New here- kyphosis and M6
 

I ve posted a couple of times already but really need some advice. If anyone has any insight on the below, it would really help. I have some kyphosis in my neck which contributed to my cord compression...that caused Ddd at c56 with osteophytes pushing on the cord and mild ddd c4-5. I got 4 different approaches to surgery and I don't know what to do now.

Approach 1 - fusion at cord compression level to free the cord now and then later get adr such as m6 at levels above
Approach 2 - adr mobi c at cord compression level-us doc said it might help with lordosis a bit
Approach 3 -2 adr m6 at cord compression level and above ( Germany)
Approach 4 - fusion at cord compression level and adr m6 above.-us ( best approach to correct kyphosis and safest for cord compression but have to go to Europe to get that done in one surgery which means $$$$$

One doctor said that the safest to decompress my cord would be fusion because the adr may fail at the cord compression level as he would have to shave quite a bit of bone there and thus putting an adr on compromised vertebrae would cause it to fail and potentially grow more bone spurs thus putting me in the same cord compression state again. And can't even use MRI on that level to see what's happening due to metal in the disc. I don't want to take that risk of course, as freeing the cord is most critical.

Has anyone had kyphosis and cord compression with osteophytes and got an adr? Can adr help reverse kyphosis? From what I understood it can only make kyphosis worse due to how the vertebrae is shaped already from unnatural stress loads.

And most importantly, how is their disc doing and is there any osteophytes growing back or ho? I'm likely a very lonely case here. A fusion at that level will have no osteophytes growing ever and the cord would be safe. But of course may need to get adr at levels above and below then. A hybrid approach that's not done in the us now, so will have to go abroad. Huge dilemma. Any advice is very appreciated.

You are correct:

"...Can adr help reverse kyphosis? From what I understood it can only make kyphosis worse due to how the vertebrae is shaped already from unnatural stress loads. ..."

I wouldn't roll the dice on ADR -- that's asking for trouble. Hybrids are done here in the U.S. and have been performed for years. Depending on the kyphotic angle, facet arthrosis et al, that may not be a good idea either. I would caution you about going overseas just because you find a willing surgeon who will take you money.

Some add’l links, pls read carefully.

http://www.medscape.com/viewarticle/489862_4

Ecperience with Activ c - cervical artificial disc

Cervical Kyphosis is NOT a contraindication? What!?

Cervical Disk Arthroplasty Versus ACDF for Preoperative Reducible Kyphosis | Orthopedics

The authors are from the Department of Spine Surgery, Orthopedics Research Institute of the Chinese People’s Liberation Army, Changzheng Hospital, Second Military Medical University, Shanghai, China.

Taly,

My situation had some of the same aspects as your own. I had kyphosis and osteophytes along with some cord compression from the vertebrae. The advice I received from 2 orthopaedic surgeons was to have fusion ASAP as I ran the risk of being paralyzed if involved in a rear end car accident. This, coupled with nerve issues already occurring in my hands, led me to make my choice fairly quickly. Fusion, for me, was a certain lessening of lifestyle with the added risk of being back in surgery soon because of increased stress on surrounding vertebrae.

My post op outcome shows my kyphosis has been corrected. The surgeon, Dr. Bierstedt, has reassured me that my chances of osteophytes are low since the fit of the ADR's is quite good (I have large vertebrae) and the osteophytes were my bodies way of trying to autofuse. The range of motion in my neck has returned to normal. I am only at about 4 + months post-op and cannot say what may occur along the road. I can say that I would make the same choice today and probably the same way - I didn't read every possible bad outcome for either procedure - but took a reasoned middle-line approach and went with it. YMMV and I wish you well making your choice.

Surprised, that's great news. I hope that the lordotic angle correction continues to stay healthy and normal forever. Still, this may be risky for kyphotic patients (depending on the severity). That seems to be the consensus among doctors and disc manufacturers.

Peace and healing to you both!

It is quite possible that my kyphosis was strictly a result of my bad disks. I had been told 30 years ago that I showed signs of whiplash... Initially the doc was going to use the Secure C implant to correct curvature but he found my case to be one in which the M6 would work. I will add that PT has played a large part in helping me "feel into" proper alignment. These days with so many people working over keyboards really requires that we practice good posture.

Thanks for the good wishes.

Yes, indeed! Thanks again for sharing. Peace and healing to you always! :shedance:

Surprised, that's great you had such an awesome outcome! I will send X-rays to dr bierstedt as all he saw was my MRI and I don't think it's enough to just make a decision here. I have mild reversal of lordosis and was told that the fusion at c5 6 will correct it likely. My main concern is for stability of the adr when I have such a narrow space there for the cord. I was told the adr might malfunction and move towards the cord since the osteophhytes will be cut in the back of the vertebrae. I will ask dr b. This question. I'm kind of tired or researching all this and took a couple of days off and feel so much better about itall. As so many people out there get much worse diagnosis of some cancer or something crazy, that I now feel that this is just a surgery that will correct things and I will be fine. I think it's all a matter of perspective, I just need to choose right...
Harrison, thank u for the input. From what I understood, you would go with the fusion in my place, correct? I checked out the links you posted but it wasn't easy to synthesize for me, couldn't get the first article.
Can anybody else chime in? Jeff, I read you had some compression too and osteophytes but no kyphosis? Was your decision to get fusion based on the fact that it was rushed and u didn't have time to research options abroad? Or you feel like you would have gone for fusion anyways?

Thank you all for support!

ADR without X-rays
 

Taly,

I'm glad you will have your X-rays reviewed first. One US surgeon told me, rather passionately, that to do ADR without evaluating a current X-Ray was absolute malpractice.

Jen,

Do you mind explaining why the xray is so critical for an ADR consult?

Thanks