Scared Newbie here - Just told need surgery
 

I was so happy to find this website. In the last day, from reading the postings, I have learned so much.

I was told by my ortho that I need an ADR or fusion of my c5/c6 due to cord compresion with symptoms. I am a 39 year old male. Excercise daily and hope to keep it up after this. From my research, it seems ADR is the way to go and I do have a few questions I was hoping some of you could provide insight on:

1) My doctor mentioned prodisc c or bryan? From my searches on this forum there is very little discussion on the bryan. Is the bryan considered inferior? My doc said the bryan is MRI compatable which is a definite plus for me as I have had a lot of CT scans in my life for other issues and would like to avoid as much radiation as possible but not if the bryan is inferior.

2) What are the risks of delaying the surgery? He told me I should do it soon but it is not urgent that I do it tomorrow. He just said he wouldn't wait a year. Do these herniations tend to get worse over time and affect other discs? Sorry, I am quite new to all of this and scared to be honest.

3) I have seen a lot of postings whereby those who got ADR did fine (generally speaking) after the surgery but a year or so later started having issues (i.e. bone growth/ossification I guess its called). I assume its because if the surgery was successful with no issues a year later, we may not see the people posting a year later on this website. Or are these subsequent issues with ADR somewhat common?

Any insight you can provide will be extremely helpful. Thank you!

Mike

The Prodisc is also MRI safe, up to 3 Tesla, which includes most "normal" hospital scanners. AFAIK, any brand of ADR will interfere with CT or MR imaging in its immediate area just because of the metallic content.

I can't offer anything on whether the Bryan is better or worse than any other disc, but it is newer to the US market - the Prodisc got FDA approval in 2006, but the Bryan wasn't approved until 2009, so it has some catching up to do.

No idea on how common post-op ossification is, but ask your doc about naprosyn. It's contra-indicated for people that have had fusions as it interferes with bone growth, so we can use it to our advantage after ADR. I'll probably be taking a naprosyn a day for the rest of my life so my C5-6 Prodisc stays happy.

As for being scared - knowledge is power. I researched the heck out of ADR in general, the hardware, and my surgeon and can only hope you do the same. Asking questions here is certainly a good start! As I told my doctor while I was quizzing him, "my neck is literally on the line here" and the more I learned, the more comfortable I was with it. Knowing that he had already done roughly 400 disc replacements over the past 13 years also went a good way to calming my fears.

Mike sorry for not replying more comprehensively. In the meantime, pls search this site for the term: heterotopic ossification. You will find many topics which will get you started in framing your concerns.

ADRSupport Community - Search Forums

Ga night. :sleeping:

Thanks guys. My doc said the prodisc-c interferes with visualizing the MRI results as you said but the Bryan will not.

Your doctor is incorrect, both will cause problems for MRIs and CTs, both. The Bryan disk uses titanium so it might, stress might, cause fewer problems but it's not a solution to the problem of artifacts on scans.

Nolefan, what's the latest? Are you OK? Plan in place to get well?

I am seeing another doctor on Friday to get a second opinion. Reading the stories here, it doesn't seem like too many people had a smooth recovery after the surgery so I want to be 100% sure I need this. I will keep you posted.

This website has been great. Thank you!

First, I agree that you shouldn't get surgery if you don't need it. On the other hand, you should glance over the huge number of people who post a few times, have a successful surgery and disappear from the board. This board is a good solid representation of the breadth of what you can expect pre-surgery and a reasonable selection of post-surgical problems. It isn't a reasonable representation of success rates because many who have good successes go back to living their lives and rarely post again. I'd suggest reading the board to know what you should ask but seek real success statistics in the refereed papers mentioned on the board and with your surgeon.

For anyone interested - I found this regarding MRI's and visualization restrictions of ADRs. It does seem the Bryan has benefits versus the Prodisc-C in this regard.

Magnetic resonance imaging clarity of the Bryan, Prodisc-C, Prestige LP, and PCM cervical arthroplasty devices.

“ CONCLUSIONS.: Postoperative visualization of neural structures and adjacent levels after cervical arthroplasty is variable among current available devices. Devices containing nontitanium metals (cobalt-chrome-molybdenum alloys in the PCM and Prodisc-C) prevent accurate postoperative assessment with magnetic resonance imaging at the surgical and adjacent levels. Titanium devices, with or without polyethylene (Bryan disc or Prestige LP), allow for satisfactory monitoring of the adjacent and operated levels. This information is crucial for any surgeon who wishes to assess adequacy of neural decompression and where monitoring of adjacent levels is desired.

https://www.medify.com/insights/arti...plasty-devices

You are reading and that is good in my limited opinon. Several journal articles cite the above difference, so I agree with the above in general. I am not MRI trained.

There are trade-offs, surgery v. no surgery, waiting time for symptoms to decrease, type of disc replacement, ...

A second medical opinon for surgery will encourage most patients to get serious about it. We can live with a lot of annoyance in life.

You mentioned ProDisc v. Bryan. There are stats/data on the FDA sites, but I did not compare them. The 2012 AANS/CNS annual meeting abstracts might compare them, but it is impossible to put it into a table with the software used on most any internet forum.

The type of disc replacement is of interest. You may want to browse through the FDA documents:

Bryan - FDA Link

The FDA clinical trials compared the Bryan to ACDF (fusion).
2 year overall success rates page 22

95.5% Bryan
85.4% ACDF (Control)

May I also suggest

Upadhyaya, Wu, Trost, Haid, Traynelis, Tay, Coric, Mummaneni
Analysis of the three United States Food and Drug Administration investigational device exemption cervical arthroplasty trials
Journal of Neurosurgery and Spine, 2012


Sasso, RC, ...
Clinical Outcomes of Bryan Cervical Disc Arthroplasty A Prospective, Randomized, Controlled, Single Site Trial With 48-Month Follow-up
Journal of Spinal Disorders and Techniques
("During the 48 months of follow-up at our institution we also report 6 secondary surgeries in our control group (ACDF) and only 1 in our investigational group (Bryan). Of the 6 surgeries in the control group performed, 3 or 12% to date were for adjacent level degenerative disease and 1 or 4% for remote level degenerative disc disease. The remaining 2 surgeries were performed on the same patient for a pseudarthrosis. In the investigational group there was only 1 secondary surgery performed to date for adjacent level disease 5%"


Sasso RC, Anderson PA, Riew KD, Heller JG. Results of cervical arthroplasty compared with anterior discectomy and fusion: four-year clinical outcomes in a prospective, randomized controlled trial. J Bone Joint Surg Am. 2011 Sep 21;93(18):1684-92.


Heller JG, Sasso RC, Papadopoulos SM, Anderson PA, Fessler RG, Hacker RJ, Coric D, Cauthen JC, Riew DK. Comparison of BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion: clinical and radiographic results of a randomized, controlled, clinical trial. Spine (Phila Pa 1976). 2009 Jan 15;34(2):101-7. (two year)

I will try to post something about heterotopic ossification in the Articles section.

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slackwater_sf