic is one of the main reasons for the surgery. Make no mistake, I do have pain. After my first 2000 surgery, I don't want to go through that excruciating pain again. What levels did you have? What was your kyphotic deformity caused from? When you say "prodisc," does that me ADR? I am sorry but this is all new to me. I have read alot on the different forums and sites on the internet and I haven't found anyone that has had an Anterior-Posterior Fusion from C1 through C-6. My Neurosurgeon says to get as many opinions as I need. Where is your Dr. from?
I may not even be a good candidate for ADR since my kyphotic deformity is from C1 to C6. Sometimes I can loose my balance but I have never fallen. I have had neurological testing, I haven't done very good on those.
Any info I would definitely appreciate it.
Thanks again.

[paulam310]

Prodisc is an artificial disc replacement that should be approved on one level by the end of the year. I had the prodisc at C4-5,C5-6,and C6-7 December of last year. My doctor is from LA county in Santa Monica. I believe that my kyphosis started from a few bad falls as a child. The doctors told me that my neck could not come back into lordosis because of the degenration in my disks. I believe that 80% of the curvature of the spine is determined by the quality of the disks. Within a week of surgery my neck went into lordosis which shocked me since I don't think my neck has ever been normal. I also grew 1/4" from the implants, that tells you how degenerated my disks were. I also had a three level foraminotomy at the same type because I was so arthritic. It seems like on you the doctors want to fuse quite a few levels, maybe another option which quite a few people on this site have had is the combination of fusion and adr(artificial disk replacement). It seems like a good option to me. Artificial disks are created to mimic the natural disk you were born with. It might cushion the effects of the fusion. As you know, fusion often creates compensatory movement, especially to the disk immediately above and can cause it to wear out more quickly. I have more range of motion now than I have ever had in my life and I don't have to worry about sharp pains in my neck. Another doctor who is now doing adr's in LA is Dr. Regan of Cedars Sinai. His office called me recently to tell me that they are in trials for I believe the PCM ard. I don't know that much about it, I believe it is suppose to be a good disk. You could at least get his opinion, he is also a very well respected doctor. Maybe you can get adr's at the top and bottom of a set of fusions. I don't know. I believe when it comes to our spine we need to be creative and pro-active. The field is changing immensely right now, there are doctors that don't even know that 2 and 3 level adr's are being done. So you are smart to get a lot of opinions. I hope I have answered all your questions. I would be happy to answer any other questions to help you along your quest to be the healthiest you can be.

[Fortitudine]

Wow. That's a really serious situation. You may lose your rnge of motion. There are all sorts of new things happening in spine surgery that might help you avoid total fusion.Why did you have the 2000 laminectomy etc.?

You might want to make contact with Yorb on the BrainTalk Spinal Disorders forum. He's in the same situation as you, thus one of the best persons to talk to.

Yours is definitely a challenging case. You might want to contact Mark ******* (mmglobal on the forum) and see if he has any suggestions for neurosurgeons who might help.

I don't understand why laminectomies cause kyphosis but I know they do. That's why there is usually fusion at the same time, in the case of several levels.

Someone else to connect with is Cervie Queen, though she is fused c2-t1 all anteriorly.

Good luck in searching for answers; you should find lots of help here. Keep us posted.

[Nancy from NC]

Linda,
I also have DDD and had previous anterior fusion on C5/6, 6/7. That was followed 7 weeks later by a laminectomy on C3/4, 4/5. A year later I began having "symptoms", and it has now been 2 years since my surgeries with a lot of pain. I have been told that I also have kyphosis due to laminectomy. And this is something would be interesting to see addressed more on these forums. I started pursuing ADR through my U.S. dr in a clinical trials. But was told I do not meet the "criteria" due to too many degrees of lean in my neck. In layman's terms they seem to refer to this as too much instability. So, I got two other opinions from Germany - Stenum, and Alpha Klinik. Both have told me the same thing. "That due to the dorsal laminectomy there is not enough stabilizing elements to warrent ADR". I do not write to discourage you from your search. But I do write in order to help you to go into this with your eyes open. I feel that unfortunately at this point ADR is NOT for everyone. I have read about a couple of people that have had ADR after laminectomy. But I would find it very interesting to know first of all if all laminectomy's have about the same in the amount of bone removed. And then if anyone has been able to have ADR after a laminectomy that wasn't as high up as the C1/2 area. I think that searching does bring peace of mind when you do have to do something down the road, such as more fusion. I would not have been satisfied to go into the fusion I am facing without knowing for certain that there wasn't any other option for me. One other note, my U.S. dr. recommends for me that I wait until I can't stand it anymore before doing more surgery. I think you need to hear from the doctor recommending such a drastic surgery: why you need to do it at this point, what would happen if you wait, and what will be the results expected afterwards as far as quality of life issues (like lack of mobility), hopes of decreased pain. I do encourage you to search for yourself, and I wish you the best.