New Girl here...Thanks for all the INFO

[DAnn]

I keep losing my posts. Ughh.

I will go out to try to add the info. But I'm putting below too.

But Jeff, do you know if there are any other groups like the M6'ers where one can find out specifics about certain cervical ADR outcomes?

I need to understand which one is best for me. I think Doctors have a LOT to do with outcomes, but I'd like to be as informed on the mechanics as well.

Here's my info that I need to add:

DAnn
September 2010 MRI (after 2006,2007, 2008 conservative therapy)
C6-7 disc moderatlye to markedly narrowed, retrolisthesis of c6 on c7, mild narrowing of left neural foramen
c5-6 disc moderatly narrowed, anterior and posterior disc bulge with anteriour cord impringement.
c4-5 potential posterior annular fissure.
(first doctor also noted listhesis at c2-3, collapsed c5-6,c6-7)

[jss]

DAnn,

I don't know of a group like the M6'ers for other devices. I don't doubt that there out there, but I've never seen one.

Jeff

[jss]

DAnn,

here is a link that lists and briefly describes many of the cervical ADR devices. This page is almost five years old and so doesn't contain some of the newer disc such as the NeoDisc and M6.

Here are some of the more popular discs that are still being used, and some pro's and con's for each (as I see them).

- ProDisc-C

• Long history and large implant base, so a lot of data is known
• Simple device with only three pieces
• FDA Approved
• Can get in the US
• Possibly covered by your insurance
• Large keels have caused longitudinal fractures of vertebral bodies in a few patients
• Has been associated with accelerated facet joint degeneration
• Does not preserve all motion
• Preserves motion in only unnatural ways

- Prestige

• Long history and large implant base, so a lot of data is known
• Simple device with only two pieces
• FDA Approved
• Can get in the US
• Possibly covered by your insurance
• Does not preserve all motion
• Preserves motion in only unnatural ways

- Mobi-C

• Long history with moderate implant base, so much less data available than ProDisc
• Simple device with only three pieces
• Not FDA approved. FDA trial is currently active and scheduled to complete in 2013.
• Not currently available in the US, so you must travel to get this disc
• Extremely unlikely that your insurance will cover this device
• Does not preserve all motion
• Some motion is preserved in natural ways, and some in unnatural ways

- NeoDisc

• New device with a small implant base, so there is very little data available, even in non-US markets
• Simple device with only one piece
• Not FDA approved. FDA trial was completed in October 2010 and the FDA's mountain of paperwork is probably being done right now. This device could potentially come on the market within the next several months?
• Not currently available in the US, so you must travel to get this disc
• Extremely unlikely that your insurance will cover this device
• Preserves all motion, and in more natural ways that the ProDisc or Prestige

- M6

• New device with a moderate, implant base, so much less data is known than for ProDisc
• Complex device with five pieces, three of them moving
• Not FDA approved. There are internet rumors that this device is enrolling for an FDA trial, but that has not been announced on Spinal Kinetic's site.
• Will not be available in the US for multiple years, so you must travel to get this disc
• Extremely unlikely that your insurance will cover this device
• Preserves all motion, and in more natural ways than the ProDisc, Prestige or Mobi.

Something about the M6 that I think is too substantial to omit; I have spoken with two spine sufferers that Dr Zigler at TBI has referred to Dr Boeree in England for M6 implantation. Coming from Dr Zigler, that speaks volumes for both the M6 and Dr Boeree.

Good luck, Jeff

[Harrison]

Jeff, that's quite a perspective. Naturally, this may evoke some differences of opinion, everyone has their own ideas about the best "kinematics" and design. I like many of your points:

- simplicity; less is more in terms of parts and number of materials;
- keel designs are injurious to the bone; perhaps more problematic for cervical ADR. Cleated endplate designs enable less injury and are easier to revise, should a revision be needed;
- you forgot the Charite', which was first implanted 26 years ago and has been implanted in thousands of patients.

Of course, there are many other designs too. Thanks for the thoughtful, analytical assessment.

D'Ann, what's your latest?

[DAnn]

Thanks to you both,

Now I'm even more confused, but I'm so glad to have as much information as I can.

We are doing our best to research all of this. Kind of glad now I've had the additional time (although painful) to learn more.

I thought the Charite was only lumbar? I'm so glad it has been around so long and has proven so worthile for so many spine patients.
D'Ann

[tooyoungforthis]

I love the idea of starting a north TX group! I am in Lewisville! I find that there are quite a few of us around here! We should form a gathering!

Beth

[DAnn]

Hi Beth!
Wow, you are SO close.

We should get a group together.
I'll work on this for the new year.
Hope you are doing well.
D'Ann

[DAnn]

Jeff, and anyone else out there (Tyler and someone else I can't right now recall??)

What was the cost for the m6 in Barcelona? It sounds promising, and I am willing to pay out of pocket to recover faster. I am young and very active (although not running marathons like many of you--although I did run the last 6 miles in Dallas with my best friend and neighbor for her first run!)

I know some of you have had fusions as well as ADR m6's. I see another post about someone who had a several level ADR but wishes he'd had a fusion at two levels instead.

I guess I'm stressed and confused. I want to return to work as soon as possible and be down for my family (mother of very busy twin boys), in as minimal time as possible. So, any fusion sounds terrible. My current solution is fusion with ADR, so a little of both. But, I've been told I'd only be out for a bout 3 weeks. Is this realistic? I give speeches and am a pretty public persona for my job.
Plus I drive 30 miles every day to work (I'm having a very hard time driving.... now but doing it).
Jeff, I just saw your post about the frog neck....would this be a detriment to me????

Let me know what you think.

THANKS!
D'Ann

[Jstuckey]

DAnn, don't know if this is helpful, since my situation is lumbar. (Longer stay, so more expensive I would guess. More expensive hardware?) I was just quoted $40,123 for a 2 level M6 lumbar (L4-5, L5-S1) ADR with Clavel (Includes 5 days in the hospital, 7 days in a hotel, airport transfer, and breakfast for me and companion in the hotel).

I am most likely going with Nick Boeree in England with a hybrid fusion (L5-S1 STALIF TT) and 2 level M6 ADR (L3-5). $36,000 (no accomodations included). Working through some of my fears right now too! I feel your pain - and not just physically!

[jss]

D'Ann,

For two level cervical M6 I paid 18656 euros, which at the time was $27533. The day I checked out of the hospital I pulled my own 50lb suitecase the 1.1 miles to the hotel (downhill), and then walked 5 or 6 miles the rest of the day touring the city. The next 5 days we easily walked twice that touring the city. That was MY experience, which I think is a little better than average, but not atypical. I do know one patient that had a double cervical M6 with Dr Clavel that took three months before she was unimpeded by the surgical pain.

There are a number of complications possible with ADR, and there is no guarantee of a positive outcome. Though my experience reading these forums is that complications after cervical ADR requiring revisions to fusion are not common.

Per the frog neck, that resolved after all of the surgical swelling went down; perhaps ... eight weeks? That was an issue with me because I had level C3/4 done and, per Dr Clavel, have a very unusual anatomy of the hyoid bone, which made it difficult to access the spine at that level. I've never heard anyone else complain of the "frog neck", and I didn't have it after either of my fusion surgeries. One day I'll have to have C7/T1 addressed, and I don't expect that particular difficulty.

It is very understandable, and I'd say even natural, to be "stressed and confused". These are very difficult decisions that you're having to make right now. But, one day, possibly soon, you'll be "on the other side" and feeling great.

Good luck, Jeff