New to the ADR group
 

Attachment 340

Attachment 341

Hello my name is Lee and I have been in the Army for almost 14 years now. I had my disc replacement surgery on the 18th of July. At first I was just having normal pains that I was told would happen but now I have been having really bad pains in my neck severe headaches and pain down my spine. It wasn't till the neurosurgeon looked at my post surgery x-rays for the third time that he realized that the disc was not set in my neck properly. I glad that I found this community. I was just wondering what every ones thoughts to this are.

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He told me one of two things could happen depending on an MRI that I will be taking Sunday. He said if its not that bad he would inject botox into my neck or if it is bad he was going to take the disc out and do a three level fusion.

I'd suggest flexion/extension x-rays as well. It is possible to get an "off-centered" ADR that is really just off centered because of the way you've held your head. Deliberately moving through the range of motion forces the ADR to move and brings out a host of problems, including adjacent level concerns. Your doctor's probably right about what's happening but the flexion/extension shots are so easy to get and add a lot to your understanding.

You might also want to add what kind of ADR you got, who did it, etc. It's pretty likely that someone here has experience with your surgeon and ADR type that could help you make a decision.

They did the flexion/extension x-rays. Everything from the replacement and down are not moving but everything above is hyper-flexing and extending. He said that it was extremely unusual and even though it is allowing almost full range in motion it is causing complications. The type of ADR was Prodisc C. and I thought It was Col Caram (Army doctor) that did my surgery but come to find out it was his apprentice.

I'd agree that's unusual for all of the levels above the ADR to be hypermobile and all of the levels below to not be moving. I'd suspect something deeper than simply poor placement of the ADR. That might be true as well but I wouldn't accept a easy, off-the-cuff, analysis of this unless everything hangs together. An ADR revision is pretty serious and triple level fusion is also serious. I'd hate to get either and discover that there was a deeper, unaddressed problem.

Lee, can you tell us more about your overall health? Spinal health? Diseases that may have been diagnosed or undiagnosed in childhood? Trauma like car accidents? Sports' injuries? Some of the above?

When spine patients get to the point where they/we are disabled, we tend to suffer from what many docs describe as "just-fix-me-itis." And that's why the pathology behind the DDD tends to get ignored:

http://www.adrsupport.org/forums/f44...l-causes-9218/

Patients tend to ignore this etiology, as it appears to be too challenging and not actionable. The medical establishment tends to ignore it because it is in their financial interest to have you as a patient. Healthy patients don't pay medical bills --because they don't have any -- because they don't need surgery. For example, see this multiple page topic: http://www.adrsupport.org/forums/f60...-ulcers-10655/

Let me know if you need help with this:

http://www.adrsupport.org/forums/f58...-health-11053/

As far as my spinal health x-rays show that I have deginerative disc disease, severe arthritis in my lower back along with fluid in my joints. Iv'e been through several deployments to Iraq where I mainly did foot patrols so I could imagin that from wearing all that gear took its toll. Not to mention being hit by several IED's. Every time I went in because of back pain I was just told that I was overweight even though I meet the army requirments for height and weight. Off of duty the only injury I can remember is being bucked off of a horse and landing on my back. My current pains starting from my head to toe are: Sharp pain going up both sides of my neck with on and off migrains, sharp and burning pain going all the way down my spine, Pain in both of my shoulders, pain going down the backside of my left arm and numbness up the front of my left arm. Sharp pain shooting down the backside of my legs, and numbness down my left leg all the way to my toes. By no means am I complaining about any of this pain but I just wanted to give you a general idea of what I deal with on a day to day basis. Also I just got off the phone with neurology to let them know that I did my MRI last night and was told that the soonest I could get seen for the results would be Dec 4th. On my last visit all he would give me was Tramadal and it has no effect on my pain. So now I gues i'm just in a waiting game.

Why not ask for a copy of the images and radiologist's report yourself so you'll be armed with knowledge on the 4th?

I get a copy everytime I go in. I think the main problem i'm having is the fact that i'm dealing with military doctors.

Indeed! Pls get copies of all your radiology reports -- as many ones through the years as possible. They will all help you and your docs better understand your spinal health!

The surgeon called me back today and said that I have one of two options. A metal plate in the front of my spine or in the back. He said my neck was way out of alignment and that it would be nearly impossible to remove the artificial disc so he wants to brace it to limit the movement. He said he is going to get with "his buddies" from what he said and see what there opinion on the matter is. I'll keep you all updated but it looks like i'm going back under the knife soon again.

You are talking about a pretty extreme surgery for that kind of revision. If you have the time and money, I'd strongly suggest getting all of your films, reports, etc together and seeking a second opinion from another doctor. There are several surgeons inside and outside the US who will perform that service for a fee so there's no long-term expectation that you have to go with them for surgery. If you look around at the cervical revision patients who have posted here, you'll see that it isn't just "put a plate in" simple. It's a pretty serious surgery and you really deserve a second opinion before you commit to something of that level.

Agreed, again, with Annapurna's comments. And pls share your radiologist reports verbatum. It will also help us better understand your situation, as does the initial request for your signature in this forum (first topic here).

Here are the Radiologist Reports

If anyone is interested you can also add me as a friend on FB

http://www.facebook.com/thejoker6981

:beer:

Thanks Lee, and for updating your signature too. Keep us posted.

Oh also I don't know if you all have the same problem but I still can not feel my chin and most of the time when I yawn my neck knots up really bad right under my incision site.

Just a suggestion but your reports also show your name, birth date and phone numbers.
I would suggest removing that info and re-posting the reports.
You'd be surprised what people can find out with tid bits of that kind of personal info.

Hope you get everything worked out :)

Thank you for bringing that to my attention. I cannot find the edit tool anywhere please help.

Done deal -- deleted the files.

In case anyone wondered what a Prodisc C looks like in an MRI.

Started doing some research on what the Radiologist's report said about my middle and lower back compaired to what the Neurosurgen said "Just bad muscle spazems". Due to increased pain and its only getting worse. And I'm not really likeing what I'm finding. Its seems like there is alot more to my pain then what he is saying. Any advice from what anyone sees in the Tscan? Maybe Scheuermann's disease?

Lee, I am no expert, but this image looks impossible. I'd be curious (know I mentioned this before) to know what the radiologist report says. If you can, cut and paste that info here (sans personal information).

This is the only thing that the radiologist's report said about my t-scan. word for word.

Hello Lee,,

I am new to the forums also and am very sorry to hear of what you have been going through.. I had a Prodisc-C at C5-C6 in March of '08.... it migrated fwd enough that I had a revision in September of '08. The revision has been stable. The surgeon told me that I had incurred some scar tissue on my right nerve root at C5-C6 which he cleaned up but he said it might return... I do have some positional associated pain I think is related to this but for the most part, seems to be good. Much better than how I was previous to the first surgery.

When my surgeon went in for the revision, he did tell me that if we ran into issues, he would have to do a fusion.

I hope you can get a proper diagnosis of you pain and can get it remedied. I know how difficult and depressing it is to be limited and in pain.

I wish you well, Sincerely, Ken

additional xrays
 

In addition to getting some flexion/extension xrays, it might be helpful to get some oblique views .. they can show the condition of your foraminal canals where your nerve roots pass through... I asked my surgeon if we could get them at one point and they did it for me. I was curious to see the alignment after the prodisc was put in

I will dig out my cds and try to get some screenshots over the weekend...

cspineantobl

take care, Ken

For about a month after my surgery I was doing great. I only had the normal pain the the surgeon told me I would have but then I started going down hill fast. From looking at the X-ray's I wondering if the disc was set way to far back and its pushing on my cord. Also I was wondering if anyone else still has numbness in their neck? I was told that the feeling would eventually come back but from the inscision site all the way to my chin is still numb.

Hello Lee,,, I was also numb up to my chin for quite some time.. I'm can't recall how long though.. I would say easily 3-4 months..

I think that your adr is placed far enough back, to far off of center, that it throws off the dynamics of movement greatly. Looking as the side view, I can see that the spacing between your spinous process is a good bit larger than at the other levels. I think as you bend your head back the level where the adr is would lock up before it should stopping what should be natural movement at that level. When you bend forward, the forward part of the adr will touch and create a fulcrum that leverages on the vertebra above and below in a way that is not natural or good. Also by being placed to far back, it creates a new vertical center axis that creates issues when turning your head to the left or right. Ad in bending your head back and turning left or right or whatever I think would surely cause weird movement on your facets to... leveraging on them in a bad way.

Of course I'm not a doctor but in some ways, it is simple mechanics.

My Prodisc is also not perfectly placed. I gotta dig out my xrays and post up some for you to see. From a side view it looks like my adr is almost touching in the rear instead of being parallel in the prone position. I also get a fulcrum action going on when bending my head back. I think that quite possibly the surfaces of my vertebra were not properly surfaced so that once the disc was inserted the two endplates would sit parallel to each other. This might also be inherant of the prodisc being a ball and socket device. This is why I am concerned about how it would work out getting one in my lumbar spine.

I think I need to see more images of other folks that have the prodisc to see there are folks with ones that sit nice and parallel.

Ken

Thanks for all the advice everyone. I will be meeting with the neuro again on the 26th and I'll post what he says. I have "A LOT" of questions to ask him.

:chainsaw: update on my situation. New surgery date of December the 18th. I was told by the surgen that he will be removing the pro disc C. And because of the alignment of my neck he is going to have to do a fusion on several levels. Of course I will have limited movement in my neck afterwards and I will be forced to medically retire from the Army but I will be ok with that as long as some of the pain I have been feeling has gone down. My post op date is on the 13th and I'll ask him this question but I was just wondering. Will I be put in a Halo or just have to wear a neck brace until the fusion is complete?

Happy Holidays everyone and god bless you all :angel:

I am so sorry to hear of all that. Is there any chance you can get the cash to go overseas and get ADR with another implant?

It just breaks my heart (as I'm sure it does yours). After all of your service...

Joker,

Sorry to read of your troubles & pain.... Hopefully, the fusion will make things better for you.

Wishing you the best.

And thank you for serving our country. :)

Lee, if I were in your situation, I would request my doctor take any excised tissue and send it to a top diagnostics lab -- one that has advanced molecular diagnostics. The results might help explain what went wrong, as well as what antimicrobial treatments could be used during and after surgery.

Again, this is just a suggestion, if in fact there was any kind of infection process that contributed to your complication. You may expect some resistance, but do your best, as this can only help. It could lead to a quicker, lasting recovery.

Lee,

I feel for you brother. I hope whatever decision you make that it helps alleviate your pain. No one can understand how dibilitating pain is until it actual occurs to them? I'll be thinking about you!

Going in for post op tomorrow and surgery on Monday. Wish me luck everyone. Ill post pics as soon as I can on my facebook after Monday.:angel:

Wishing you lots of luck and will keep you in my prayers. I hope that everything is successful and turns out good!

We will all be thinking of you, Lee!

Good luck Lee. Hope all goes smooth!

I PMed you, pls be careful and ask the doc about testing your area of surgery...

Great Luck!!!
 

Great luck. If they go in posterior, it really stings... Come home with a ton of meds/scripts..

Praying that it works out for you!

Be happy that they are taking the ProDisc out.

Keep us posted as much as possible!!!