Hello everyone -- multi level DDD in the C spine, cord compression at 5-6 and 6-7
 

Hello everyone,

I have been battling a slowly deteriorating neck for the past 6 years (mostly inherited, but have had some minor auto accidents and ran a marathon), and have finally reached the point where my doctors feel I must have surgery to relieve the compression on my spinal cord at C5-6 and C6-7. So far, I have seen two surgeons (Johns Hopkins and New York Presbyterian Hospital) who both recommended a two-level fusion, another (UCSF) who has recommended a hybrid surgery (fusion at 6-7 and ADR at 5-6). I've also been in touch with Dr. Bertagnoli and Dr. Fenk-Mayer, who are recommending ADR at 5-6 and 6-7 (and possibly levels above pending further x rays and EMG results) -- however, I am admittedly a little apprehensive about going overseas to have surgery, especially if I have any complications or need any type of follow-up surgery or revisions.

I also reached out to the Texas Back Institute after doing some research on here, and got some disappointing news today. Dr. Zigler and another surgeon reviewed my information and concluded that my condition was "not surgically remediable" and referred me to a local surgeon at Jefferson Hospital in Philadelphia (close to my home). I have an appointment with Dr. Bitan in NYC next week and am hoping to get some better news...

The compression on my spinal cord is starting to affect my legs (difficulty walking uphill, up stairs, stiff, achey and increasing amounts of nerve pain), and the surgeon I saw at UCSF told me in no uncertain terms that I need to have this surgery ASAP to relieve the compression on my spinal cord.

I guess I'm just looking for any insight you might have in terms of other possible surgeons I might be able to talk to, or any other advice or guidance you might be able to offer. I feel somewhat lost right now, but I know that I need to take action soon!

I look forward to getting to know some of you, and thanks in advance for taking the time to read my post -- or any thoughts or insight you might be able to offer.

Best regards,
Scott

Scott, thx for your eloquent introduction. You've already made some considerable progress indeed.

Unfortunately, you seem to have an incredibly wide range of recommendations! Can you tell us why Dr. Z said that your C spine was "not surgically remediable?"

Dr. Bitan is highly experienced as you may know, as are the other docs you mentioned. You're on the right track getting these assessments!

BTW, do you happen to know the degree of compression on your spinal cord? Did they mention the specifics on the radiology report?

I hope we can help in your journey to the right decision. BTW, what is your PCPs role in all this?

Harrison, thanks for responding... this board has definitely been a good source of information along my journey, so thank you for providing such a great service and sounding board!

As for Dr. Z, I did not get a chance to speak to him personally unfortunately. Someone in his office called me back to break the news. The line "not surgically remediable" really felt like a punch in the gut! I tried asking whether she meant that Dr. Z (and the other surgeon who reviewed my case) didn't feel that I needed surgery yet -- or whether things had gotten so bad in my neck that they didn't feel they could help me. She said it was the latter. She basically just told me it didn't make sense for me to make the trip to TX, and gave me a referral for a surgeon in Philly. My gut feeling is that they don't want to take my case maybe because of its complexity -- I don't know. I had another surgeon at UPenn in Philly tell me something similar last fall. He said he could attempt a laminectomy to try to widen the area around my spinal cord, but there was no guarantee that it would help. He also said he would not attempt a two-level fusion on me because he felt it would be too risky.

I'm not really sure about the degree of compression, but I've attached a copy of my latest MRI report, which was taken on May 18th...

My PCP has really not been involved at all in the process -- however, I have been receiving treatment over the past 6 years under the care of the Penn Spine Center, so I consider them like my PCP for my neck. They are strongly urging me to have surgery at this point, as they feel there is not much more that can be done conservatively and I am starting to show signs of myelopathy. However, they are not really providing much guidance in terms of choosing a surgeon or the whole fusion vs. ADR decision.

I'm staying optimistic and hopeful for my appointment with Dr. Bitan next Thursday, and I'm also seeing an orthopedic surgeon (Dr. Jason Cohen) at Monmouth Medical Center that morning. He performed a 3 level cervical ADR for a good friend and work colleague of mine, and he has been recovering very well so far.

Sorry for the lengthy reply, but thanks again for responding Harrison!

Scott

Scott,

I am a bit surprised and sorry to hear more details of your cervical spine, especially problems at T1-T2. :(

I noted that on your MRI report there is a history of brachial neuritis. Did this precede the onset of cervical issues? How do you think the neuritis relates to the condition of your cervical spine?

Scott,

Condolences on your condition. My first and third cervical surgeries were to relieve compression on the spinal cord. However, in my case every doctor I saw agreed on the course of treatment, and no one told me that surgery wouldn't help. I can imagine that you feel punched in the gut.

Dr Zigler's comment still seems ambiguous. Did he feel that his surgical abilities were insufficient for your case? Or did he feel that no current surgical technique would help your condition? Even having read your radiology report, I still have many questions; did Dr Zigler see your problem as neurological, or as being with the vertebra and joints? I did not see anything mentioned in your radiology report for which there does not exist an accepted and generally successful surgical intervention. Did Dr Zigler see something in your images that the doctor that wrote the report missed? As Dr Zigler's credentials are beyond question, it would be a good thing to know what he meant. You can call TBI and request Dr Zigler's notes.

I understand your reservations about surgery in another country. I had a double ADR with Dr Clavel in Barcelona, Spain in 2009, which to date has been very successful. But had there been a problem, not only would I have had no recourse, but my physical and financial conditions would have certainly become much worse. If you do eventually seek foreign treatment, I would strongly encourage a lot of research.

Good luck, Jeff

Harrison -- To be honest, I have never even noticed the "brachial neuritis" history thing before, nor has it ever been discussed by my doctors at Penn!! Having read a little bit about it, I'm not really sure that I have the symptoms... maybe it was a typo?? I'm kidding.. Seriously though, I will make a point to discuss it with my doctor at Penn next time I see him for a follow-up.

Jeff -- Thanks for the condolences, I really appreciate it. I'm sorry to hear about your surgeries also, but I'm hopeful that things continue in a positive direction for you. As for Dr. Z, I definitely will call to follow up and try to get more info. I was really hopeful that they might be the answer for me, so you can imagine how disappointed I was to get the news. They really did not offer a reason behind not wanting to see me, only that I should consult with a local surgeon in Philadelphia, and they also suggested that I get a CT Myelogram. When I asked if I should send the results of the Myelogram CT scan, she said "sure" but also made it clear that the doctors view was that they did not see a surgical solution for me. I'll try to get more info and let you know. I'm not in any way trying to tarnish Dr. Zigler's reputation or speak badly about him or his staff. I was just disappointed that I wasn't going to have the opportunity to see them. I'm really hopeful that Dr. Bitan might have a different prognosis for me next week...

Jeff, I'd really be interested in learning more about the process you went through to choose your surgeon -- because I really have no idea where to start or what to look for. I found Dr. Bertagnoli through a Google search, and he seems to be well represented on here and has done thousands of ADR surgeries -- so that's why I contacted him. Beyond that, I really am not sure where to start...

Thanks again, and I hope you both are having a great day!

Scott

Just a few thoughts on surgeon selection: You're going to need someone who's going to look at your back as an interesting puzzle to solve rather than as a threatening lawsuit when total recovery isn't possible. I'd try to work through phone consults whenever possible when you can't go in person. I'd also spend some serious time in research and thinking for yourself what you'd hope for in recovery. I'm over my head in guessing how much recovery you could expect but if you go in to conversations with potential surgeons talking about stopping the ever-worsening condition and trying to get some of you life back, they may be willing to talk with you a bit more frankly about what they can and can't do for you. Please don't think that I suggesting that you settle for less, but the more you work with the surgeon, the more he/she's going to see you as a person rather than a statistic. Laura's had good luck with her back but the problems she's fought, and is still fighting, with her knee have become so consuming that she's really only walking now because a surgeon decided to treat it as a challenge to solve. Of course, he up and quit so we're going through the step now of looking for another Don Quixote surgeon.

Scott,

I clearly understand that you're not trying to tarnish anyone's reputation; but just sharing your experience. That's all that any of us can honestly do.

How I selected a surgeon ... My experience is so different than your's, I don't know that it can be helpful, but ... here goes. First, I went through the process backwards; I selected a device first and foremost, and then selected a surgeon.

I'd had two fusions ten and eight years earlier. I'd since also earned two pre-med degrees and so knew in 2008 when I started having problems again that two more cervical fusions would leave me severely debilitated for life (I'm 47). By 2008 cervical ADR was available, but the ones available in the US would, in my view, be only marginally better than fusion because none of them (including the one that Dr Zigler wanted to implant in me) cushioned axial compression. The Nuvasive NeoDisc did, and I tried to get in on the trial; but because it was a double blind study, I had a 50% chance of waking up with another fusion. I pleaded with Marc Kowalkowski, the director for the NeoDisc trial at TBI, to be assured of an ADR, but to no avail. Since the M6 had a proven track record with thousands of implants (overseas), and since it cushioned axial compression and addressed the major problems with other ADR implants (subsidence, migration, facet joint & adjacent segment disease), and since I was an engineer and felt qualified to make a decision on a device (rightly or not), I decided to have M6 ADRs. Since the M6 was not, and still is not, approved for use in the United States, I accepted that I'd have to go overseas.

With the device selected, only then did I set about looking for a surgeon. Of course I looked into Stenum and Bertagnoli (Zeegers does only Mobi-C). I didn't expect my insurance to pay, so I looked for less expensive avenues with surgeons just as qualified. I went to PlanetHospital.com and Healthbase.com; two companies that hook up patients with international avenues for treatment. To my shock I learned that the M6 was not approved for use in India (where I was fully expecting to go)?! There were only a handful of other options that turned up that use the device I wanted. Only Dr Clavel at the Barcelona Spine Center in Barcelona, Spain met all of my cost/credentials criteria. He wasn't even close to the cheapest, but the cost was two thirds what I'd pay in Germany. He had only about a tenth of the experience of the Germans, but at almost 300 ADRs performed (only 10 at the time with the M6), he had more than any US surgeon. He'd also been involved in ADR R&D, and went to high school, college and medical school in the United States.

When I put all of that into a pot and mixed, and did a cost/risk/outcome analysis, the decision had been rendered academic; so I went to Spain. I've since finished two half-marathons, one full marathon (with a new personal best) and a 100 mile bicycle race.

That's what I did, and how and why I did it. So far, it looks like I made the right decision.

BTW: Since my double ADR I have seen a few patients come on this site that have had highly successful surgical outcomes in England. Had the English options presented themselves during my research, I would certainly have looked into them as well.

Good luck, Jeff

Jim,

Thanks so much for sharing your thoughts and suggestions. Alot of what you said in your post really hit home with me. I think why this process has been taking longer than I anticipated is because I am really trying to find that special surgeon who thinks they can help me despite the many challenges in my cervical spine. So far, the doctors who really seemed caring and confident they could help me (Dr. Bernard Rawlins at NY Presbyterian and Dr. Dan Sciubba at Johns Hopkins) both agreed in the recommended approach -- a two level fusion at 5-6 and 6-7, which is a surgery I really don't want to have (my older brother has had three failed cervical fusions and is headed for a fourth, but that's another story that I don't really feel comfortable sharing). Dr. Mummaneni at UCSF suggested a hybrid surgery (fusion at 6-7 and ADR at 5-6) but I only had like 5 minutes to talk with him so I didn't really get a great feel for the personal side of things. I'm really hoping that Dr. Bitan might be that surgeon for me, who looks at my situation as a puzzle he can help try to solve. I'll know next week, but I'm definitely keeping my fingers crossed.

As for my expectations for recovery, things have gotten so bad for me physically that at this point I'm really just hoping to retain as much functionality in my legs as possible, and avoid some of the long-term damage that can result from myleopathy. I'm already having trouble walking, having really uncomfortable nerve pain radiating down my legs, and starting to have other worrisome developments. I just hope to arrest of all that -- and have the best chance for a normal life possible. Sure, I'd love to play tennis (my lifetime passion) or hoops again -- but I realize that may not be in the cards for me.

As much as I want to do all of my research and find the best possible surgeon and surgery for me, I also feel like I'm running up against a clock here with this compression on my spinal cord. Each day my legs ache and stiffen up a little more, and my hands feel like they are getting increasingly clumsy. So hopefully I will find a surgeon soon and get a date on the calendar!

Thanks again for taking the time to write, I really genuinely appreciate it. And I wish you and Laura all the best of luck in her ongoing journey and in finding the right surgeon!

Best regards,
Scott

Jeff,

Thanks for providing the detailed background on your search for a surgeon and a device.. what an amazing journey! I wish you all the best of luck with your continued recovery, and I hope you keep on cycling and running those marathons!! I ran one (Chicago) right before all of my neck problems started, and it was an incredible experience. I've pretty much given up on the idea that I'll ever run one again (due to my neck), but I think it's amazing that you are back at it!!

The M6 really does sound like a great device with alot of potential. I'm not sure if it would work for me given the condition of my spine, but it sounds like a very interesting option.

Do you know of any docs in England that might be worth checking into? I thought I saw the name Nick Boeree (sp?) on someone's post recently (I think it was Tyler). I just need to make a decision and move quickly in the next couple of months.

Thanks again for sharing your experience, and best of luck for continued progress!

Scott

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

Hey everyone,

Just thought I would attach a quick snapshot from my last MRI in May. I am still contemplating what to do -- but am leaning toward the hybrid surgery (fusion at 6-7 and ProDisc at 5-6) with Dr. Bitan. My insurance company (CIGNA) has denied the ADR portion of the surgery, so I will likely be paying out of pocket and then trying to pursue reimbursement through the appeal process (ugh).

While I have some concerns about the ProDisc, I think it's probably a better choice than a two-level fusion given the deterioration of the discs above. I'm also not really sure about going overseas for a different device (like the M6) given the complexity of my neck and the likely need for additional surgeries in the future.

While the thought of potentially needing additional surgeries in the future is a little unsettling, most of the surgeons I've talked to are in agreement that 5-6 and 6-7 need to be decompressed relatively soon. So at some point I need to make a decision and get going I guess!

Thanks again for all the support, and I hope everyone is doing well.

Scott

Hey everyone,

It's been awhile since I last posted, so I just wanted to provide a quick update as I'm still agonizing over my final surgical decision (my hair is literally falling out as a result of all this stress LOL)... sometimes, just posting on here helps get some of the weight off of my shoulders and I always genuinely appreciate everyone's feedback and thoughts. http://www.spinepatientsociety.org/f...coolthmbup.gif

So I met with Dr. Yue up at Yale a number of weeks ago. Really nice guy, and I thoroughly enjoyed talking to him. Biggest take-aways were that he urged me to get a CT Myelogram before surgery (which I did right before the holidays), and he also is a pretty big fan of the Spinal Kinetics M-6 disc. He said something to the extent that if he could implant one device in all of his patients today, that would be it. He also confirmed that I've lost all reflexes in my left arm at this point. I followed up with him after I got the CT, and he recommended facet blocks at 2/3 (left) and C7 / T1 (right) before I got a two-level fusion or ADR. At this point, I think I need to move forward with surgery to alleviate the cord compression although I appreciate his conservative approach.

I also followed up with Dr. Bitan and Nick Boeree after the CT scan. Both are sticking to their original recommendations... a hybrid with Bitan (which he thinks is slightly preferable to a two level fusion), or a two-level ADR (M6) with Nick Boeree. Dr. Bitan said my facets appear to be in pretty good shape, and Nick Boeree said he didn't see anything in my CT that would be a contraindication for the two-level ADR. Nick also feels strongly that a two-level ADR is the best course of action for me.

My biggest concern, however, is that I was finally able to get TBI to review my CT Myelogram (which they suggested a while ago) and give me some feedback. I believe it was Dr. Zigler and Dr. Blumenthal who reviewed them. While I did not speak to the doctors directly, the feedback was that they did not think that I was a good candidate for ADR given (1) the severity of the stenosis, and (2) the amount of osteophytes or bone-spurring going on in my neck. In summary, they felt my neck was "too unstable" for ADR. http://www.spinepatientsociety.org/f...lies/frown.png

While I trust both Nick Boeree and Dr. Bitan when they say that I am a good candidate for ADR, I have a hard time getting past the feedback from TBI. I read something recently on one of these forums where someone who had a two-level M6 surgery is likely going to need to have them removed and fused as a result of osteophytes forming at those levels. If I already have some osteophytes, my concern is that I could be in this very same boat. However, on the other side of the coin, I worry that if I fuse these two levels now (5/6 and 6/7) I may end up with my whole neck fused at some point (which is keeping me awake at night) http://www.spinepatientsociety.org/f...ies/coffee.gif

Anyway, I'm sorry for the long post... but I'm just trying to sort through all of this info in my head http://www.spinepatientsociety.org/f...s/confused.gif As much as I really would prefer to have a two-level ADR with the M6, I think I am leaning toward a two-level fusion because I just worry that I might not be an ideal candidate given the amount of degeneration.

I'm curious... of those of you who have had cervical ADR's -- did you have any osteophyte formation prior to the surgery??

I also attached a recent X ray snapshot where you may be able to see what I'm talking about...

Thanks in advance for the feedback, and sorry I've been MIA for so long. Hope everyone had a great holiday and is doing well!!

Scott

Scotto,

For my untrained eye the loss of disc height seems apparent at C6/7, but I'm don't know enough to see the osteophytes at C6/7 and C5/6.

I had a "very large" osteophyte on the right side of my uncinate process of C4 that had the spinal cord compressed over to the left side of the spinal canal. It looked really wicked on the MRI. It was removed before the placement of the ADR.

That was 13 months ago. Today I have no symptoms, but I haven't had a follow-up either. If it's grown back it is currently asymptomatic.

Good luck on making a decision.

Jeff

Scotto,

Just my two cents.... I had a three level ADR in Barcelona Spain with Dr. Clavel. He iplanted 3 m6 cervical discs at c5/6,c6/7,c7/t1 and I am 32 days post op and feel pretty darn good. Symptoms such as numbness, tingling and needles feeling is fading week by week, and I think over the course of another 4 months I willl be in pretty ggod shape. I had osteophytes at alll three levels that had to be removed also. It seems that bone spur formation is common in a normal aging spine and that surgeons will encounter this quite often, which leads me to believe that it is only a small percentage of patients who have this reoccurance after surgery. My surgeon had me take 600 mg of ibuprofen 3 times daily for the firest 6 weeks after surgery, this helps slow bone growth formation after surgery. I hope this info helps, also Jeff basically has a a hybrid configuration in his neck and seems to be doing great, he also had Dr. Clavel and the m6 disc.

Jarrod

Scott,

I had (2) M6's almost 2 years ago. Before I had the surgery several Dr.'s told me that one of my levels would fuse (C6/C7) regardless. I didn't listen had the M6's. I had to have revision due to Stenum not removing osteophytes. Anyway when my surgeon did the C6/C7 revision, he did tell me the M6 was starting to have bone overgrowth and was fusing. I am not saying this will happen to you or anyone else, but it did to me. And I was informed this would happen.I was taken Ibuprofen, but that didn't slow things down.

I currently have (2)ADR (C3/C4, C5/C6) and (2) Fusion (C5/C6, C6/C7). I don't notice any range of motion issues. If I had to do it all over again, I would have fused 2 or 3 levels from the onset and top it off with an ADR. I say this based on my experience and my C3/C4 level was perfect from an osteophyte perspective, which made that level a good candidate.

Of course everyone is different. Good luck with your decision.

Scott, I am no expert by any means; but based on your explanations -- a hybrid or fusion sounds like the safer route.

The reasons for spurring are complicated, but can involved any combination of these factors:

- previous trauma;
- repetitive stresses;
- poor diet or health;
- autoimmune disease(s);
- localized disease in the spine (which is really what degenerative disc disease is!).

So, my question is perhaps more specific: what is the rate of changes that have been documented in your spine in the last few years? Is the spurring localized? What about the rate of change? Could this process continue AFTER disc replacement? If so, fusion is safer...

Spurring is said to be a biomechanical compensatory mechanism, but I can't untangle that from the mess of other variables or symptoms.

Dunno if this helps or hinders the process...

Harrison,

I have follow up x rays due at 3 months which would be march for me. How long does it take for heterotrophic ossification ( hope that's right) to start showing on X-rays, and if someone dosent show signs of it after a certain amount of time can they assume they won't get it.

Jarrod

Scott,
I'm so sorry you are so young and are in this situation.
I'm new to all this, but all the dr names all look good to me given my research.
I am sorry that you did not have luck with the doctors at TX Back. I wonder if there was some contraindication for ADR? You should definitely ask.
Harrison posted the contraindications for ADR in a post on this site. You can also just search ADR and find them. My worry is your diagnosis of stenosis. I believe that is one.

Good luck, and keep us posted.
D'Ann