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Old 09-08-2010, 05:21 PM
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10skiclimd 10skiclimd is offline
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Join Date: Sep 2010
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Cool Large C5-6 herniation with compression of cord

My symptoms started July 31, 2010. No pain whatsoever. Just weakness in my legs, trouble with running and a strange hot feeling all over. I finally saw a neurologist on August 31 who put two and two together and ordered the MRI that made the diagnosis.

My particular case is not complex. I have a single c5-6 central herniation that is causing some myelopathy but no radiculopathy. A radiologist that I trust says I have no significant disease (spondylosis, facet degeneration, disc degeneration) at any other level, so I suspect what I have came from an acute skiing injury this spring.

I have talked to a neurosurgeon and an orthopedic spine surgeon at my home hospital (Kaiser in northern California). Both agree that I need to have the disc removed and the cord decompressed ASAP. That's a no-brainer. I'm actually scheduled for anterior cervical discectomy and fusion (ACDF) on Sept 15.

What I am wondering about is whether or not I should instead be considering ADR rather than ACDF. The orthopod said that I am not the classic candidate for the FDA approved procedure because I do not have radiculopathy or neck pain. It sounded like he has done a few ADR's but not many. The neurosurgeon did not recommend ADR at all, saying results have not been favorable.

My own research of the medical literature seems to suggest that there are a lot of biased studies being done, but that the jury is still out on long-term viability of this technology. Short-term outcomes seem to suggest that ADR and ACDF are equivalent (no statistically significant difference) in reducing pain and neurologic disability.

So, at this point, I am asking for the input of this group. Here are my pointed questions:

1) Can you point me to a spine surgeon on the west coast that you know has extensive experience (personally done 50 or more cases) with ADR that I can talk to? I am limiting myself to the west coast because my time window to get the procedure done is very short. One study I read said best outcomes were achieved when people with cervical myelopathy due to soft disc herniation were decompressed less than 2 months after onset of symptoms. I am already 5 weeks out.

2) Do any of you have experience with Dr. Lali Sekhon from Nevada Neurosurgery in Reno? I have a visit with him tomorrow.

3) Have any of the you undergone ACDF or ADR for a myelopathy without pain? How has your outcome been so far? Subsequent disease at other levels? Complications with surgery? Did you get the result you expected?
__________________
7/31/2010 Began developing torso and proximal leg weakness. No back or neck pain.

8/31/2010 Diagnosed with C5-6 large central disc herniation with myelopathic symptoms.

9/14/2010 C5/6 anterior cervical discectomy and Prestige disc placement.
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