ADR and Heterotopic ossification, bone spurring

[RAP1]

I can’t thank Harrison enough for this site. I my goal for this site it to help support finding more ways to market, expand and have people share their stories.

My question is going to be primarily around Heterotopic ossification, bone spurring and how this effects ADR after they have been placed.

First my cervical background:
C2-3: Minimal right eccentric disc osteophyte complex with no focal protrusion.
Patent foramina.

C3-4: Diffuse disc osteophyte complex with superimposed moderate right
paracentral disc protrusion displacing the spinal cord posteriorly and effacing
the dorsal and ventral CSF, similar to the prior exam. There is bilateral
uncovertebral spurring with mild to moderate bilateral foraminal narrowing. No
significant interval change.

C4-5: Small disc osteophyte complex with right greater than left uncovertebral
spurring and mild left facet hypertrophy. The ventral thecal sac is indented.
There is moderate right and mild to moderate left foraminal narrowing. No
significant interval change.

C5-6: Left eccentric disc osteophyte complex effacing the ventral thecal sac
with left greater than right uncovertebral spurring and mild left facet
degeneration resulting in severe left and moderate right foraminal narrowing. No
significant interval change.

C6-7: Right eccentric disc osteophyte complex/disc bulge with right-sided
uncovertebral spurring resulting in severe right and mild left foraminal
narrowing. The ventral thecal sac is indented. No significant interval change.

C7-T1: No significant posterior disc pathology. Mild bilateral facet
degeneration. Patent foramina. No significant interval change.

7 years dealing with past two being most severe. 2yrs of epidural that have worked fairly well along with regular traction, walking.

Biggest symptoms are left arm radiculopathy. and upper left shoulder pain.

Currently, I have consulted two doctors (Boston area). My most recent mentioned C5-6 fusion though he said we could do ADR but he is mentioned the likely hood the spurring could lead to the ADR fusing. He also mentioned if the ADD fused it would mot likely be in a position that would not really effect the angle of the cervical area. Both have also mentioned the ADR helps more with radiculopathy and Fusion helps more with the pain since there is no motion.

One thought is start with C5-6 fusion and since adjacent issue will most likely happen we tackle C6-7 with ADR when that time comes.

So back to my question to folks that have had ADR.
• Could they comment if they have had to have revisions, (details why)?
• Have folks had ADR in levels that had some spurs anyway?
• Comments in general to hybrid cervical levels?
• Do we agree ADR helps more with radiculopathy and Fusion helps more with the pain since there is no motion?

Thank you for listening and support!!

[Harrison]

Rap, your questions are logical but surprisingly difficult for us to answer with any specific evidence. That said:

- spurs are common before ADR; not so much after unless patients were not on NSAIDs to retard HO processes.
- spurs do occur postop but are less common with the proper ADR selection and endplate sizing.
- see the Revision Forum for more details.

I know this does not answer all your questions, but keep reading. Have you used the advanced search feature yet?

https://www.adrsupport.org/forums/search.php

[Gorrito]

Originally Posted by RAP1

My question is going to be primarily around Heterotopic ossification, bone spurring and how this effects ADR after they have been placed.

• Do we agree ADR helps more with radiculopathy and Fusion helps more with the pain since there is no motion?

Thank you for listening and support!!

Hi. Isn't radiculopathy considered to be a form of pain??
I am pretty sure my surgeon did some work on parts of bone when he was in there for my ADR. That being said, some people think bone dust is a risk factor for developing HO....

[RAP1]

two things I like to follow up on for questions.

I ask about HO because they say the risk of the ADR fusing can be common. Have folks heard this mentioned form their doctors?

Also, as important question. When a person who has had ADR also has foraminal narrowing is there still the risk of nerve radiculopathy since that level is still moving?