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Old 04-12-2022, 09:37 AM
annapurna annapurna is offline
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Join Date: Dec 2004
Posts: 1,651

Unfortunately, I don't has as much to offer about your questions. Some truisms to offer and then a speculative conclusion: (1) The cervical spine is less prone to adjacent segment problems than the lumber spine. (2) Even in the lumbar spine, it's not uncommon to go many years before seeing disks adjacent to a fusion begin to show problems. (3) It's really difficult to spot the early stages of disk impingement on the cord through imaging as the focus is on MRI & CT, where the patient is supine and the spine unloaded during imaging.

What I'm wondering is whether at least one, possibly, more disks in your c-spine was more damaged than everyone thought. The main pain generator was removed and the segments fused but the surrounding weakened disks were susceptible to any kind of overuse/overloading problems caused by the fusion because they were weakened to start. The reason why I think this is important is that you might revise to a ADR only to find that those weakened adjacent disks aren't up to the task of an ADR recovery.

Have you had the chance to get more recent MRIs? You might want to check the hydration state of the adjacent disks (white=good, grey=okay, dark or black=beginning to desiccate). That's an easier check for a layperson. Interpreting where nerve impingement is happening is harder. You might need a loaded MRI, where you're standing, or try to get by with flexion/extension x-rays of the c-spine and look for deflections of the smooth curve of the spine (other than the fused area). I've never seen the latter approach with a fused spine but it has the advantage of being simple (two flat film x-rays and some time with x-ray image analysis software).

To add: you might need a hybrid, current fusion and ADRs at adjacent levels, instead of a revision of your existing fusion to ADR. It's worth making sure of the adjacent disk condition before jumping to the revision surgery.
Laura - L5S1 Charitee
C5/6 and 6/7 Prodisc C
Facet problems L4-S1
General joint hypermobility

Jim - minor C5-6 instability and facet damage, currently using regenerative medicine to address

"There are many Annapurnas in the lives of men" Maurice Herzog

Last edited by annapurna; 04-12-2022 at 04:37 PM. Reason: typo and closing point
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