[locorebob]

I've had a pancaked cord at C5/6 now for nearly 9 perhaps 10 years or more and now there is evidence ( Jan 2017 MRI ) of non-symptomatic myleomalacia. Numbness and pain down both arms and posterior neck pain. My intuition says get ADR, however two local surgeons - both qualified for Mobi-C implants - are reluctant and still recommend fusion. Why is that?
I can't imagine how fusion would be superior to ADR... perhaps it's the facets or foraminal Stenosis... or perhaps the aggressive osteophyte growth/activity and so maybe the implants will auto fuse.. Or will ADR implants cause facet preloading and result in issues later. I am waiting for Appt with one of the pro-fusion surgeons so he can explain why ADR is not ideal in my case. Meanwhile, I've heard from another surgeon in Texas who is pro-ADR and said yes by all means he would implant ADR..
And so, I need to decide what to do and then I need to do it..
I'm cautious and constantly thinking of the adage..."be careful what ask for"...
I need and want a discectomy at C5/6, however it's the instrumentation choice that I'm struggling with...

Thanks, Bob

Here is most recent MRI report.
.
DATE OF EXAM: 01/09/2017
EXAMINATION: MR C-Spine without contrast
CLINICAL INDICATION: Neck and right arm pain.
TECHNIQUE: Inversion-recovery, T1-, and T2-weighted images of the cervical spine were obtained in multiple
imaging planes without intravenous contrast.
COMPARISON: MRI cervical spine, 03/28/2011, Center for Neurosciences.
FINDINGS:
ANATOMY/ALIGNMENT: Slight reversal of the usual lordotic curvature of the cervical spine. Mild posterior
subluxation of C5 on C6, unchanged.
VERTEBRAE: Disc space narrowing and small anterior osteophytes at C5-6 and C6-7. Unremarkable marrow
signal. No evidence of recent or remote fracture.
SPINAL CORD: No change in small focus of hyperintense signal on the inversion-recovery and T2-weighted
images within the cord at C5-6, consistent with myelomalacia.
CRANIOCERVICAL JUNCTION/C1-2: Unremarkable.
C2-3: No cord deformity or foraminal stenosis.
C3-4: Disc/osteophyte complex, producing minimal cord deformity without cord compression. Mild to moderate
left foraminal narrowing.
C4-5: Disc/osteophyte complex, producing minimal cord deformity without cord compression. Moderate left
foraminal narrowing.
C5-6: Disc/osteophyte complex eccentric to the left and mild retrolisthesis, producing moderate to severe cord
compression. Mild facet joint degenerative changes bilaterally, with severe bilateral foraminal narrowing.
C6-7: Disc/osteophyte complex, producing minimal cord deformity without cord compression. Mild facet joint
degenerative changes bilaterally, with foraminal narrowing moderate to severe on the right and moderate on the
left.
C7-T1: Mild posterior osteophytic ridging, without cord deformity or foraminal stenosis. Mild facet joint
degenerative changes bilaterally.
OTHER: No significant findings.
IMPRESSION:
Degenerative changes in the mid and lower cervical spine, greatest at C5-6. There is moderate to severe cord
compression and a small focus of myelomalacia within the cord at C5-6, with multilevel foraminal narrowing
which is severe bilaterally at C5-6. There has been no significant change since 03/28/2011.
Electronically signed by
Bxxx X. Xxxxx M.D., Neuroradiologist