Scott, thx for explaining that you will talk to your doc about the brachial neuritis. Sorry to be so tenacious, but did this condition precede your cervical issue? Was there any other medical condition (or not) relating to it? My concern relates to undiagnosed conditions which may affect the outcome from any possible surgical procedures.

Scott,

I am at the begining of investigating things myself so I dont know if this idea would be viable at all, but would one of the less invasive sugical centers be able to buy you some more time by doing a bit of cleaning?

I have my second apt with the (first....) neurosurgeon on mon, but he indicated he thinks fusion is the way to go. I will not agree to that option untill I am walked through ALL the reasons nothing else would work. I am looking at the laser spine center with the idea of a lower impact clean up buying me 10-20 yrs being worth it even out of pocket.

Dont know if this is an option, but Good Luck!

I have seen that name mentioned relating positive experiences on this forum more than once. His bio looks impressive. Anyone who owns two dogs, three cats, several chickens and his own Harley is Ok in by book.

Good luck, Jeff

Hi Scott -

I had a great experience with Nick Boeree in England who was not only an excellent surgeon but a super guy to talk to. Some info is posted at the following thread:
http://www.adrsupport.org/forums/f47...6-tyler-10743/

But if I can be of any further help, don't hesitate to ask.

In the meantime wishing you all the best,
Tyler

Scott -

If ADR does turn out to be a practical solution for you, the following thread has some more info on M6 technical features that might help you explore it further when you're talking to docs:

http://www.adrsupport.org/forums/f51...istance-10767/

Best,
Tyler

Hey everyone, sorry I haven't been on in awhile. Just wanted to provide a quick update...

Harrison -- I finally did check into that "brachial neuritis" thing with my doc at Penn. As I suspected, it was a coding thing. Cervical radiculopathy (which I have had on multiple occasions) and brachial neuritis have the same "ICD9 code" used by the radiology group at University of Pennsylvania. So, no brachial neuritis here thankfully! But it certainly was a good catch on your part!

I also wanted to close the loop on the Texas Back Institute issue. I finally was able to get a hold of someone at their office to discuss the "not surgically remediable" diagnosis. While I really pressed hard (in a very polite and thoughtful sort of way) for further information, I was told that by Texas law unless they actually see me for an office visit -- they can only say "yes" they think I am surgically remediable, or "no" they don't think they can help me surgically. I really pushed hard to try to further understand the reasoning behind their assesment of my case (as it might be helpful in my journey), but to no avail. I did infer, however, from the discussion that perhaps they thought I was not a good candidate for ADR and it would not make sense to travel all the way to TX for a fusion. Hence, the referral to a surgeon at the Rothman institute in Philadelphia. However, that's just a hunch from what I was able to discern from my conversation. So time to move on!

Well, I had two more surgical consults late last week. The first doc (Jason Cohen at Monmouth Medical Center, a really great guy) proposed a two-level fusion -- but interestingly said if I were 60 years old and had the same exact films he would recommend a four-level fusion, given the problems I have at every level in my neck. Then I met with Dr. Bitan in the afternoon. I really liked him alot. He also noted "wow, you have problems at every level in your neck" but thought it best to address the two levels where I have the most compression on my spinal cord first. He proposed the same surgery that Dr. Mummaneni at UCSF proposed -- a fusion at 6-7 and an ADR (Prodisc C) at 5-6.

I am leaning towards going with Dr. Bitan and am trying to go through the insurance approval process now (ugh). I liked that he proposed the same surgery as Dr. Mummaneni (who also has great credentials), and I also like the idea of at least one ADR at 5-6 as opposed to a two-level fusion. Perhaps most importantly, I like that he is alot closer to home -- only about an hour and a half up the highway or on the Amtrak. With the amount of problems I have throughout my neck and the likely need for additional surgeries in the coming years, I think it makes alot of sense to be relatively close to my surgeon (or at least it feels better to me).

I'm still somewhat apprehensive about the whole thing, given that I will likely need additional surgeries in the coming years -- but I know that I need to decompress my spinal cord relatively soon, which is starting to cause some problems with my legs and hands. However, everything I have heard about Dr. Bitan is very positive and he seems like a great surgeon. So at some point, you need to take a leap of faith (to some extent) and address the most severe problems relatively quickly.

Sorry for the long post -- hope everyone is doing well, and thanks again for all the support!!

Scott

Scott,

That's sure irritating that TBI simply refused to tell you what they meant. It sounds like you're getting opinions from doctors that are just as qualified as TBI, so I don't think it's a big loss.

You're doing a thorough job in trying to determine the best course of treatment. Please keep us posted.

Good luck, Jeff

Scott, I'm pleased to see that you had a good visit with Dr. Bitan. I also saw him a year ago April for a badly compressed C5/6, with moderate compression at C4/5.

I also had severe lumbar pain, with little cervical pain, but many of the same neurological issues that you are describing. I also had a positive Hoffman's test, where he flicks my finger to check for response. I live about eight hour's drive from him, and he actually called me on a Friday and urged us to meet with him as soon as possible after looking at my MRI. He was very concerned about my c 5/6 and the consequences should I have a fall or accident.

So we made the trip on Monday and we spent several hours with him going over our options. He made it clear that I most likely wouldn't be able to reverse the damage done, but only stop any more.

Despite him personally contacting our government insurance, we were unable to get coverage for the surgery, so I had to keep looking. He had recommended a hybrid, a fusion at C5/6 and ADR at the site above. Plis hybrid for my lumbar.

As it turns out, the surgeon that I eventually had with Dr. Pimenta in Brazil decided to just use the Nuvasive NeoDisc at my C5/6 and fusion at the two bottom lumbar levels. His opinion was that the C4/5 will probably stabilize and he does as little as possible, levels wise. So far it has worked. I had other surgeons want to do a third level in the lumbar too, and again, the two levels seem to be sufficient.

That of course is no guarantee that my constantly aging body won't need more work later, but for now everything is good.

All this to say that all the surgeons' opinions seemed very reasonable at the time, but less seems to have worked for me.

I believe that Dr. Bitan recommended the hybrids because the regulations discourage or do not allow multi-level ADR in the US. I am planning on seeing him again in November for a checkup and will ask him that question.

Oh, forgot to add that all of my neurological problems have disappeared :D So there is hope, even if you are told otherwise.

Hey Maddie,

Thanks for reaching out and sharing your experiences -- I'm so glad to hear that you are doing so well!! I'm pretty sure I read your story at one point while I was doing some research on here. While I'm sure it was an incredibly frustrating and emotionally draining journey for you, it sounds like things really worked out for the best -- and hopefully will continue to move in a positive direction for you in the future.

Yeah, I really liked Dr. Bitan. Most of the docs I have met with in the states have proposed a 2 level fusion -- and one said he would do a 4 level fusion given that things are pretty bad at 3/4 and 4/5 also. Dr. Bitan and Dr. Mummaneni at UCSF both proposed the hybrid with the ADR at 5/6 and the fusion at 6/7 (which is the really, really messed up level for me) -- which seems like a sensible approach, although I agree with you that it seems to be largely driven by the current state of insurance approval in the US. My big concern now is the disc, and whether or not the ProDisc-C is really going to help delay the need for additional surgery in the next couple of years.

I've reached out to Stenum and Dr. Nick Boeree, since both are using the M6 disc -- which I really like the overall design of quite a bit. However, I still have some apprehension about going overseas for surgery -- especially since I am very likely going to need additional surgeries in the near future. But at the same time, I want to be as sure as I can be (in this type of situation) that the disc I'm choosing gives me the best chance for longer-term success given the problems at so many levels in my neck.

Tough, tough decision... but hopefully one that I will figure out in the next couple of weeks! Thanks again for sharing your experience, especially as it relates to the progress you've made in recovery -- that is definitely very encouraging and gives me some hope!!

Talk to you soon,

Scott