I originally met with Dr. Etminan back in March for a disc herniation at c6-c7 causing weakness numbness and tingling in my right arm. I had a posterior approach foraminotomy which was successful in ridding me of my rt arm symptoms but not the back pain. I have since asked Dr. Etminan why he did not suggest ADR at the time, he stated because ADR is only good for healthy discs with an acute rupture (what he calls a soft disc) not discs that have degenerated - it seems he needs to read up on his literature because that opinion is his alone. None of the ADR surgeons, nor the clinical trails done, nor the medical literature agree with his opinion. In fact the overall majority of ADR's performed are performed on those with DDD.
I have now met with several surgeons Dr. Zigler @ TBI, Dr. Bitan, Dr. Lauryssen, and Dr. Regan - They all had some what different points of view but none said that my posterior foraminotomy is a contarindication for ADR and all stated I am a very good candidate for ADR.
As for my impressions of the surgeons (take with a grain of salt - only met once and only one man's opinion - I am in the medical field which possibly means something).
I was most impressed with Dr. Regan - anyone else have experience with him?
Dr. Bitan suggested a fusion at C6-C7 not because I'm not a candidate for ADR but rather because he rarely places ADR in C6-C7 due to technical difficulty. He said he only places ADR in C6-C7 when someone has a very long neck for greater accessibility - none of the other surgeons seem to find any problem with placing ADR's at that level - nor does the medical literature seem to have a problem. He also stated that C6-C7 disc has little to do with Neck ROM and therefore fusion is almost the same as my current state.
Dr. Zigler is a very nice man - He suggested I do a discogram first in order to determine if surgery will be affective and if fusion may be a better option - none of the other surgeons suggested this or think that was needed.
Dr. Lauryssen seems to be a very capable surgeon - although seem to be very eager to operate. He also stated he would like to retain the PLL (posterior longitudinal ligament) and if not recommended possible fusion at C5-C6 - Does anyone have any opinion on retaining vs cutting the PLL? It seems most surgeons remove the PLL, otherwise very difficult to smooth out the vertebral bodies for proper placement of ADR and also retained osteophyte may lead to greater inflammation.
Another very important question I had for the surgeons was what is the risk of doing nothing - How will that effect my chances to have an ADR at a later date? and if by not having the ADR how is that effecting my other healthy discs. In short all said somewhat different things - the consensus seems to be If I do wait to long placing an ADR may be difficult. As for causing DDD in other discs - some surgeons felt my adjacent discs were already starting to show very early signs of disease others felt they looked healthy and the current DDD is not effecting the healthy discs.
I have not explored the European option yet, I will, mainly because of the M6 disc, Dr Lauryssen is a big fan - and also read some of the other favorable posts on M6. Does anyone have negative opinions on Prodisc? I understand M6 probably has the best biomechanics of all the discs however from my understanding how this translates clinically is still undetermined?
In addition it seems my insurance will cover one disk replacement which will reduce a large portion of the cost
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