Prodisc C surgery

[Marisette]

Hello. I have been reading many of the post on this site since oct. 2010 and finally just got the courage to become a member. I'm hoping that I can get some additional info. before I decide to have ADR surgery. My C5-C6 herniation has affected my job performance and I fear I must make a decision quickly in order to keep my present job. A neurosurgeon informed me I'm a good candidate for ADR because I have a one level herniation with no other spine abnormalities. He said he has performed more ADR than other neurosurgeons in the area. I did some research on the internet and saw he had some favorable reviews by patients and no licensing issues in the past. But how could I verify that he has performed numerous ADR surgeries in the past?

The doctor said I will not have restriction on activities after 6 weeks. My job requires that I lift 30-35 lbs on occasion throughout the day. Can this be possible? I'm not in constant pain. In fact, I usually just get thumb pain both hands. I do restrict my activities to avoid injury and pain and I'm on prednisone about 3 times a year to reduce inflammation and be able to go to work. Is this surgery indicated for pain relief purposes only or is it meant to restore more normal functioning? Here in Chicago, there are trials for a new disc, M6 possibly. If a person enters a trial,is there a possibility that they must undergo fusion surgery. I would not consider this. I'm also terrified of post surgical pain and restriction on mobility post surgery because I'm a restless sleeper. How bad is the throat and back pain after surgery? Maybe I should just forget about this and get another job. Any Advice?

[jss]

Marisette,

Condolences on your condition. But I am delighted that you think that you've found a doctor that will do a "bang up" job on you.

I don't know how you can determine your potential surgeon's track record, or verify the number of ADRs that he's performed other than looking him up on local forums; which often don't provide much information.

In three surgical sessions over a 10 year period I've had two cervical fusions (2000, 2002) and a double cervical ADR (2009). After each surgery I was 100% ambulatory within two days, up to the point of being able to walk 20 miles on the second day after surgery. Since surgery I've run two half and two full marathons, and been in a 100 mile bicycle race. If you have a completely successful surgery, I would expect that you will be able to perform any NON-contact task that you desire.

Neural decompression is intended to alleviate pain. ADR is intended to preserve motion. But there is no way to know before surgery if either of those goals will be met. Unfortunately it is a roll of the dice. From talking to dozens of fellow fusion/ADR recipients, cervical surgery almost always achieves both of those goals.

I haven't read the M6 study, but can tell you ...

• If the study is a double blind study then you have a slightly better than 50% chance of waking up from surgery with a fusion.
• If the study is a blind study then you have a slightly better than 50% chance of waking up from surgery with a fusion.

I have two M6's and wouldn't trade for them.

After both of my fusions I had a TERRIBLE sore throat for ... maybe six hours. After my double ADR there was no sore throat. I don't know why the difference; probably improved surgical technique in the ten years between the procedures. After all three surgeries I was on pain medication for two day, and ibuprofen for a further two. Some people are on narcotics for weeks; everyone is different. Sorry, but there's no way to know where you'll fall until you have surgery.

I don't envy the many difficult decisions that you're going to have to make. Even worse, you can't know if you made the right decisions until possibly years after you've made them. I would strongly encourage you to research, research and then research some more. The most beneficial research I think is reading patient outcomes with different surgeons and different prosthesis.

Good luck!

Jeff

[Marisette]

Thanks for your response. This answers most of my questions. I will be going for a second opinion at one of the universities with an orthopedic group that has conducted trials on artificial disk replacements. The group is currently looking for volunteers for trials on a new artificial disk, but I don't think I will volunteer. I just want a second opinion on my MRI. I don't truly understand the degree of injury to my disc or spine. I could not figure out where to add my history on this site, but I had three epidurals and some occupational therapy. I was misdiagnosed and informed by two orthopedic md that I had carpel tunnel five years ago. Two years ago, I went to a pain clinic, where I was diagnosed with the cervical herniation.

Somehow, I thought I would get better with the epidurals and the "pain clinic" kept advising me to have another one. I refused the fourth because I realized, I was continually going back to performing the same activities and my injury was aggravated and I was not going to get cured. The epidurals were done under general anesthesia and my insurance was paying about $9000 per epidural. I'm embarrased because I feel I should have known better because I've been a nurse for 22 years. I don't work with people with spine problems, but I see many people with very poor surgical outcomes who suffer the consequences of being too trusting. There seems to be no way to find out if the surgeon is competent other than word of mouth. I emailed the manufacturer of one of the artificial disc to see if my neurosurgeon was one of the md's that could have possibly had experience with ADR, but did not receive a response. I was fortunate to find this site which is where I have found most of the information that will help me make my decision.

Thanks again. Marisette

[Ann F]

Marisette,
I also have had both fusions (late 90's) as well as an ADR in 2005. The ADR is the preferred way to go as it does preserve motion. While fusions stabilize the veterbrae, they can cause more stenosis since the muscles are working harder to compensate for less motion. It's very important to find the right doc, one who is experienced with ADR. And definately gen a second opinion. I had a great doc in CT and now have moved to TN. I have a doc in Knoxville who thinks my nexk pain might be from my elbow. ??? I'm still in touch with my CT doc and will go back there if I have to.

Ann

[Marisette]

Hi. I'm not so sure I"m pleased with my second opinion. The doctor recommended fusion. He said that ADR had it's risk and is "too unpredictable." I was hoping this surgeon in this large university orthopedic group that participated and is currently participating in ADR trials would recommend an ADR. The doctors says my spine is "perfect" other than the herniation so he does not think I need ADR. He said my mobility would not be that limitied with fusion. Perhaps because the rest of my spine is "perfect"? He said fusion surgery would only require a one day hospitalization and that I would be walking the same day.

I was not so sure about my first opinion doc. either because he said the ADR would last forever. I don't expect a cure, just some honesty. I think I'll stay away from the surgeons for awhile, or at least, for as long as I can continue to manage at work.

Thanks for sharing your experiences Ann, and Jeff.

[jss]

Marisette,

Please note that the second opinion dissed ADR, because his/her personal opinion of it was not high; not because you were contra-indicated for it. There is a BIG difference. If you are contra-indicated for ADR I would strongly urge you to heed that contra-indication. But if not, I hope that you won't let this deter you from pursuing ADR, as it has been clinically shown to be a superior treatment for the right patients.

And of course no one can tell you that an ADR will last forever; considering the first one was done only 25 or so years ago.

Good luck, Jeff

[annapurna]

Originally Posted by Marisette

I was not so sure about my first opinion doc. either because he said the ADR would last forever.

Forever is a bit of an overstatement but the first ADR was put in something close to thirty years ago and I haven't heard of a case where the ADR had to be revised or repair simply due to wear. There's been wear concerns when the ADR wasn't in correctly but that is to be expected.