[RP_OutWest]

Hi all,

[Long Story – or skip to Short Story]
I’ve read through a significant amount of this forum and you all inspire me. I’ve got nothing on most here. My problems seem almost petty compared to what I’ve read. Sure I’ve had symptoms on and off for the last 10 years or so but they’ve been mostly manageable. I did have to give up volleyball about 8 years ago and cycling about 5. But except for that I’ve not had serious bouts with pain. That is until January of 2012 when I started a headache that lasted until the end of that August.

After working through all the #@# procedures set forth by insurance, I was finally granted an MRI. To this day I don’t understand why they order a $1000 worth of PT when a $500 MRI can show everything including why PT won’t work. Anyway the MRI led to steroid injections into C7. Through the course of 3 shots the headache(s) diminished and became infrequent but not entirely gone. However, the pain management (PM) specialist was still concerned about the loss of strength in my right arm.

The funny thing is that each time I went in for a visit, my prognosis seem to become more severe. It’s like he was easing me into the real diagnosis. Six months after my third ‘general’ shot, I return for a focused shot into the right side where he was sure that the actual problem existed. This time he was very tempered and recommended that I make an appointment with a neurosurgeon.

Remember, my main symptoms were/(are) headaches and neck pain on the right side. The PM doc said he didn’t know why the shots worked pretty well. But didn’t think this was a solution because he was more concerned about my weak right arm.

At the neurosurgeons appointment I was still too stunned about needing cervical surgery to be on my best game. I didn’t insist on better answers. He had a decent enough bedside manner and exuded the typical surgeon confidence. He recommended a hybrid fuse C6/7 and a Prodisc-C at 5/6. I ask about a multilevel and was surprised to see his willingness to say yes, well sort of. He said that sometimes it cannot be placed a C6/7 because of the clavicle or other bone can obscure the xray. I know the prodisc needs to be dead center but I have not read about anything obscuring the xray from seeing C7.

As he went on, he described fusion needing “inflammation” to help the fusing process. But, ADR doesn’t like inflammation at all. So with ACDF I don’t get to take ibuprofen (a candy to me: see headaches above) but with ADR I do. The first question I didn’t ask was, “how does performing ACDF and ADR in the same procedure work if they require two different healing plans?”

So he showed me a Prodisc-C. Wow that is pretty small. Hey, it’s just a ball and socket. How come we haven’t been using these things for decades? (…What we have.) My next question that didn’t get asked so it couldn’t be answered was, “aren’t two ball and socket joints on top of each other inherently unstable?”

At least I did remember to ask how all this going to help my headaches? He assured me that the nerve bundles where the MRI indicates a narrowing could not be responsible for my headaches. These nerves are very well mapped out and headache is not a symptom. Again, like the PM, he was more concerned about my weakened right arm and predicted the numbness I had experienced in my left hand would occur in my right.

Not one month later did my right thumb and index finger get tingly and a little numb. It only last a few days. But then over the weekend I started feeling pain in my right forearm…now all but dissipated. Both these doctors have stated they are much more concerned about nerve damage then my other symptoms.

[Short Story – or to the point]
So after 10 years of on-again, off-again issues with arm weakness, hand numbness, and back/neck pain, I had a headache for 8mos. Steroid injections made my headaches manageable but I’m concerned about the new occurrences of tingling and pain in my right hand and forearm. The recommendation to have a two level ADR using Prodisc-C is disconcerting because they are ball and socket joints were a ball and socket don’t currently exist. Not to mention that the doc may revert to a hybrid.

I’m also concerned about fusion as I’ve read that somewhere between 12% and 20% of ACDF recipients eventually need one on the adjacent level. (Are those stats right?) This concerns me because my adjacent levels aren’t looking so good. Stressing them with a fused joint does not appear to me to be a good idea.

So now I have a list of questions which is what lead me to this site. Some of them were answered just by reading other posts. But I still have more (some from above which I’ll sum up now):
1) Are NSAIDs forbidden during the recovery period of an ACDF?
2) If so, how does a multilevel hybrid work if the ADR recovery often uses NSAIDs?
3) A two level ADR with Prodisc-C would seem to be unstable because there are two ball and socket joints on top of each other. Can the vertebra in the middle be tilted because of this? Can there be excessive wear on the facet joints? (Facet joint issues have been suggested as a possible cause of my neck and upper back pain.)
4) Does everyone that can afford an M6 getting one or are some still going with the Prodisc-C for multilevel?
5) Someone mentioned that Spinal Kinetics lost funding, I think for FDA approval. I’m not sure what that means in terms of their stability.
6) What are the negative with the M6?
7) Is there any more news on the Mobi-C and FDA approval for multilevel?
8) Oh, and where do I start if I want to explore doctors outside the US. Do I just cold call them or is there a rep to help out?... I haven’t explored that part of the forum (if there is one….).
9) For non-local doctors, what format do they need for reviewing my info? DICOM files or JPGs...?

Wow, that was really therapeutic. I normally don’t go that that kind of thing.

Thank you all (and Harrison) for such a wonderful, supportive community;

-RP.
(edit: added #9)