new, considering adr. UHC insurance. C3/4 central spinal stenosis.

[kiddsteven]

hello. I'm Steven. I'm only 21. Back in January, I was doing wrestling stretches in the gym ( i practiced wrestling in high school) when i heard a little pop in my neck. It didn't hurt too much or anything, just really stiff and tight. The next morning i woke up and the muscles around my scapula were all abnormally stiff and painful. I thought it would just wear off, but it got worse.

Short Story:
there is definitely stenosis at the c3/4 level. Whether it is cause my symptoms isn't solid. there aren't any other problems with my neck. Due to process of elimination, i've ruled out problems like local peripheral nerve and muscle problems (trigger point injections and over 11 months of physical therapy) and any other possible levels in the neck that could cause symptoms (c4/5 and c6/7 selective epidurals). After an epidural with a catheter threaded all the way to the c3/4 c4/5 level gave me 1 week of relief, i decided maybe an adr would be the best option. (c3/4 selective ep. was too dangerous)



Long story (you don't need to read, this is a bit of a ventilation of my frustration):
My primary doctor, lets call him Dr. Al, referred me to physical therapy and a shoulder specialist named Dr. K. Dr. K got me a cervical MRI showing spinal stenosis @c3/4 DISC level and referred me to an Orthopedist, Dr. M. Dr. M reviewed my symptoms and said my symptoms are actually coming from c5 and/or c7 NERVES (not disc). So Dr. M did selective transforaminal epidurals at those levels and concluded that the symptoms are definitely coming from c5 NERVE based off of my reaction when he injected the medicine despite NOT having any relief. Dr. M just told me to do physical therapy (which i'd been doing for 4 months with no help at this point) for the rest of my life. dead end. Went back to Dr. Al with the MRIs and he suggested to see a neurosurgeon, Dr. Y, right away.

Dr. Y said forsure 100% the symptoms are coming from the c3/4 disc and recommended single level fusion...no. I did think his diagnosis was accurate though.

Went to another neurosurgeon Dr. H, who is sure, but not 100%, that the symptoms are coming from the c3/4 disc. Recommended artificial disc. Sounds promising for me.

My mom was a nurse at stanford hospital and recommended a couple surgeons to see:
Dr. Korea (stanford) was a complicated doctor.
1st visit: there is no way the c3/4 disc is cause problems. He told me there are no problems with me whatsoever. No recommendation. Basically told me to go home. he was 100 percent sure.
2nd visit: he told me was slightly possible that c3/4 could cause problems, but he doesn't want to operate on it. He thinks i have a local nerve problem. Referred me to a neurologist. Seeing the neurologist was like hitting a rock, she wasn't sure about anything. She says its possible that c3/4 could be the problem too. Dead end.

Dr. R(stanford) told me that it is very possible the disc is causing problems, but surgery would be too aggressive especially someone as young as i am. (again, i'm only 21) And referred me to dr. Lev for an selective epidural at c3/4 to diagnose it.
Dr. Lev refused, and did an emg instead. Emg came back with problems with trapezius and serratus anteior muscles (scapular muscles). Talking to him, we concluded that there my be a nerve problem. he said it was slightly possible that the c3/4 herniation could be the problem. Still didn't want to do the epidural. There are no other problems with my neck. Referred me to a shoulder specialist...again. Dead end.

After a ton of research, i was considering an adr. Dr. H seemed to be okay, but i wanted someone forsure with experience.

Dr. Lauryssen told me (via email) to get an epidural to diagnose it and he said i might be candidate for m6 trial.

I got an epidural injection interlaminar c7/t1 approach with catheter threaded to c3/4 and c4/5 by dr. Ray with 3 days of complete relief and 1 week of any relief.
Emailed back to Dr. lauryssen's office to realize hes moving out of state. He never got to look at my epidurals. The office referred me to another m6 site at stanford.

Went back to Stanford to talk to dr. law for the m6 trial. Dr. law saw my xrays, mris, and epidural injections and gave them back. He's talking to dr. R(stanford) for eligibility for the m6 trial. Not sure how long he's gonna take.

While this is happening i went back to dr. H and now i'm waiting for United Healthcare to approve or deny my claim for adr. should take 10-15 business days for them to respond.


I really hate the waiting. The fact that i might not get treated for this is killing me. If dr. law approves my m6 trial i'll cancel the adr appointment i have with dr. H. If not, i'm hoping insurance will approve my adr with dr. H.

[kiddsteven]

the doctors/surgeons names are made up. you can pm me if you really really want to know the doctors names. just doctor lauryssen is a real name becuase i see him as a well known surgeon on this forum.

[NJ Gene]

Steven,

Have you gotten opinions from multiple surgeons? There are procedures much less invasive, like a foraminotomy, where they cut off the part of the disc that is protruding out and pushing against the nerve. The place where they cut heals over 3 months and you basically have most of your natural disc left. I had this procedure done twice. This is just one of many minimally invasive procedures to consider. This is why I suggest the opinions of at least 3 surgeons.

At your age, I would look to do something less drastic than fusion or ADR unless it's absolutely necessary.

Good luck whichever way you decide to go.

Gene

[Harrison]

I agree with Gene. You are too young to have this surgery. Is there any reason to believe that your neck might have been a health risk prior to this? Any pain? or any health problems (whatsoever) not seemingly related to this issue?

E.g., Lyme disease and other microbes (bacteria, viruses, protozoa) that have a proclivity for collagenous tissue (spinal meninges, spinal disc, and especially organs like the thyroid). These "sub-clinical" issues can weaken cartilage and supporting tissue at the early stages, setting up problems for unexpected demands on the spine later. In your case, extreme torsional stresses in wrestling.

See this topic: very detailed multi-paged topic summarizing decades of research detailing how microbes cause disc degeneration:

http://www.adrsupport.org/forums/f44...l-causes-9218/

Are you ready to make big changes in your lifestyle? Going organic? NO processed foods? Cleansing your body in whatever way you think you can?

I hope we can assist you in your journey to wellness!

[kiddsteven]

@gene- hi gene. yes i agree with you, i'm too young to have any of these done. Thats why the doctor recmmended adr. I have looked into mircodisectomy/foraminotomy and has very low success rates central disc bulges. They are mainly for bilateral disc bulges 5mm or more. The doctor that wants to do the adr is known for performing microdisectomy/foraminotomy. I even asked him about it, theres no way it would benefit me. I'm pretty much out of options. I'm really trying to live through it.
Thanks for the advice.

@harrison
hi harrison
Again i agree, and i'm really trying to go to school and live my life without intervention. It's almost been a year since it happened and i've failed my first class since then. I'm an A, occasional b student, but i've never had problems staying in class before the accident. I've been a complete shut in for the whole year waiting for the pain to go away. It's a stinging feeling when i move my neck back. and it goes down to the back of my triceps.
I have slight disc degeneration at c3-c6 with no osteophytes or bulges other than c3/4, according to the mri report. No neck problems prior. My family has high blood pressure, which i caught on. Its not over 140, which is the limit for high blood pressure, but it gets close sometimes. I don't smoke or drink. I was competitively athletic, but i can change that if i have too. I can still cancel it, but i've got no options if i do. thank you for the advice.

[drewrad]

Neck ADR is much less of a hassle and risk than lumbar so good news there, as well as recovery. I know how you feel. I was not a candidate for micro/lami either. In my case at 45. There was no 'there' there, that is nothing to remove, just no discs anymore. I'm glad I went with ADR in my lumbar.

There are very good success rates with ADR depending on the neuro you choose, and yes, I would choose a neuro. You have done well in isolating the genesis of your pain. It sounds as if you have hit upon it well.

[kiddsteven]

Thanks for the input drewrad, i appreciate it. yes i've seen 5 neurosurgeons and they said that its very likely that the c3/4 disc is the problem. Only one said it wasn't. They all agreed that my symptoms aren't really "in the textbooks".

I have a question. How do you guys do spine traction with the discs in your spine? Prodisc-c and Mobi-C patients pretty much have 2 spines now if you think about it. traction would hurt the facet joints for those specific discs wouldn't it? M6-c and bryan disc users have to worry about the disc detaching from the vertebrae. Don't you guys have to watch out for any pulling of the neck or back?

[drewrad]

Conservative care postop is the key, always, followed by a long easing in period. I used to do aggressive traction all the time. Not needed anymore and, you're right, after treatment you don't want to risk a full vertical drop, which BTW aren't good for ligaments anyway, regardless.

Not worth it IMO.

[Jerry5]

ANY ADR will need 3 months to 'heal', the bone needs to grow, and with those that have a Fusion, it may take a YEAR for the bone to heal, completely.

The gone may gap, but the 'filling in' may take quite awhile.

At any rate, not a cervical expert, not lumbar either, but they caution, any loading on a disk for at least a month, and really it should be 3 months.

Hope this can help.