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The Big File All issues not easily categorized in the above forums are here. Comments on general health, diet, "getting comfortable," and more are here.


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  #1  
Old 10-18-2008, 11:28 PM
Do I Need This Do I Need This is offline
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Default Do I really need surgery?

Hi, I'm new here and have read a lot of your posts. And, I feel that if anyone can help me, it is all of you.

In a nutshell, I have constant neck pain when turning or tilting my head in any direction. I have gone through Chiropractic, PT, Pain Management, and am currently doing acupuncture. All have given only temporary relief. Once every couple of months I have flare ups where my normal pain of a 4 goes to about an 8 and the pain extends down between my shoulder blades and into my left shoulder, but not down my arm. Reading Spine-Health.com my symptoms seem to be more consistent with Osteoarthritis than due to a bulging disc pressing on a nerve. Could it be a combination of both?

So anyway, I had an MRI and a Discogram with Cat Scan done. And, I have a bulging C5-6 disc. I don't have a healthy curve in my neck, like I should, and have been told there is evidence of Osteoarthritis. I've been to 2 surgeons in the Milwaukee, WI area who have both recommended surgery (I'm going to a third next week). Both, have said fusion mainly because ADR is hard to get covered by United Healthcare (as you all know). From reading this forum, it sound like most of you would recommend ADR over fusion surgery for a single level cervical operation. Most of the time I can function fine (except when it flares up), of course sharp pain everytime I move my head is annoying.

Given all this, I have some questions:
1) For those who have had surgery, what type of outcome can I expect from surgery?
2) Will the pain ever completely go away?
3) What is the failure rate of surgery? Both not getting better and catastrophic results?
3) Is surgery right for me? If so, ADR or fusion?
4) Do I have any chance of getting UHC to cover an ADR?
5) Which ADR is best? Prodisc-C? Prestige? Another one?
6) Is there a surgeon in Wisconsin who you can recommend?
7) Since my pain doesn’t travel down my arm, is that a sign I don’t need surgery, or can I expect it to worsen and travel down my arm over time?

Thanks in advance for reading this and taking the time to respond. As you can appreciate this is a big decision for me, and I don’t want to make the wrong one.
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  #2  
Old 10-20-2008, 02:15 AM
builder5840 builder5840 is offline
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Posts: 67
Default Re:Surgery?

Hello,

I'm still new here and like you trying to figure it all out. As for whether or not Surgery? only you can make that final choice. For me the decision to have surgery came only after I had exhausted all other forms of relief and posible help. The pain became so intense that I could think of nothing else and decided that I had to do the surgery. I'll be having it done the first part of next year. I'm not sure about your insurance but many are coming around to doing a single level surgery, with FDA approved devices but you'll have to research this with your insurance which can take a while and much persiverance becuase they are not always upfront about what they will cover.
I would be doing a lot of research on ADR and Osteoarthritis, my Neurosurgeon went to Europe to have an ADR put in his neck several years ago becuase he was having neck pain with arthritis in his neck also (i'm not sure which type of arthritis) but he told me that the ADR worked great for the first 4-5 years but is now giving him trouble he believes that the arthritis has cuaght up to him. Somthing to think about and somthing to research whether ADR or Fusion? which is better with arthritis? Most of my pain is in my neck with no sign of arthritis so I've opted for a two level ADR but i'm going over seas to get it. Good luck with which ever way you decide

Fall off Ladder 05
Disc C5,6,7 buldging DDD lots of pain
planning surgery march 09 two level Discover disc
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  #3  
Old 10-20-2008, 09:18 AM
Grumpy Grumpy is offline
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I've had 3 neck surgeries so can speak from experience. Right now I don't think you are quite ready but that is a good thing cause now is the time to shop around for a good neck doctor. I would check out CHICAGO and do all your homework. If I was to do it over again, I would get a ADR.... and since you are a 1 level makes you a better canidate.

Your neck is telling you that you have a problem and believe me- CAN GET WORSE AT ANY TIME...usually on a Friday or Saturday night. My second herniated disc blew just by sitting in a recliner watching a movie (on a Saturday night). The pain was terrible, and I thought I was having a heart attack but since it went down my left arm, I was pretty sure it was the disc they were debating on whether to fix or not. MRI on Monday confirmed this and I had the 2 level fusion 4 days later.

If you don't have a soft collar-get one now. It will give you some relief.
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3 level ACDF done separately (one level failed) & 1 Posterior, repair w/rods, 3 level lumbar herniations, DDD T10 Down- 2 shoulder repairs
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  #4  
Old 10-20-2008, 11:56 AM
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Terry Terry is offline
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I have had two neck surgeries in the past. Hemi-laminectomy in 1995 for two levels because of bone spurs. Then I had 4 level ADR with two cervical discs in November 2006. I have range of motion now that I have not had in years and no regrets.

When the quality of life starts suffering you will know when it is time.

Terry Newton
__________________
1980 ruptured L4-L5
1988 ruptured SI-L5
1990 ruptured C5-C6
1994 ruptured C6-C7
1995 Hemi-Laminectomy C5-C6, C6-C7 Mayo Clinic
Bicycle Accident 2004
MRI, EMG, Facet Injections, Epidural Blocks, Lumbar Discogram.
Stenum Hospital Surgery November 4, 2006
Prestige Disc C5-C6, C6-C7
Maverick Disc S1-L5, L4-L5
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  #5  
Old 10-20-2008, 10:00 PM
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tazdell tazdell is offline
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Posts: 42
Thumbs up my two cents!

Hi there,

I am sorry to hear of your pain. I can't speak of neck pain but I did just have a double fusion for back pain. All that I can advise is this...

There are no garuntees that you will be pain free after surgery. You can have some pain forever just from the scar tissue that will set in. You have to trade pain that interferes with your life for pain that is mild and liveable. You may be lucky and have no pain but I think those that expect perfection will always be dissatisfied with any outcome. For me, my pain is gone and I feel amazing.

As far as fusion or ADR...I have been told by my doctor that if you have an unstable spine then ADR may not work. As long as your spine is strong, straight and you are only having disc and nerve problems then ADR is appropriate. My spine was crooked and unstable so I had to opt for fusion. I have read that cervical ADR is more successful then lumbar ADR, so that is good news for you!

I say wait for surgery until you absolutely can't live your everyday life. You will know whene enough is enough and if you don't know that now then maybe it's not time. Only you can tell!

Best of luck....hope some of that helped!

tazdell
__________________
2 disc lamenectomy at 17 years old.
chronic pain since...
Disc herniations a few years later...
tons of conservative treatment...
DDD...
Epidurals, felt better, playing tennis again...
car accident 2008 that tore a disc and collapsed spine...
Denied ADR twice by blue cross....
Double fusion L3-4 and L4-5 Sept. 29 2008.
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  #6  
Old 10-21-2008, 12:44 AM
hezeronek hezeronek is offline
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Join Date: Oct 2008
Posts: 44
Red face When you're completely fed up... and have tried everything else

I have struggled with the decision of whether or not to have surgery many times. I have not yet had it, but I do feel the time is right for me. I still have some good days mixed in with the bad, that make me think twice about getting sliced... but my general trend has been towards the more painful days of late.

I am in pain anyhow, so any relief surgery may have for me would be most welcome. There just comes a time when you say "enough's enough." That's when you know you're getting ready to take the plunge... you're ready to accept the risks for the chance of the potential benefits. Be realistic about your expectations though. The unfortunate reality for many of us is the fact that we will likely be in some amount of pain for the rest of our lives. It just comes down to what you can and can't live well with.

There's no rush, of course, so take your time in making your decision. Surgery will almost always be available later, but once you have it there's no turning back. Good luck making your decision! I truly wish you the best!
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  #7  
Old 10-21-2008, 02:56 AM
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Eddie_G Eddie_G is offline
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Join Date: Apr 2005
Posts: 238
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I don't think it's as much what's the "best artificial disc" as it is who are the best doctors and best hospitals for your procedure. You should really read alot deeper here and research which doctor/disc combo would be good for you. I have had problems for 5 years. I have a Prodisc at L4-L5 but I am having another discogram done in a week to determine if the L5-S1 is giving me pain. The surgery for the ADR was horrible. Don't do it unless you are at the end of your rope. I couldnt move in the hospital bed for 3 days. It wasnt the complete answer for me. My Prodisc is implanted perfectly so I cant imagine the problems I would have had if an inexperienced surgeon had screwed me up on top of the problems I already have. Like bad placement, poor procedure, inferior handling of the implant etc... I fought for a more experienced surgeon with Workers Comp and made them send me to NY where they have more experience. Although my L4-L5 disc was degenerated and needed replacing, it wasnt the only issue so they may do a fusion or hopefully a non invasive to fix L5-S1.
This site has been helpful. Try attending a symposium too. I got to meet the top doctors in the world for this procedure at a symposium in NYC setup by my patient advocate.
Attending were: Dr. Bertagnoli, Dr. Zeegers, Dr. Regan, Dr. Bitan, Dr. Hochchuler Dr. Buettner-Janz, Dr. Yeung, Dr. Yue etc.... Each doctor has their own favorite disc they use. For example, Dr. Bitan uses only Charite. I didn't want a Charite even though Dr. Bitan was the most experienced Charite implanter, but Dr. Goldstein was the most experienced Prodisc implanter. I went with Dr. G even though he has less overall experience with Artificial discs. It so happens not many people in America are as experienced as Dr. Bitan since he has been doing ADR in Europe since the 80's.
My patient advocate also has my films online so all my doctors can see them. I find that helpful as well. Keep up with the clinical trials too...

Good LUCK!!!!
__________________
12/16/03 Work Accident
Herniation and DDD at L4-L5
4/1/05 Discectomy
Epidurals and facet injections
5/15/06 Discogram confirmed L4-L5 DDD also an asymptomatic L5-S1 tear
10/24/06 L4-L5 Prodisc surgery with Dr. Goldstein
CAT scans & X-Rays show ossification
Trigger Point Injections, Medial Branch Blocks, Acupuncture, Weekly Deep Tissue Massage
10/27/08 Discogram (positive L5-S1 tear)
11/25/08 L5-S1 fusion with Dr. Goldstein
FAILED BACK SYNDROME
Liberty Mutual WC
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  #8  
Old 10-21-2008, 06:04 AM
Alastair Alastair is offline
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Posts: 2,391
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What you need to do, is to get MRI x-ray done and see if it really is a disc problem or if it's osteoarthritis. Get the facts and evidence in front of you, and then think about making a decision.

If this flares up only every three or four months than I would say that you are in no way ready to surgery, and the medication helps at the same time, then wait.

Do remember that the surgery is non-reversible and not every surgery is a success. Also you need to be with the best surgeons available to you in your area.
Best,
Alastair
__________________
ADR Munich 26th July 2002 L5/S1. Aged 82 now
Your best asset is your health
My story is here
http://www.adrsupport.org/alastair.html
Thank goodness for Dr Zeegers I am painfree
I am here to help,I live in the UK


I now run the UK spine site and can be contacted at

www.adrsupportuk.com/
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