kyphosis, stenosis, and the quest for the best choice
 

My story began in december 2010 when I began to feel intrascapular pain, then in January came pressure on the tip of my left pointer finger, then tingling in my left arm. After many opinions, the consensus is that I need a 4-level ACDF (possibly posterior as well) to correct the severe pathological kyphosis that has lead to a whole host of problems from C3-C7 (moderate to severe central stenosis, disk bulging and herniation, osteophytes, cord impingement and flattening) -- something I can't imagine doing. I've digressed a bit more over these months-- feeling tightness and numbness/pressure in my thumbs and pinkies, hands occasionally, as well pain in my neck and bottom of skull. But none of the pain rates more than a 3 or 4 at worst. And PT has helped.

In fact, my numerous NY doctors have been surprised at the relatively good shape I'm in as compared to the mess my films show. I've gotten an opinion from Dr. Bertagnoli and am awaiting word from others. Bertagnoli says fusion at C4/5 with ADR's at C3/4, C5/6, C6/7. Question is, has anybody out there had a hybrid of this magnitude done? And the bigger question (and fear) is, has anybody had a severe kyphotic deformity corrected by ADR's?? Every NY doctor says that it's crazy and won't work for a variety of reasons.

And yet, I've heard so much good about Dr B and very much want to trust his plan. It's just that there IS some sense to the concerns, especially regarding abnormal motion, instability-- typically contraindications to the use of ADRs-- And also the fact that, if I need a revision, me, my wife, and two young kids will be nearly bankrupt... so there's that...

There are lots of research options still open to explore. Out of the many, here are a few:

1. Do a search on this site with a few different terms, like "kyphosis." You'lll find a lot, many of which are in topics from patients describing their outcomes. Read them carefully, then you could PM those patients.

2. Consider the large number of specialty surgeons in this country that perform corrective surgeries for spinal problems like scoliosis and kyphosis. Perhaps yours is correctable, but it does sound risky. The scoliosis research society has a wonderful resource available, see: Scoliosis Research Society (SRS)

3. Note the past articles on the kyphosis subject are primarily focused on the Bryan disc; see http://www.medscape.com/viewarticle/489862_4 (free account subscription).

There's more, but these should help you get started...

Thanks much. No doubt the "sounds risky" part of your response puts a twinge in my gut, but nothing I haven't already heard. That said though, "risky" as in: Bertagnoli's offered approach is questionable at best and not, in your opinion, an easily chosen path, given the choice between a 4-level fusion and adr? Meantime, i'll continue researching but afraid of what I might find: that a 4-level fusion IS my best option. Can't imagine how I'd ever be able to choose that.