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  #1  
Old 11-07-2012, 04:29 PM
Marita Marita is offline
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Default Adr vs fusion

Hi,

I'm new to this group and in need of feedback, and maybe even a little moral support. I had a sports-related injury in June that exacerbated three cervical discs that were already bulging, but asymptomatic at the time. Now, I have radiculopathy in both arms and weakness and other myelopathic symptoms in the legs. My CT scan report also says I have some osteophytes and end plate spurring. (Same thing?) i am told I have stenosis, but it's not always clear if it is congenital or just from the bulging discs...depends on which doc I talk to.

I have done a lot of research, had x-rays, CT scan and MRI, and have seen two orthos and three neurosurgeons. The best recommendation, from two of the neuros, seems to be a Pro Disc at c5-6. My other option is a three level fusion.

My questions are the following:
- Does anyone know of a surgeon in New Mexico who is well practiced in adr? (My insurance won't cover outside of their NM network.)
- if there isn't a surgeon with significant experience available, would you have someone with less experience do the adr operation, or...
- Choose a three level fusion, instead?

It seems so much depends on the capability and practice of the surgeon. So, very soon it seems I will have to decide if I go with a less "practiced" adr surgeon, or a highly competent fusion surgeon. (Sigh.)

Thank you for any advice that comes to mind.

Marita
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Herniated discs C3-4 - C6-7
Mild - moderate spinal cord compression at three levels
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  #2  
Old 11-07-2012, 11:01 PM
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Harrison Harrison is offline
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Marita,

I would not go to a less-practiced surgeon, especially if you might get a cervical fusion. In fact, if you only need a one or two-level "correction," a cervical fusion state-side may serve you well. I have a few friends here in Mass. that had cervical fusion years ago (15 or 20) and both are doing well. That said, many patients here abhor the notion of fusion, since adjacent level degeneration is a possibility down the road.

But we STILL can't say what causes DDD since docs aren't diagnosing the causes -- which I believe have a definitive etiology stemming from infection.

Check out TBI and the others in the US. Dunno about NM, but you can search members by state - I'll help you do that this weekend if you need help with that...
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  #3  
Old 11-08-2012, 10:01 AM
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jss jss is offline
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Marita,

Welcome and condolences on needing to be here.

I will ditto Harrison in cautioning against using an ADR surgeon that doesn't have a proven and stellar history in ADR. I would encourage you to research your surgeon and be very certain of his outcome history with the ProDisc before letting him put one in. A bad ADR surgery very often leads to a tragically bad outcome.

Too bad your insurance won't cover you next door in Texas. The most successful ProDisc surgeon I'm aware of is Jack Zigler at Texas Back in Plano, TX. If I were getting a ProDisc, he's the only one I'd let put it in.

I'm not a fan of choosing fusion over ADR, but as you are looking at a multilevel procedure, they tend to cause adjacent segment disease significantly less than seen after a single level fusion.

Good luck, Jeff
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  #4  
Old 11-08-2012, 11:31 AM
Marita Marita is offline
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Thank you so much Harrison and Jeff for the feedback and support. Thank you for confirming what I suspected about surgeon experience. I'll have to do some more digging to see if anyone in my neck of the woods is experienced enough. (I thought I had the right surgeon lined up but for some reason I have not been able to get back on his schedule since our first consult!???)

I think I am not using the right nomenclature regarding the fusion. I have been told I will need three discectomies, and therefore c4 - c7 will be fused. Do you know what outcomes are for that many levels? Meanwhile, C3-4 is also extruded and there is lateral and foraminal stenosis. I am afraid that eventually my whole neck is going to be fused. (Sigh.)

Jeff, your experience sounds similar...how is your neck now with the combined fusions and adr?

Thank you, again.

Marita
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Herniated discs C3-4 - C6-7
Mild - moderate spinal cord compression at three levels
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  #5  
Old 11-08-2012, 11:52 AM
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jss jss is offline
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Marita,

The more levels that have to be addressed, the more difficult the recovery and the more likely there will be complications. I don't specifically know any more than that regarding three level fusions.

I don't recall hearing of a single ADR surgeon in New Mexico; so I don't know of anyone to point you to.

I didn't notice any loss of mobility after my first fusion, but I did notice it after the second; things like looking up at something my wife was pointing at, or trying to back a car, all required new techniques. The double fusion wasn't a problem until eight years later when I was told I needed three more! Which is when I had the double ADR. Less the loss of mobility from two fusions, I'm doing great, can do anything I want, have no pain and no limitations. I do have residual numbness in my left hand that is probably permanent; most likely from waiting too long to have the issue addressed when it reared its head again in 2008.

Good luck, Jeff
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C4/5 - ACDF in 2000
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Conceded defeat to a manifestly disingenuous BCBS-TX in my quest for reimbursement, Jan 2011
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  #6  
Old 11-14-2012, 11:09 AM
Marita Marita is offline
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Hi Harrison,
I did a search using New Mexico, but not sure that brought up members in NM...I probably could use your help, when you can. Thx!

Marita
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Herniated discs C3-4 - C6-7
Mild - moderate spinal cord compression at three levels
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  #7  
Old 11-15-2012, 07:26 AM
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laid up doc laid up doc is offline
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several states have a major paucity of neurosurgeons due to malpractice issues... I know that NV has such a problem (and has therefore had problems maintaining their trauma designation), not 100% sure about NM.

also, if the major payors in an area won't cover certain procedures, you won't find surgeons doing them.

good luck in your search.
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  #8  
Old 11-25-2012, 05:10 PM
Marita Marita is offline
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Default Sent images to Dr. zigler

I am hoping to hear back from Dr. Zigler and TBI this coming week. I believe the biggest hurdle will be whether or not my insutance (hmo plan ) and TBI can work together. I'm not very hopeful, and the myelopathy is getting worse, so will have to take action soon.

Thanks again for all of the input!
Marita
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Herniated discs C3-4 - C6-7
Mild - moderate spinal cord compression at three levels
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  #9  
Old 11-25-2012, 08:17 PM
JeffR JeffR is offline
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Just to second what JSS said, Zigler at TBI institute is a pretty good IMHO and he has a good rapport with his patients - unlike some of the divas out there.
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Lifelong history of back issues from a young age, spasms etc.
1995 - Weightlifting injury
1997 - Hip Injury
2009 - Trampoline injury (just bounced down on my butt)
2009-2011 Physiotherapy and medication, progress but no lasting pain relief
2010 - X-Ray DDD L5-S1, L4-L5, L4-L3
2010 - MRI Herniation L5-S1, Bulges L4-L5, L4-L3
2011 - Epidurals - No relief
2012 - Facet Injections - No relief
2012 - Discogram TBI - positive L3-S1

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  #10  
Old 11-26-2012, 12:23 PM
Marita Marita is offline
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Thank you all for the votes of cnfidence for Dr. Zigler. I have learned that not all surgeons are very good with their patients, the hard way. I was supposed to have surgery two weeks ago, then my doc cancelled me. I have lost three months, back to starting point, and myelopathy is getting worse. The patient coordinators at TBI have been super supportive thus far.
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Mild - moderate spinal cord compression at three levels
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