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  #1  
Old 09-08-2010, 05:21 PM
10skiclimd's Avatar
10skiclimd 10skiclimd is offline
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Cool Large C5-6 herniation with compression of cord

My symptoms started July 31, 2010. No pain whatsoever. Just weakness in my legs, trouble with running and a strange hot feeling all over. I finally saw a neurologist on August 31 who put two and two together and ordered the MRI that made the diagnosis.

My particular case is not complex. I have a single c5-6 central herniation that is causing some myelopathy but no radiculopathy. A radiologist that I trust says I have no significant disease (spondylosis, facet degeneration, disc degeneration) at any other level, so I suspect what I have came from an acute skiing injury this spring.

I have talked to a neurosurgeon and an orthopedic spine surgeon at my home hospital (Kaiser in northern California). Both agree that I need to have the disc removed and the cord decompressed ASAP. That's a no-brainer. I'm actually scheduled for anterior cervical discectomy and fusion (ACDF) on Sept 15.

What I am wondering about is whether or not I should instead be considering ADR rather than ACDF. The orthopod said that I am not the classic candidate for the FDA approved procedure because I do not have radiculopathy or neck pain. It sounded like he has done a few ADR's but not many. The neurosurgeon did not recommend ADR at all, saying results have not been favorable.

My own research of the medical literature seems to suggest that there are a lot of biased studies being done, but that the jury is still out on long-term viability of this technology. Short-term outcomes seem to suggest that ADR and ACDF are equivalent (no statistically significant difference) in reducing pain and neurologic disability.

So, at this point, I am asking for the input of this group. Here are my pointed questions:

1) Can you point me to a spine surgeon on the west coast that you know has extensive experience (personally done 50 or more cases) with ADR that I can talk to? I am limiting myself to the west coast because my time window to get the procedure done is very short. One study I read said best outcomes were achieved when people with cervical myelopathy due to soft disc herniation were decompressed less than 2 months after onset of symptoms. I am already 5 weeks out.

2) Do any of you have experience with Dr. Lali Sekhon from Nevada Neurosurgery in Reno? I have a visit with him tomorrow.

3) Have any of the you undergone ACDF or ADR for a myelopathy without pain? How has your outcome been so far? Subsequent disease at other levels? Complications with surgery? Did you get the result you expected?
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7/31/2010 Began developing torso and proximal leg weakness. No back or neck pain.

8/31/2010 Diagnosed with C5-6 large central disc herniation with myelopathic symptoms.

9/14/2010 C5/6 anterior cervical discectomy and Prestige disc placement.
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  #2  
Old 09-09-2010, 08:48 PM
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Toebin Toebin is offline
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Hi 10skiclimd,

The LA Spine Institute, Rick B. Delamarter MD is someone that is on the West Coast and has done several ADR surgeries. They are located in Santa Monica California.. There are several people on this forum that have gone to him with good reviews. I'm sorry but I am not familiar with any others though.

I DID have an ACDF but only after years of discomfort and trying other treatment modalities. So I can't really compare our two cases.

I'm sure others here will pop in with more info and I hope your visit with the second opinion in Reno helps with your decision.

Best of Luck and please let us know how and what you are doing!!
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Hyperparathyroidism-CURED! Aug08, lets see if I can grow bone now!
DDD for as long as I can remember.
Myofacial Pain Disease
Severe Vitamin D Deficiency
Spinal Fusion C5-C6, C6-C7 - May 2007
Multiple epidurals, L 3/4/5 & S1
L 3,4,5 & S1 herniated/bulging disks-under control for now.
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  #3  
Old 09-09-2010, 11:59 PM
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jss jss is offline
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Join Date: Nov 2009
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10skiclimd,

I can address only number 3.

In 2000 I had an ACDF at C4/5. I had loss of motor and sensory, but no pre-surgical pain. Almost certainly due at least in part to the 2000 ACDF, I had to have another in 2002 at C5/6. Again, loss of motor and sensory, but no pre-surgical pain. Again, almost certainly due at least in part to the 2000 and 2002 ACDFs, I had problems again in 2008 through 2009 (this time debilitating and incapacitating PAIN) for which my original surgeon prescribed TWO more ACDFs. Instead I went to Spain for a double ADR with the Spinal Kinetics M6.

After each of the three surgeries I returned to 100% of my pre-problem capabilities. After each fusion I did notice loss of motion. Prior to the double ADR my left hand became maybe 35% numb. I've not yet regained that sensory.

Good luck, Jeff
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C4/5 - ACDF in 2000
C5/6 - ACDF in 2002
C3/4 & C6/7 - M6 ADR, Nov 2009, Barcelona
Conceded defeat to a manifestly disingenuous BCBS-TX in my quest for reimbursement, Jan 2011
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