As so many people appear to have multilevel disc disease, I thought it would be interesting to start a short survey which tracks this sad issue. Please respond to the question below, and feel free to comment as well.

When you read the question, please think about your past and present condition. E.g., if you had 3 levels replaced, and all your other spine segments are "good," then choose "Three Levels."

Please encourage other members here to vote too, I think this will be an interesting survey...

Just to keep tabs on this informal survey, here are the results so far:

Patients..%..Number of Levels:

4 (19%) One Level
7 (33%) Two Levels
3 (14%) Three Levels
2 (10%) Four Levels
1 (5%) Five Levels
2 (10%) Six Levels
0 (0%) Seven Levels
1 (5%) Eight Levels
0 (0%) Nine Levels
1 (5%) Ten + Levels

So far, roughly half surveyed showed three or more problematic spine levels. http://adrsupport.org/groupee_common...icon_frown.gif

If you are a patient and have not yet voted, please do!

Oh My God! 6, 8, 10+ Levels. We have bionic people wandering around out there!

Seems they don't call it degenerative disc disease for nothing.

Interesting. Sure would be nice to figure out why some have so much pain and others whose MRI's look horrible have no issues.

Doctors treat symptoms rather than causes. What caused us to turn to mush spine?

Terry Newton

Terry some folks who voted have not yet had surgery. The point is to simply demonstrate how widespread multi-level disease is for many people. http://adrsupport.org/groupee_common...icon_frown.gif

Well said, on the question of causes...we need more insights on the root cause of these life-robbing spinal problems!

Yup.

I don't post too much, but maybe you could guess that I was the ten level person. I've already had surgery on nine different levels. But then, maybe we should do a survey on age: onset and surgery or present......

I've have two theories about my DDD. The truth is probably a blend of both.

1. One level goes bad and we don't fix it, the instability it creates is the first dominoe and the "cause" of the future disc problems?

2. It truly is a disease. The joints just start going bad and until medicine can find the "cause" behind the disease, we are SOL.

I hope they find out before my kids are old!

edited cuz I can't spell, type and think at the same time.....

Well said, Don. The authors of this recent paper talk about this in more detail -- see below for an interesting viewpoint on these conversations we've been having.
_________________________________________

Modic changes, possible causes and relation to low back pain.

1: Med Hypotheses. 2007 Jul 9; [Epub ahead of print]
Albert HB, Kjaer P, Jensen TS, Sorensen JS, Bendix T, Manniche C.
All The Back Research Center, Part of Clinical Locomotion Science, University of Southern Denmark, Lindevej 5, 5750 Ringe, Denmark.

In patients with low back pain (LBP) it is only possible to diagnose a small proportion, (approximately 20%), on a patho-anatomical basis. Therefore, the identification of relevant LBP subgroups, preferably on a patho-anatomical basis, is strongly needed. Signal changes on MRI in the vertebral body marrow adjacent to the end plates also known as Modic changes (MC) are common in patients with LBP (18-58%) and is strongly associated with LBP.

In asymptomatic persons the prevalence is 12-13%. MC are divided into three different types. Type 1 consists of fibro vascular tissue, type 2 is yellow fat, and type 3 is sclerotic bone. The temporal evolution of MC is uncertain, but the time span is years. Subchondral bone marrow signal changes associated with pain can be observed in different specific infectious, degenerative and immunological diseases such as osseous infections, osteoarthritis, ankylosing spondylitis and spondylarthritis. In the vertebrae, MC is seen in relation to vertebral fractures, spondylodiscitis, disc herniation, severe disc degeneration, injections with chymopapain, and acute Schmorl's impressions.

The aim of this paper is to propose two possible pathogenetic mechanisms causing Modic changes. These are: A mechanical cause: Degeneration of the disc causes loss of soft nuclear material, reduced disc height and hydrostatic pressure, which increases the shear forces on the endplates and micro fractures may occur. The observed MC could represent oedema secondary to the fracture and subsequent inflammation, or a result of an inflammatory process from a toxic stimulus from the nucleus pulposus that seeps through the fractures. A bacterial cause: Following a tear in the outer fibres of the annulus e.g. disc herniation, new capilarisation and inflammation develop around the extruded nuclear material. Through this tissue it is possible for anaerobic bacteria to enter the anaerobic disc and in this environment cause a slowly developing low virulent infection. The MC could be the visible signs of the inflammation and oedema surrounding this infection, because the anaerobic bacteria cannot thrive in the highly aerobic environment of the MC type 1.

Perspectives: One or both of the described mechanisms can - if proven - be of significant importance for this specific subgroup of patients with LBP. Hence, it would be possible to give a more precise and relevant diagnosis to 20-50% of patients with LBP and enable in the development of efficient treatments which might be antibiotics, special rehabilitation programmes, rest, stabilizing exercise, or surgical fixation, depending on the underlying cause for the MC.

There has been a lot of interest in Modic changes at some norwegian spineboards recently.
Several has been diagnosed with it; in addition to degenerative disc disease.
It seems that the patient has to ask specifically for modic changes, they don't tell you if you don't ask...it seems to be a relatively new diagnosis, at least here up north. http://adrsupport.org/groupee_common...icon_smile.gif
People have read information about MC on the spineboards, and then go ahead ask their surgeon if they can see any of it...and apaprently it is quite common.
It seems that there is little to be done about it though, no cure...?

Maybe MC is part of the reason that some are still in pain after surgery...

Thanks Kanutta, for the observations. It is interesting that this type of research (and related topics) seems to be performed in non-U.S. countries. It's peculiar...but at least someone is doing it!

I hope we see more of this -- any isights that can help patients obtain a more detailed diagnostic assessment of their condition.

I wanted to post a quick note to open the ideas around healthy life habits and disc disease. I am fortunate that I have a great success story. However I work for a large disability company as a claim manager and I see hundreds of claims where obesity and other factors are common denominators. More than 70% of our population will experience a period in their life of disabling back pain. I encourge people to think about what they are doing today to take charge of their life and choose things that are preventive..a simple walk, stretching etc.. I know injuries happen, disease can occur, but try to be positive, this mind set can make a difference. I suffered for 5+ years with disabling pain. I continued to walk/run when I could. I adapted to riding a bike when I could no longer do the things I loved until my insurance company approved my surgery. I am 1+ years out and am running on a regular basis. Hang in there it can happen to you!

Since the FDA has not approved multiple artifical disc replacement, how do you get the insurance to pay. I want my life back. DeDe

1. Survey results - 6 levels: four cervical and two thoracic. As of this time two cervical ADR. Two cervical untreated. Two throracic untreated.
2. Etiology and origin: Trauma by fall from overhead stand with 200 lb hog carcass in 1987. Bruised all over going down thru augers, supports. Regained consciousness with scalding water splashed out of santizer above that was splashing off hardhat onto chest. Flat on back with carcass across my knees. Shoulders on floor, back of head vertical against neighboring overhead inspection stand (the one with the sanitizer splashing scalding water out on me). Chin pushed into chest. Hard hat still on but back of head badly bruised. Don't know why I lived. Don't know how I got up and walked away to get myself cleaned up and returned to work. By that evening terrible pain and aches all over the body. Emergency room told me it was trauma bruising. No broken bones. Chest Xrays showed T6 and T11 disc spaces narrowed. Slow progression of symptoms over 20 years. First addition to body aches and pains (thought to be chronic pain) was carpal tunnel, then tennis elbow, tendonitis in most parts of upper extremities, radial neuropathy.........couldn't button my shirt or get my socks on or zip my pants some days at last. Lost a 23 year professional career to disability.
3. Diagnosis: Misdiagnosed as Chronic pain, then inappropriate surgeries. Finally convinced local GP to take cervical spine MRI. Mayo Clinic not able to repair 4 narrowed and protruding cervical discs. Two spine centers turned me away from ADR trials because too many levels damaged.
4. Pathogenesis: Not neurological pain. Not psychological pain. It was immunological pain from undiagnosed disc herniation. Nucleus pulposa out about cervical spinal cord started cytokine cascade. Whole body aches and pain in addition to the area specific deficiencies due to loss of disc height. Can furnish peer-reviewed references to better explain thinking.
5. Treatment: Dx by Dr. Delamarter, Santa Monica, CA thru discography. C5-C6, C6-C7 Prodisc surgeries by Dr. Bertagnoli, Straubing, Germany Dec 2006. Got my arms and hands back immediately even though weak. Body aches left within about 1 month. Remainder of discs bothersome at times but I have my life back with the usual aches and pains of overdoing things! A very special Thank-you to those great ones that got my problems figured out!

I was one to reply re 3 level problem and I've not had further surgery from previous 2 discectomies (L4, L5S1) however have an annular tear at L3 that while has not been concordant for pain re 2 discograms~ personally I worry about further surgery (ADR L4, fusion at L5S1) and the health of the L3 disc.

So even with 6 surgical recommedations basically offering some recommendation~ I have done nothing but PM and have had only several really painful flareups in last year.

Am experiencing one currently. Downtime to date is going on 3 days in bed. This is unusual for me given the progress of the past year on just pain meds/exercise and activity.

Still the same stats...it is a sad survey result in terms of how many people have multi-level DDD that require some kind of intervention(s).

http://adrsupport.org/groupee_common...icon_frown.gif

In the UK, i feel like we dont get offered much information from our medical people. I just know that my lumbar is well shot at. Now my neck is falling apart to.
I have had fusion in my lumbar, then 4 years after all of my previous crippling pain is back since 2004. My neck has been also crippling me taking away the use of my hands and pain ripping my arms and hands constanlty. I have had 2 adrs put in last july 2007, but i still cannot feel any benefit from it. Now for some strange reason my left knee is crippling me. I just want my life back, i want to have just one day without pain.
Good luck with this study Harrison.
Its a great idea
hugs
Sandie

When I voted I had a 4 level problem. Now I have a 5 level problem. I also have a left knee crippling me. My right knee looks worse on x-rays but my left one hurts worse. Good luck with the study.
Linda

Quick update from 96 patients: 52% polled have three or more problematic levels in their spine.

http://adrsupport.org/groupee_common...icon_frown.gif

Just figured I'd chime in on my vote. I put 3, because really, they are the current ones causing my symptoms...at least, I think its only them http://adrsupport.org/groupee_common...icon_smile.gif. Perhaps I am just overly pessimistic about my condition, but I think its likely before all is said and done I will be able to claim 7; All lumbar disks, plus T11-T12, and T12-L1. Time will tell though.

54% of the patients surveyed have 3 or more problematic levels...

http://adrsupport.org/groupee_common...icon_frown.gif

That would be very interesting, I would love the results of that survey

Hi everyone,

I almost forgot about this important poll, as it did not stay "sticky" during the migration. Please vote if you have not yet done so. Here's the original post:

As so many people appear to have multilevel disc disease, I thought it would be interesting to start a short survey which tracks this sad issue. Please respond to the question below, and feel free to comment as well.

When you read the question, please think about your past and present condition. E.g., if you had 3 levels replaced, and all your other spine segments are "good," then choose "Three Levels."

Thanks!

Harrison:

I am confused if you are asking us to restate our original position here. If that is the case; I am a 4 level disc recipient.

I am two years out from surgery on November 4th. :D

Terry Newton

1 level; but yet to recieve disc replacement..... believe it or not, I'm waiting on insurance approval! Hehe, me and half of this forum are waiting on that, not holding my breath either.

Thanks you two! No, I was just asking people to vote in the poll if they have not already....

:)

Four levels needing ADR, (two cervical, two lumbar) with a fifth adjacent in the lumbar area that's not bad enough 'yet'.

My view is

Trauma, genetics , Lifestyle (SMOKING) either all one or some Maz

I need one level, C5/6, but will probably need C3/4 and C4/5 some day as well. C3-5 have very mild problems right now though and I don't believe they are causing many, if any, of my symptoms.

Two levels, L4/L5 and L5/S1.

Looking into either two level fusion or ADR at L4/L5 and fusion at L5/S1.
Scared to think about the possibility of further degeneration.

Five levels
 

Hi All.:shout:

Five levels L2 to S1 and c3-c4 so far:flaming:on ADR? fusion? In January

Thanks

Gil

Please vote on this poll
 

All,

Since this topic is relatively old, it's been neglected in terms of its original intent -- to survey spine patients regarding how many levels of their spine are diseased or problematic. If you have not yet answered the one question poll, please do so! Here's the first page for reference.

Thanks!

Been bumped up to five levels with a sixth T level 'in waiting'. Need emergency surgery in the cervical level, C5/6, with a hybrid going in at C4/5 & 5/6. S3/4 has escalated enough to need ADR now too and so will have fusion at S5/S1 and L4/5.

Things are getting better and better ;)

this could be a repeat...
 

I don't recall if I replied to this in the past or not. So I will reply either again, or for the first time. Regardless, I seem to have 2 levels affected, though only one caused concordant pain on a discogram. The other one just hurt, so I'm counting it as the second, since it wasn't normal.

susan/ERvet

Sorry for the confusion
 

I was asking people to vote in the poll, here's the first page if you can't see the poll question...please don't reply to this topic...

5 levels Jill

2 levels. Fusion at L1/2 & ADR at L4/5.

PLease don't reply to this topic; but DO vote in the first page poll!

:o