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  #11  
Old 10-08-2015, 08:24 PM
Cheryl0331 Cheryl0331 is offline
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Join Date: Dec 2010
Posts: 870
Default truly

Send you films to several surgeons. Get three or four assessment.

But truly if Dr. Clavel tells you that he would not do an adr in your case I would have fusion. As much as I hate to say that...

Pro-disc, not a huge fan either. The much bone milling. Mobi-C not constrained enough to protect facets; although better than fusion.

I will keep you in my thoughts....
__________________
53 yr old female 5'7" 141 lbs. non-smoker conservative treatments failed
2007 fusion @ C4-6 peek cages, failed due to long term use of cox-2 inhibitor
2008 revised C4-6 donor bone, plate & screws
2009 fusion with Roi-C @ C3-4
2015 MRI & CT mjr ddd @ C6-7, segmental kyphosis at C7-T1, 2-level M6-C prosthesis by Dr. Clavel Barcelona Spain
2019 H.O. formed behind M6-C @ C6-7 left nerve rt & in spinal canal.
2020 Revision C6-7 to a CP-ESP prosthesis by Dr. Schmitz Dusseldorf Germany
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  #12  
Old 10-09-2015, 01:19 AM
TomN TomN is offline
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Join Date: Sep 2015
Posts: 20
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Thank you Cheryl.
I will send my films to more surgeon over there for sure. What will haunt me is how Dr Watkins said fusion is the safest bet for irritability, and that ADR could quite very well leave me in pain as the cord will still hurt when bending at that segment. He even told me that Bertagnoli will suggest and ADR, and sure enough he did. And he said it will NOT affect the irritability of the spine at that segment. Ugh!
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  #13  
Old 10-09-2015, 01:30 AM
TomN TomN is offline
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Join Date: Sep 2015
Posts: 20
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Sorry for your loss too. It certainly has sent my pain into orbit for a few weeks. I had a surgeon even tell me not to operate when you're grieving since there is a change in the chemical makeup of the spinal fluid while traumatized. So I'm waiting
I'm beyond confused as I haven't seen the myelmalacia on the films but a couple docs "think" they see it. Have you heard that it's a bad idea to do ADR with spinal irritability?
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  #14  
Old 10-09-2015, 11:01 AM
simeoni simeoni is offline
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Join Date: Nov 2012
Posts: 64
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Hi Tom,

I contemplated adr vs fusion hard. Eventually went with adr. I did not experience full relief. I still have issues, which are likely caused by nerve irritation. Some spurs were left behind. This coupled with a lot of motion in my c6/7 is the likely cause of my problems. Everyone is different, but I should have fused. Now I am contemplating a revision to fusion.

So I think your surgeon may have a point. I would not rule out fusion yet. One level fusion is a successful operation in general. It will take out all possible pain generators in that segment. Proof of adr reducing adjacent segment disease in one level cases is not at all solid. Adr can be a viable option if you truly are a candidate. You see a lot of opponents of fusion on this board. But sometimes it is the better choice.

Those are my thoughts. I Am not saying you should not go with adr. But I would dig deep if there are any signs of contraindication.
__________________
- 35 year old guy
- Constant pain and tightness in the right scapula area since 2004
- Misdiagnosed for years
- 2010 cervical MRI -> c6/7 problem
- Developed frozen shoulder during "conservative treatment"
- 2011 prodisc-c nova c 6/7 by Dr. Bertagnoli
- Ongoing neck, scapular and shoulder issues
- Nerve root canal narrowing osteophytes behind adr. Considering revision.
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  #15  
Old 10-10-2015, 06:35 PM
cici cici is offline
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Join Date: Sep 2015
Posts: 5
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Hi Simeoni, What was the "conservative treatment" that you mentioned in your previous post? Do you feel that it caused your frozen shoulder? If so, how? It's interesting that I'm seeing your post today for the first time. I'm saying that because I just came from seeing my physiatrist [physical rehab doctor] Dr. Ali Guy. I've known him for 25 years and he's helped me through some rough times. He told me that he has alot of patients who've had ADR and suggested I hold off and try a cervical epidural first. Though I'm not fond of being injected with corticosteroids I've had them a couple of times in the past for dance and athletic injuries and they did help [in some cases] for quite a while. Dr. Bertagnoli and Dr. Bierstedt both recommended a 2-level cervical ADR at C5/6 and C6/7 for me. Dr. Guy looked at my ex ray and said that if I only had ADR at C6/7 chances are I might be able to get away without requiring fusion, but that if I had both levels replaced that I would require a fusion because multiple ADRs without fusion have a high tendency to pop out. So, naturally, now that I've read your post, I'd be reluctant to have ADR at C6/7 without a fusion. Still have alot of thinking to do!
Thank you. Gabrielle
__________________
July 2015 possible grade 1 anterolisthesis c6/7, multilevel ddd w disc height loss esp c5-c7, facet hypertrophy upper cerv spine, esp c2-c4, diffuse mild, marginal osteophytic changes throughout cerv spine. Cerv mri: broadband disc osteophyte complex c5/6 extending to central aspect cerv cord. Disc osteophyte complex mildly indents canal c6/7. Severe rt c3/4 degen facet arthrop. Small rt central protrusion rt T1-disc hern. USA doc suggests c6/7 cage fusion. Looking into cerv adr in Germany.
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  #16  
Old 10-11-2015, 03:47 AM
simeoni simeoni is offline
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Join Date: Nov 2012
Posts: 64
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Hi Gabrielle. I do not blame the conservative treatment for my frozen shoulder. I am just saying it started during thar perioid before surgery. I had a couple steroid shots then. I consider my frozen shoulder as a body reaction to acute pain and c7 nerve disturbance. I have never heard anyone saying that adrs pop out in 2 adr constellation. I would question the implantation technique of such adrs.

In my case, all 3 surgeons I consulted have said that my continuing problems are likely caused bu the combination of remaining osteophytes and motion. If I had a fusion and such osteophytes, I should not have a problem. Adr motion en ironment is unforgiving to anything left behind.

Your case is a 2-level case. So the points to consider are different. Hope you find a good solution.
__________________
- 35 year old guy
- Constant pain and tightness in the right scapula area since 2004
- Misdiagnosed for years
- 2010 cervical MRI -> c6/7 problem
- Developed frozen shoulder during "conservative treatment"
- 2011 prodisc-c nova c 6/7 by Dr. Bertagnoli
- Ongoing neck, scapular and shoulder issues
- Nerve root canal narrowing osteophytes behind adr. Considering revision.
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  #17  
Old 10-12-2015, 02:27 AM
TomN TomN is offline
Junior Member
 
Join Date: Sep 2015
Posts: 20
Default Diagnosis

Hey Simeoni,

I'm sorry to hear you are still having issues. Can you tell me a little about your journey with your symptoms. I feel very alone in my case as the cause of my symptoms has not been clearly identified on any MRI. And I'm wondering if we have similar circumstances. Did you have symptoms in your lower extremities? Did you have spinal irritability?

Best,
Tom
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  #18  
Old 10-12-2015, 11:56 AM
simeoni simeoni is offline
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Join Date: Nov 2012
Posts: 64
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Tom, my story is long. I started having symptoms around 2002. They were constant since 2004. got really bad in 2010 and I had surgery in 2011. My pre-op symptoms have included leg pain and stiffness, also lower back ache. But the most pronounced symptom was right scapular pain and ultimately shoulder problems. Nobody could explain how my lower body symptoms could be caused by my neck, but they were reduced by surgery. I still have some occasionally, but mainly my problems now are in neck-shoulder-scapula area. Also headaches.

I do not know how spinal irritability is diagnosed or what it specifically is, but it is a good word for what I feel. My shoulder rom is still limited after 5 years since frozen shoulder onset. Frozen shoulder usually resolves in max. 2 years, so I have been suggested it is maintained by cervical problems. I cannot really move it to extremes of rom without irritating the cervical area.

Tyere is no quaranteed truth out there. Although I am sure my problems are originating from cervical, it is always possible there are other contributors. My case is not the usual and it is difficult to diagnose. CT shows a big osteophyte in c7 root foramen and it is supported by many of my symptoms.
__________________
- 35 year old guy
- Constant pain and tightness in the right scapula area since 2004
- Misdiagnosed for years
- 2010 cervical MRI -> c6/7 problem
- Developed frozen shoulder during "conservative treatment"
- 2011 prodisc-c nova c 6/7 by Dr. Bertagnoli
- Ongoing neck, scapular and shoulder issues
- Nerve root canal narrowing osteophytes behind adr. Considering revision.
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  #19  
Old 10-14-2015, 12:20 AM
TomN TomN is offline
Junior Member
 
Join Date: Sep 2015
Posts: 20
Default Irritability

Hey Simeoni,

Your journey is definitely strange like mine. Doctors love to look at an MRI and hide behind the images and not want to dig any further.

My symptoms are constantly in my feet. Three docs think the cord is getting compressed at C6/7. I was told spinal irritability is when the cord keeps getting compressed by either the disc or the bone. The bruising of it will irritate it and many docs here agree that it's critical to stop the cord from bending where it's been bruised. Maybe that's what's happening with yours? Bertagnoli said that it's OK for the cord to bend at C6/7 while every single surgeon in the US says no way! Crazy. Don't know who to believe. All I know is my life is over until I get out of this brutal pain

Did you have instability?

Tom
__________________
46 year old male - 155 lbs, healthy
Whiplash December 2014.
C6/7 has degeneration, bulging disc/cord compression, 2mm foraminal narrowing right side.

ACDF C6/7 November 2, 2015

Currently dealing with possible non fusion C6/7 and adjacent segment failure at C7/T1.

Considering ADR C7/1
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  #20  
Old 10-14-2015, 09:36 AM
simeoni simeoni is offline
Member
 
Join Date: Nov 2012
Posts: 64
Default

Hi Tom,

My bending x-rays have never shown instability so I likely do not have it. Of course there is many kinds of instability, so who knows. I would be interesred to see your x-rays that show the presumed instability. If there is significant instability, then adr is quite clearly contraindicated. This is my impression based on a lot of reading. Please aknowledge that i do not have a medical degree.
__________________
- 35 year old guy
- Constant pain and tightness in the right scapula area since 2004
- Misdiagnosed for years
- 2010 cervical MRI -> c6/7 problem
- Developed frozen shoulder during "conservative treatment"
- 2011 prodisc-c nova c 6/7 by Dr. Bertagnoli
- Ongoing neck, scapular and shoulder issues
- Nerve root canal narrowing osteophytes behind adr. Considering revision.
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