[annapurna]

Bertagnoli may use a ligament sparing technique but you still need to remove some of them to access the spinal disks. Depending on the approach used for your fusion, that may be moot because the ligament damage from that surgery may be more than what Bertagnoli might do.

Bertagnoli's one of the best for multi-level and cases on the edge of being acceptable. He's expensive but often the surgeon of last resort for that kind of case. As to whether his patients do better - maybe. I'd say over the years, he's had a few real failures and a number of patients who didn't improve as much as they'd wished but he's also taken patients that would have been fused from skull to ribs and rebuilt their spines with a hybrid set of ADRs and fusions and given them their lives back. He's definitely one to talk with to see what you could do but there's the risk of not being able to create an stable ADR from a fusion.

Laura's much better off now than when she had the bulging disks. On the other hand, the instability has led to vagus nerve irritation and an inability to engage any activity with the hand above the shoulder. Long-distance swimming, for instance, is now off the program after being able to swim 5 miles a day.

I don't know of a ADR & facet replacement for the c-spine, though our data is about 15 years old on that front. I do know of two people using stem cells with guided prolo injections to try to regenerate disks. Facet injections are even more fiddly than that but they might, if you discuss it with them, flood the region and hope some passes through into the facet capsules.

One thing I liked about Hauser at Caring Medical was that he was focused on the effect of instability on the jugular veins. They pass through the neck in a sheath that also holds the vagus nerve. Instead of arguing too much over instability, he had doppler ultrasound check to see how open the jugular veins were under different conditions. More instability means more conditions where one or both can close. Being an engineer, I tend to like numbers and measurements. You can still argue that it's untested theory but it's at least an internally consistent untested theory.

How painful and frequent are your cervical symptoms right now? If you wore a cervical support collar for a week or two to help with the instability you may or may not have, do you think your symptoms right now are intense and frequent enough to tell if it's helping? I'm not suggesting this as a long-term solution but a cheap diagnostic to see if your feelings about instability at C6.7 and C2 are accurate. If they are, you could approach Bertagnoli, and whatever evaluation fee he charges, with some confidence that it's a worthwhile path to take.