Prepping for c5/c6 decompression - surgical choices
 

Hi Folks,

So after almost 14 years of conservative therapy it seems I now require surgery at c5/c6 to protect/preserve nerve function. This is mainly due to the exhaustion of free space around the right nerve in conjunction with related symptoms.

A local consult suggests M6-c ADR at c5/c6 (if viable) to give adjacent segments the best chance as neither are in the best condition. Previous consults have suggested fusion or ADR at c5/c6 or c5..c7.

I was feeling quite happy (well, as happy as one can be) with the latest consult but just recently heard of some M6-c failures. It seems there have been at least 2 cases requiring revision due to the nucleus becoming detached with related radiculopathy and incipient myelopathy. Maybe with the number of M6s implanted these numbers are not so significant compared to other issues requiring revision but they've got me concerned. Does anyone have any additional information on this topic?, or suggestions for alternative ADRs?

Thanks to everyone here for the wealth of shared information.

I personally would not feel comfortable with either the M6-L or the M6-C... Due to reported failures.


I'm considering both the LP-ESP and the CP-ESP. Neither have been on the market as long as the M6's, but it seems more and more physicians have been moving to them... As (apparently) no device failures have been reported.

A "few" failures
 

Some of which have not been substanciated and let's face it, all devices have had a failure or complication. There are risks with every surgery. But once you fuse, there is no other recourse.

It's a tough call - the only truth I currently see is that all surgical options are to some extent a gamble and one should weigh the risks against the potential outcome. There appear to have been two reported cases of m6-c failure in German publications. If these are outliers then probably not significant compared to the reported ca. 30 .. 50k(?) implanted m6-cs. I read the latter numbers somewhere so hopefully they're correct, this may make the m6-c the most widely used cervical ADR? I heard about these (failures) just as I was planning a date for surgery, I've now put that on hold and hope to find further clarity via additional consults.

Jacks back
 

JackBauer

"I'm considering both the LP-ESP and the CP-ESP". Jack why would you consider the CP-ESP , when your concern is your lumbar spine??
Thanks...............

Because I do have neck concerns as well - occasional pain (not constant / frequent like lumbar)... But the imaging looks pretty bad and it won't get better.


Unfortunately I'm currently "hung up" on the elastomer within the ESP and the chemicals it can degrade into... Search for "salted" in the LP-ESP 7 year study. (I also made a post about it in the manufacturer sub-forum)

My M6-C 's
 

Mine were done in May of 2015 and still look great!
Placement is key too!

And long may they continue :) I'm getting the impression surgical skill is possibly more important that technique (ADR type, fusion, etc).

Interesting
 

I also find it interesting that these reports are from Germany, where two prominent surgeons are devoted to Pro disc or Mobi.

Germany
 

Maybe because the majority of ADR surgery has/is been done in Germany?, possibly just a numbers game in that case. I have to concede it's hard to obtain reliable outcome/revision/failure data, disappointingly so.