Desperate need for answers for ADR prodisc c revision to fusion
 

Hi,I'm 42. I have degenerative disc disease and I was suffering for 3 yrs with pain down my left arm and tingling which also finally got into my right arm and was affecting the use of my hands.

My MRI showed ruptured disc and nerve root compression at c5-c6 level. My neurosurgeon suggested ADR with prodisc c..I had this surgery done 7/28/10 and now I am in worst pain than I was.:bawling:

I did not stay overnight in the hospital for pain control or get a soft collar.I was told I would heal rather quick and be ready for work in a bout a week or to post op by my surgeon...wrong! I was sent home with tramadol and told not to look up for two weeks but I could drive the next day....duh!

I was not given any at home care instructions other than not to do heavy lifting but I could resume normal activity when I felt I could. I was miserable with post op pain. I called the Dr. back and he gave me darvocet and flexeril. Two days post op I felt like my muscles in my shoulders were at war with each other, my head hurt everyday and I have a pulling feeling in the level of c-5 c-6. Two weeks post op I had severe tremors that started in my neck and then went full body. I wound up in the ER got a shot of valium and morphine to calm that down but they lasted for four days. I was told my muscles were just weak from the surgery.

Anyway, after therapy and strengthening exercise and three months later, I thought I felt fine enough to go back to work and btw.. I only work part-time as a cashier about 28 hrs a week and after two and half months of going back to work my muscles are at war again my head still hurts everyday and my neck hurts from the base of my skull down and I still have the pulling at c5 c6 level and I still get tremors in my neck. I went to the surgeon who did the surgery 5 different times and told him of the problems I was having and he does nothing but x ray and says everything is in place and I don't know why you are still having problems. He sent me to a neurologist to check for nerve damage but said there was none.

In Dec 2011, I Went back to my regular physician he gave me more pain meds lortab 7.5 and flexeril and was going to send me to pain management who never called.

On Jan 18 2011 I turned my head to the right and had tremors in my neck again which went into full body shakes. I went back to the ER and got another shot to calm that down. Had a follow up with my Dr who then sent me to a spine specialist. He is saying I need to have a ADR revision to a fusion because of disc space width and height of the ADR.....I only saw one spine specialist who knows nothing about ADR because he only does fusions but he did get another Dr. to call me about what I need to have done.

My appointment with him to discuss the revision is 2/15/2011. I am in constant pain. I can't reach, stretch, bend or stoup without causing my muscles in my shoulders and causing my neck severe problems and pain.

I am kinda dumb about all this. I don't know what to do.I am tired of pain and the pain meds. They don't help anyways. I haven't heard anything good from a fusion either and I know it's not good to keep messing with the nerves in there. They went form the front for the ADR(which btw I have very little feeling in the front of my neck?) but wanna go in through the back for the revision...help!! Does anyone have any answers for me please.. I am a single parent. I have no help and I have a family to take care of and just want my pain free life back.:sulkoff:

Thanks in advance

Msrudy
　

So Sorry!
 

I know your feeling. Your post and mine sound a lot a like. Same disc, almost same timeframe.

I was scammed into this surgery and am suffering badly.

The people on this site will help you and give you great advice. It is good to keep checking here for their responses and direction.

I wish you luck and feel free to email me anytime.

Sorry again,

Dustin

Can you get your hands on your x-rays? They should tell most of the story about positioning of the ADR. Even if you can't get the radiologist's report on the x-rays you could choose to post a picture of it here and get unqualified but eager assistance or send it to a ADR doc who can give you an opinion, mostly likely for a fee.

How did the neurologist check for nerve damage? Typically, that's done with an EMG which is an unpleasant enough test that you would have likely mentioned it. Being stuck with that many needles tends to stick in your memory (sorry, terrible pun while you're in pain). If he didn't use an EMG, I wonder how he managed to make the decision that you don't have nerve damage. That might be something else you could try.

You might have had a second level go bad. You can get another MRI to check for adjacent levels. The ADR will mess up the image at that level but you should be able to see other levels. CT with contrast could be used to check the ADR level but that's a difficult and somewhat risky test so you'll want to try the easy stuff first.

I'm not trying to lead you away from the ADR revision to fusion but that's a difficult and expensive surgery. So much so, that you'd really want to be sure you need it before getting it and it doesn't sound like your surgeon has been giving you any of the answers you'd like to have before you try something that serious.

Reply to annapurna to ADR revision to fusion
 

About the x ray..the other spine specialist I am seeing on 2/15/11 has those x rays and my old MRI from before the surgery but he says it looks like there is too much disc space and that is what is causing the problem... which is not the same Dr. who did the ADR surgery. I don't ever want him to touch me again...scary!:disgust: At the same time, I don't want anyone touching me if they are just trying something or guessing. I want to know how I can know I can trust them on their advice enough to let them do what needs to be done.

The neurologist that did the nerve damage test used needles and a machine that read out the results. They stuck the needles in my arms and shoulders and hands.I believe it was an EMG from what I remember the test being called. Yea, pretty painful!:( I guess I didn't mention how he done the test because of the lengthlyness of my post. I do however trust his opinion of the nerve damage test. He was very concerned about the tremors I was having but I only went to him to have the nerve damage test done. I still don't know why I am having the tremors. I understand the ones with my neck because they happen when my muscles draw up and I believe they are in spasm I just don't why they sometimes go full body shaking. Should I go back to him about the tremors or should the Spine Specialist be able to tell me about why I am having those.

I will ask the Spine Specialist I am now going to about if he thinks I have had a second level go bad and see if he would run some test for that. Thanks for mentioning that. I am kinda dumb about all this and don't wanna take any more risk or do any unnecessary surgeries. The ADR surgery was bad enough.I just need to know what questions I need to ask when I go for my visit to the specialist on tuesday. I don't wanna have the ADR revision to fusion if I don't need it but how can they prove to me that I need it and that this ADR has to be taken out because that is what the problem is(?). Please help me with any questions I may need to ask and what test I may need to have done and how to know I can trust their judgement. :confused:
Thanks for your reply and your help.
msrudy

First, there's really no way to find a sure thing doctor or surgeon. Everyone's going to be guessing. Your best bet is to find one that lays out a reasonable course of action that starts with minimally invasive stuff to understand what's happening with your body. If the doc refuses to discuss things with you or answer your questions, don't go back. I've often suggested pre-planning two visits, the first visit to get a diagnosis and a course of action and the second after you've done your research to ask all the questions you wished you asked in the first.

That said, the whole body shakes sounds like it could be pointing to something serious enough that a doc might chose to move through minimally invasive to more more invasive pretty quickly. I'm not saying that because I recognize the symptoms; it's just a guess that whole body symptoms suggest more serious problems.

You should be able to ask for a copy of the x-ray and ask for a second or third opinion, even the freebie ones you'd get here. Too much distraction, too much space created by the ADR, could cause pain at that level but Laura, the better informed of the two of us, heard your comment about whole body shakes and immediately thought myleopathy, not distraction pain. It might be that the ADR was slightly misplaced and led to too much space and too much spinal cord irritation. You might even be forced to go the route of CT with contrast to really see what's happening at that level. If you and your new doc try that, make sure you go to an imaging center that's willing to take time with it. CT's are like MRIs; they take "slices" through you and render what each slice looks like on the output film or CD. If the slices are too wide, caused by trying to rush people through the machine, the slices are very likely to miss the details you need to figure out what's happening.

Reply to annapurna
 

Thanks so much for that info. I will most definitely be asking these questions on my visit on Tuesday and what my options are. I will also get copy of my x rays and post them here as soon as I can.. Thanks so much.
msrudy

Msrudy,

One way to get your x-rays/MRIs: just call the facility where you got the x-ray/MRI done and say, "I got an x-ray/MRI on [date]. Can I get a copy of the results on CD?" They should make this available to you (as well as their radiologist's report) for at most a nominal fee.

If you get the runaround, do a google search for the law on patient medical record access in your state (assuming you're in the US).

-Karl

reply to all about ADR to revision
 

Hello,
I am going today for a CT Scan and MRI on my C-Spine.The Dr. is checking for arthritis at the least,and at the most something that could be wrong with the placement of the ADR, spinal compression and nerve compression and looking at the other levels above and below the ADR.The Dr. said if any of the above were present I would have to have the revision from the ADR to the fusion done, except for arthritis and if it was just arthritic I would have to get shots in my neck and pain management for that. I am nervous about all of it but am glad I am finally getting a move towards finding answers and relief.
Thanks again for all the advice. It really helped me when I went to my Dr, visit on Tuesday.It also educated me a bit about my C-Spine.I will keep you posted as of what they find and what they are going to do.
Thanks again to you all
msrudy

still confused...PLEASE HELP!
 

My MRI Cervical Spine with and without contrast Impression

1.Status post cervical disc replacement at the c-5-6 level with marked magnetic susceptibility artifact emanating from the metallic artificial disc. This precludes adequate assessment of the underlying spinal canal, neural foramina and opposing vertebral bodies.
2.early disc desiccation at the C2-3,C3-4,C4-5, and C6-7 levels.
3.Loss of the lordotic curvature.

CT of the Cervical Spine with Contrast

1.loss of lordotic curvature.
2.Status post cervical disc replacement at the c5-6 level without evidence of artificial migration. The artificial endplates appear to be well incorporated into the opposing vertebral bodies and in satisfactory alignment and position.
3.Incidentally noted is subtle pleuroparenchymal scarring and emphysematous changes in the bilateral lung apices, particularly on the right.


WHAT DOES ALL THAT MEAN..COULD SOMEONE TRANSLATE THE IMAGE RESULTS IN ENGLISH FOR ME PLEASE...HELP! :insane:

Non professional translation:
MRI #1: Can't see the ADR and surrounding structures very well due to "artifact" meaning interference.
#2: Early deterioration
#3: Loss of normal curve of the spine
CT #1: same
#2: No artificial migration = it hasn't moved- that's good. All looks positioned well.
#3: Scarring on your lungs, emphysema (is this news?)

The loss of the lordotic curve sounds like a huge symptom of something serious. I don't know exactly what it's indicating but a properly placed ADR shouldn't have altered the curve, December to now is also likely too short for boney damage and similar changes to have removed the curve. I'd wonder about muscles relaxants for a really short time, week at most, to see if shutting down knots in muscles might restore function, other than that I'd guess that you may have a misplaced ADR or too high/too low a spacer.

I'd call your doctor, and make sure he/she explains your results (you got your report without an explanation?), but I would guess the deterioration of the C spine at multiple levels, even though mild, has made you lose some of your curve. One segment would have to be terribly out of place to change a curve, and that would very apparent. I would think it's your several segments that are thinned.
But, here we are.... not radiologists, guessing! Talk to your doctor!

I'd would have also wondered about the disc dessication but that note, early disc dessication, generally was attached to blackening, full height disc by our radiologists. There's also the possibility that what one person sees as early stage dessication another would call advanced height loss.

Thanks you for your reply
 

Thanks annapurna and Jstuckey :
What could the loss of lordotic curve lead to or be a serious symptom of and what can be done about it and the early disc desiccation at the C2-3,C3-4,C4-5, and C6-7 levels? I have been on muscle relaxers but they dont help much. Rest helps some but then when I try to get back to my normal activities they flare back up at the least thing I try to do.....and yes Jstuckey that was news about the Scarring on my lungs, emphysema?? It was very scary to hear that. I have has pneumonia twice could that be the scarring. Now I got double trouble??
Thanks and please help me know what can be done, I am a nervous wreck about all this neck stuff and also the other thing.
msrudy

Oh my, please don't let my guesses scare you. I speak only from the knowledge of an occupational therapist, not a doctor. Yes, a history of pneumonia scars the lungs. I'm not saying you have emphysema, but maybe the doctor was saying it was an emphysema- like scarring. Make an appointment tomorrow so you don't worry needlessly! Maybe your ordering physician or a nurse practioner will even explain it on the phone.

For tonight.... type those words into a google or similar search engine and read what they mean. Calm down until you speak to a professional. Not good to stress out without the real medical advice piece!

If I remember correctly, loss of the lordoic curve happens when you lose disk height, your vertebrae bodies are damaged and sloped or you have something causing the lordic curve to be temporarily pulled out of shape. These are all symptoms of other problems. Some of them can be ruled out by the infomation you already have but it's probably a good item to pursue to figure out why you hurt.

trying not to stress...
 

Thanks for all the replies and advice...I have been googling just about all day and all I find on the c spine and the problems I am having from the imaging results is to have a spinal fusion or pain management...and about the emphysema or scarring ,I will not stress about it until I know more about it and probably have more test done.I gotta get rid of this pain in the neck and deal with the scarring later but as soon as I can but the pain in my neck I can't take anymore..... anyways, I wont stress about none of it till I see my Dr on March 4th and let him explain it all to me..thanks again guys.

msrudy

Don't worry about the scarring. Laura got her first x-ray for her L5S1 problem and talked through it with our local doc years ago. The conversation went something along the lins of "that's l5s1 and you can see that it isn't too bad yet and that's your gall stone that needs to come out as soon as possible, when could you meet with a surgeon for that?" Sometimes finds aren't clinically important because the radiologist doesn't know anything abut the rest of your medical condition, sometimes they are important and early detection can head things off while they're easy to treat. I'm prostate cancer-free because of lucky detection with a PSA test done when I was 37, better than 10 years earlier than most docs do them.

You are right and I am glad they seen it so I can have it checked into before it turns into something bad or worse..thanks for the advice and support...not stressing today just praying and waiting on my Dr. appointment or the Lord whichever comes first..:) I just don't want anymore surgeries....but if I have to, I have to and sooner or later I probably will have to. :(
msrudy

msrudy,
I am so sorry for your situation and your current pain. You are so brave, so keep hanging in there. I hope your current doctor can figure out what is going on when you have your appt. Sounds like you are on the right road to figuring out to know what to do next.
We are here for you, so keep in touch.
DAnn

Thanks DAnn. It is so good to have so much support and advice as well. It really does help. I am trying to be brave and strong.I have a 16yr old boy and a 7yr old lil girl who I put on my happy face for and endure the pain. Sometimes they can't help but notice how much pain and stress I am in that to breaks my heart for them. It is seeming like FOREVER until my Dr. appointment on 3/4/11 but I believe I will finally get the answers to my problems I need and the treatment plan will follow and then
some relief.:clap:
I am still trying to be patient and not stress it. Thanks again!
msrudy

I have young kids as well (but not teenagers yet)...keep that happy face going for them! (It will help you too).
DAnn

Thanks again DAnn. My visit to the spine specialist on 3/4/11 went like this. He is sending me to pain management to have pain blocker shots in my neck on 3/29/11. He said this will tell him a lot as to where this pain is coming from and it will determine what type of treatment I need as in another surgery from ADR revision to fusion or what and that's as far as he went on explaining what my other options would be if the pain was not coming from my C-Spine. He thinks it is level C-6 C-7 level that is giving me the problem.

If it is I believe if I understand right he will remove the ADR and do a fusion on C-5 C-6 & C-6 an C-7 and I am terrified about it all and if so they will have to go through the back this time. Any info on this surgery would be helpful...and if the pain is not coming from there then its in my shoulder muscles and any advice on what could be done about that would be helpful also.

Thanks for all the advice and support. I'm hanging in there as this keeps dragging out but I know it takes time to have all the right test and procedures done.
msrudy

Holy Moly
 

Gosh, we are right on track with each other! Scary. I went on my John's Hopkins Neurosurgery Visit today and he said that he is going to put me in a Miami J neck Collar for 1-2 weeks and see if that eases my pain. If it does, then it is obviously a problem with that same disc C5/C6 (ADR surgery-ProDisc C level). The next step beyond this is to schedule me for a fusion over the ADR disc...going in through the back.

So, I am going to grab that collar tomorrow. He wants me to wear it everday when I am not sleeping. I may even wear it when I am sleeping if it doesn't prohibit my sleep too much.

If I start feeling improvements...it is under the knife again. My Hopkin's Doctor seems very confident and is certainly more experienced then my initial surgeon.

My hopkins Doctor doesn't like these ADR surgeries. He said that I only had one level and that a fusion at the single level of C5/C6 works 99% of the time without mobility issues, etc... He was curious as to why the Fusion was not done originally.

He thinks that my initial, young surgeon got too cute and deviated from what works to "try" the new technology. So hear I am 9 months into an agonizing situation b/c the surgeon wanted a little more moolah and he got a woody relative to utilizing the "newest and greatest" ProDIsc.

They can't take it out, so just fuse over it. Hopefully it works.

I'll keep everyone posted.

Still no relief or real answers...need support and advice
 

Hi everyone,
I haven't been on here since March but I wanted to check in and let you guys know what has been going on with me and I really need some support and advice. I went to pain management in March and got evaluated and the pain management doc is giving me the epidural and steroid injections. I have had two rounds of four. My next one is scheduled for June 3rd.Seems they are scheduling them once a month when in the beginning I was told it would be every two weeks?? This thing keeps on dragging out! I recently found out May 6th, when I had my second round of shots that I had a significant amount of scar tissue in the lower level of my c-spine?? My muscles are still tight and weak and spasm a lot. Still have headaches and pulling in my neck. I can't reach,bend, lift or stoup without pain and spasms. I am still sore from the shots and it is day four and I am still sore because this time the doc used a catheter to get the medicine in deeper. So I can't tell if I am going to get any relief. So far NOT! The first round the soreness only lasted for two days but I didn't get ANY relief from the first round. I am now on percocet 7.5 3 times a day and Zanaflex at night. Still confused and no relief. Still putting on the happy face and being brave.

About the scaring on my lung..my regular physician said it was nothing to worry about, could be the two times I had pneumonia. He didn't do any test to check. He must have had a busy day that day. Still gotta get that checked but now I am so broke and I can't even afford to go to the dentist or the eye doctor and I need to real bad. I am still outta work and all I have is medical coverage and I don't even know for how long because my FMLA time has run out and personal time on my job is probably about to run out.

Just as a reminder, I had ADR prodisc surgery July 2010 on C-5 C-6 level and pain is worse since my surgery.

Here is all I know that is wrong with me so far:

My MRI Cervical Spine with and without contrast Impression
1.Status post cervical disc replacement at the c-5-6 level with marked magnetic susceptibility artifact emanating from the metallic artificial disc. This precludes adequate assessment of the underlying spinal canal, neural foramina and opposing vertebral bodies.
2.early disc desiccation at the C2-3,C3-4,C4-5, and C6-7 levels.
3.Loss of the lordotic curvature.

CT of the Cervical Spine with Contrast
1.loss of lordotic curvature.
2.Status post cervical disc replacement at the c5-6 level without evidence of artificial migration. The artificial endplates appear to be well incorporated into the opposing vertebral bodies and in satisfactory alignment and position.
3.Incidentally noted is subtle pleuroparenchymal scarring and emphysematous changes in the bilateral lung apices, particularly on the right.
and now.....significant amount of scar tissue in the lower level of my c-spine??
I suppose after I get all four rounds of the shots and I go back to see the Spine specialist possibly by August, he will know by the relief I get from the injections if any, how to come up with a treatment plan. Hopefully, I don't get stuck at pain management with all these docs giving up and telling me I don't know what is wrong and wind up at square one because I don't wanna take pain meds the rest of my life.I want my life back and I definitely don't wanna have another surgery until it is absolutely necessary...and yes, I was asked that question by a co worker who ask do you wanna have surgery!! DUH!! NO!! It seems no one understands because I don't look sick but I am in a lot of pain. I'm trying to think positive and not give up hope. So with that said just maybe they will figure it out. In the meantime, does anyone know what all of this could mean.? What could be wrong? What could be done about it with the info I have so far??
Thanks in advance for any support and advice,
msrudy

PS sorry dustman9725 for what you are still going through. Let's try together not to give up hope. :)

Tremors that start in my neck and go full body shaking...HELP!!
 

Hello, I noticed no one replied to my previous post. Does that man no one knows what is going on with me?? I have had all rounds of my ESI's (Epidural Steroid Injections) and got 3 wks of relief from them. I still have pain in my neck, hands and arms tingling and pain in my left arm. Shoulders still tight in muscles. Do light stretches and exercises but then I go into these shakes that start out like tremors in my neck then go to full body shaking. I don't do the stretches anymore because of that but if I do light house work or anything in my normal activity I get tremors that go into full body shakes. I have an appointment with my spine specialist on 7/22/11 hope he can help. In the mean time, does anyone think they know what is going on with me or ever heard of this before?? You can read my previous post to update on what's been done and going on since my ADR surgery on 7/28/10. Thanks in advance for any advice or help.

MsRudy,

I am so sorry to hear that you've had little, if any, relief after your surgery. I've had four cervical surgeries in three surgical sessions and unfortunately don't have any insight or advise to give.

Please keep us posted on results from your appointment in two weeks.

Good luck, Jeff

MSRudy how are you? Update?

I hope you are finding the answers you are looking for I was
just wondering if you have gotten plain xrays lately? Thats how my dr found out what was wrong with me. Sounds almost word for word what I have been going through and Dustin too. I finally got fed up of being a pin cushion and being miserable every single day going through horrible painful procedures that never helped(botox injections were the worst) not having a life and wouldnt take "its just muscle pain" for an answer any more :flaming: stopped being the nice patient and started demanding answers. My surgery is for September 9th posterior cervical fusion over prodisc-c c5-c6. Please let me know how you are doing now

Reading all these negative pro disc threads is getting discouraging. I find no comfort in other people suffering with the same problem. Just makes me wonder about the design of the implant...Smh

Still unbelievable - We need a bulldog of an attorney
 

Remember what we were saying dude? I think it is just a bad idea to get a prostethic (A PRODISC 4 SURE) at the c4-c7 level? We see so many examples of nightmares, on this site alone with people who have had a prodisc at C5-C6.

They simply did not do enough research and pushed this product through FDA approval so that they could start raking in the bucks. We now have to suffer for the rest of our lives.

I am trying to put a dollar figure on the prospect of myself suffering everyday for the rest of my life. The neck starts aching, within a half an hour my headache starts...this turns into a migraine and then within 2 hours I am laying flat on my back, sick. Running to the bathroom to vomit.

If this is the story of my life forever and in addition, having to endure Methadone and sleeping pills...weight loss and all of the other issues. What is the dollar figure daily that Synthes or my surgeon or someone/entity owes me? I'm serious! I have to endure this crap everyday for the rest of my life. It is not getting better. The fusion did not work. I need someone to hear me scream!!!!!!!!!!!!!

If I could get my hands around my surgeon's neck...

I hear you man. I wish I could have been less desperate and used common sense before I let the doc put me to sleep and cut my implant in. I just don't know why I thought a knee/hip implant (basically what the pro disc is made of) would work in my neck. I feel so damn dumb for letting someone do this to me. If I die young, I hope I can save someone from making the same mistake I made.

To Dustman
 

It seems to be a common problem prodisc at c5-c6 just doesnt work..

Scream:rant: all you want to I am here for you I dont know how to help but I will listen

Laura has a Prodisc C at C5-6. It's working, sort of. She's been told that she has too much motion and is irritating the facet capsules slightly leading to ongoing pain. Could be C5-6 simply moves too much and a more constrained design is needed for that level.

I know other people from PT that did extremely bad with the pro disc also. Worse then me.

jkde - did they in any way address your stenosis during your surgery? that alone can cause all kinds of sx...

Has there been some sort of poll to see if this is true of just ProDisc or does it apply to many other ADs?

I had the Nuvasive NeoDisc put in just over a year ago in Brazil. It was not approved in North America yet, and I think it is just finishing trials here now. It is a very simple design and I've had great success with it. I don't know if I am just lucky with the design or the doctor or a combination ?

There does seem to be a large number of people who have had problems with the ProDisc, but I'm wondering what the percentage is, from all that have been inserted, compared to other kinds. Are surgeons still using the Maverick, or is the M6 replacing the Maverick in popularity? I am out of the loop since my surgery. The M6 was just coming out and wasn't suitable for me.

I'm very sorry for those of you who are still suffering after going through so much already. :disgust:

The doc told me he took a bone spur off the level he put the pro disc in. That's all I know.

Your disc is soft with no keels, my disc is hard with giant keels. :(