[Zymergist]

Well, things are moving along towards surgery. I saw Dr Uchiama and have also gottena second opinion from DR James Bruffey. James Bruffey - Scripps Health - San Diego I had some aditional imaging done to check visualization of the C6-7 area and due to my build it does not look good. Neither Dr would be comfortable with placing an ADR due to the visualization problems. My age, the unknown wear factor, and small disc space which would cause distraction problems along with the almost gauranteed insurance denial due to preexisting adjacent fusion finished sealing the deal on that one. So I am down to my least desirable option, fusion.

LSI was quite flip about my diagnosis and said a laminectomy and foraminotomy were the way to go and not get a fusion even though my images show all the compression is at the front of the spine. They got fired quickly.

I got in to see Dr Bruffey very quickly due to the professional relationship of a family friend who was trained as a PA to assist in spine surgery and graft harvesting, and is now a medical device rep. Dr Bruffey is actualy recommending that both C6-7 and C7-T1 be fused as C7-T1 looks almost as bad on the MRI as the disc above. He feels that only doing one level the probability of having to go back in within a year is better than 80%, and that repeated surgery would lead to a lower probability of success and increase the posibility of complications. He is using the Globus Coalition implants (hybrid PEEK spacer with attached plate) and very strongly recommends using hip graft bone to pack the implant. What he says makes sense, and is being backed up by review of the information by friends in related medical fields.

Dr Uchiama was talking about using a plate or cage procedure, though I would probably need a custom cage due to dimensions in my neck. He also wants to do a hip graft with the cage but would be comfortable with a cadaver graft with the plate. I have gotten feedback from other sources that a cage without a plate is a bad idea and not stable enough to heal well and quickly.

Both Drs come with top recommendations from other trusted Drs, so now I need to choose neuro vs ortho.

Either way I will be going into the new year with a fresh scar.