Another New Cervie Introduction

[Reddy2ride]

This is my first post since I was diagnosed with degenerative disc disease in my cervical spine. I've had recurring episodes of neck pain for quite a few years usually worsened by doing some type of overhead lifting. Most recently I was throwing my kids into the air from inside the pool (I know/I know) and have been through many months of neck pain along with minor tingling in my left forearm. I currently have no ROM or strenght loss.

After all the usual injections, PT, NSIADs, etc. I obtained X-Rays and MRI's which diagnosed DDD at several levels (see signature) with the most noticable disc height reduction at C5/6 (lost about 1/2 the height).

I just don't know what to do as I have had different opinions from various surgeons. I feel that since I do not have excruciating arm pain that I've had to deal with these recurring bouts of neck pain for 10 years therefore continuing with degeneration and likely why I have multiple levels affected. I fear that if I continue to limp through life with this condition that it will continue to worsen to the point that my only option will be a multi-level ACDF.

I've talked to several doctors to date. One local surgeon indicated to just adapt activities and learn to live with this issue noting that I'd get more stiff and lose ROM over time. Another wanted to do a multi-level ACDF. Neither of these surgeons do ADR's. I've had three international surgeons recommend 2 level ADR's (one of them said possibly 3-level).

As most of you I'm scared to death and pretty much in denial over all this. This part of the human body seems so weak and why do we age in this painful manner while others do so gracefully with little to no symptoms?

I'm planning a trip back to TBI (Texas Back Institue) next week for a qualified opinion from another U.S. surgeon. On my last trip they wanted me to do some add'l tests but thought a single level ADR may be helpful. I have a lot of questions for them on why one level would be recommended vs. multiple based on my images and recommendations from other surgeons. I hope the FDA's approval of only single level's isn't the reason for this. They should also have some feedback from my Health Insurance company at that time.

In advance I'll just say that I appreciate all the advice and support I know I'll receive from everyone on this site. I've already learned so much from others that have come before me and it is helpful to know that we are not isolated and alone! Has anyone had surgery predominantly due to neck pain ...which isn't simply secondary to excruciating arm/hand pain?

[JEVE19]

Not a fan of TBI.
Too much "business" too little care.

I would recommend getting neutral opinions from non US docs who aren't in constraints.
Read surgical outcome posts if you haven't been on in awhile.

I know Dr Boeree told me to make sure that when updating MRI'S, make sure the machine has the latest magnet (I think he said 2.0?). He said whoever did my cervical used an older machine and the pics were not good.

Do lots of reading and don't wait too long.
I wish now I had done it sooner.

Good luck to you and the fun in the pool was worth the laughs and smiles you now have in memory.

[annapurna]

The MRI magnet isn't as critical as you might think. Higher magnets tend to make for more signal faster. 3 Tesla magnets seem to be the big thing now. The problem is that many places compensate for the increased signal by speeding up the scans; the final result isn't any better than what's produced by a smaller magnet. The best thing to do is to make sure the doc who orders the MRI specifies what he/she needs to see and that you go somewhere where they'll work to make sure their images support that need.

[annapurna]

Hi Reddy, this is Laura - the more "orthopedically challenged" half of annapurna. Having done both ADR's and biological repairs in both my lumbar and cervical spine, I would highly recommend both.

Right now, biological repairs include regeneration of disc nucleus material using either transplanted chondrocytes (usually from material removed during discectomy) or stem cells (usually bone marrow aspirate derived). I've had the transplanted chondrocytes (called ADCT for autologous disc chondrocyte transplantation) with Dr. Bertagnoli, and I recovered significant nucleus material and have stopped losing disc height at the treated discs. Other folks have applied mesenchymal stem cells (from your own bone marrow aspirate) for disc annulus repairs. The guys at the Centeno-Schultz clinic in Denver seem to be good at this and are very willing to share their outcome statistics.

If you've lost most of a disc AND it's not moving AND it's painful, then just replacing the whole darned thing with an ADR makes a lot of sense. At the end of the day, an ADR may be better than a "nearly gone" natural disc that doesn't move or provide stability.

If you're interested in going either the biological or ADR route, one absolute requirement is prompt action - especially with the biologicals. If it's pretty clear that you're going to have to do something with your c-spine at some point in your life, then it's best to plan a course of action that maximizes success.

While you're sorting out your spine action (or watchful waiting) plan, I would highly recommend prolotherapy for pain management and ligament stabilization. This won't help regenerate discs, but could really help with overall stability, possibly helping with nerve impingement issues. This therapy promotes growth of structural collagen at connective tissue-bone attachment points and could, therefore be considered an outside-the-spine biological repair. If you end up going with ADR, having nice, strong ligaments will help, too.

Last, but not least, if you can possibly do it, be careful about cortisone shots and non steroidal anti-inflammatories. These drugs really inhibit tissue growth and, if you attempt one of the biological repairs, you will need your body's full repair capabilities "locked and loaded" so to speak.

Congrat's on getting lots of opinions - including some for abroad! Knowledge really is power, and the options for true spinal repair and restoration are more abundant today than they were even five years ago. You may have to travel outside the USA to take advantage of some of them, but no one ever died from too many passport stamps.

Best,
Laura

[Reddy2ride]

Happy Thanksgiving everyone and thanks for the warm welcome. On the topic of Mesenchymal stem cell transplantation, I had the opportunity about one month ago to talk with a doctor at Celling Treatment Center in Austin, TX about the ReginaDisc for tissue regeneration. They commented some of my discs were candidates but the one with significant degen was likely too far gone and they noted that the PH within the bad disc would likely not be a suitable environment for new tissue growth. However this seems to be a hugely promising area although I would think that early prescreening tess will be required to catch early onset of DDD before it is too late. It seems to me that most doctors conservatively don't do anything these days until you are pretty far gone.

I have a lot of decisions to finalize on next week along with a few more follow-up consultations. I'll post some updated info on what I learn. Also I want to sincerely thank a few of the members of this forum for some direct conversations we've had on surgical experiences as it answered a lot of my questions and helped me be a little more at ease.....especially with the overseas option.