My 3 mo X ray - Discs tilted all over the place

[Bill1961]

Steve,

Glad to here your doing so well. Keep it up and take it easy. I mentioned some time ago that I met a couple of 4 level cervical fusion patients. Both of them where doing great no post op pain or problems. You could barely tell any left to right rotation issues. They did have a bit of limit up and down. But overall very happy and normal.

I hope that others will follow your story and learn. There is a place for fusion as well as ADR. There is also a place for less invasive techniques such as foraminotomies and partial discectomies which should be the first surgical choice if possible.

[steve55]

Wow! Thanks for telling me that Bill. Good to hear then.

[steve55]

I just found out that I actually got a corpectomy done after all. I noticed it on my discharge papers. I was confused because I specifically recall dr B saying "the good news is that we didnt have to do the corpectomy". I guess he meant, we didnt have to do 2 corpectomies as the dallas surgeon recommended. So I got a corpectomy at C5 and fusion at C4-7.

I immediately did some research into long term outcomes of corpectemies including many multi level corpectemies and it looks very good. It seems the danger in corpectemies is only during the surgery. But prognosis is that they hold up quite well. I just need to fuse well now. Basically, that infection ate my C5 vertebrae for breakfast, lunch, and dinner!! Darn critters.

I asked for, and will be granted a bone stimulator to aid in fusion. Bone stimulators are controversial as Dr B and this american doc dont think they really work. But I reserached on google for many hours and clearly, there is evidence that they do indeed work, but only in speeding up fusion. Studies seem to show that fusion without bone stimulators simply take alot longer. For me, the sooner I fuse the more free I will feel. Psychologically, I feel I wont have to worry about neck movements once Im fused, so Im all for anything that speeds it up. Plus, when I peruse back boards, it seems to me that 50% of the docs out there DO BELIEVE in them, so go figure. I wonder why half of the doctors say yes t hey work, and the other half say no they dont work. How can this be???? Are they reading the same studies?

At 2 weeks post op, I am able to fast pace walk 20 mins with no limp at the hip bone graft site, only minor ache. Im able to sit and work at my computer for unlimited hours it seems, only minor aches in my neck. I feel I could go back to work already for real. Im amazed. Maybe it's dumb luck or because of the work of Dr B. They say he is a master carpenter, and his name is immediately recognized by all 5 docs Ive been to! Hell, even my cousin's husband who sells medical devices knew his name too. Unbelievable. So Ill hang out at home for 1 more week and then start back to work. Been cleared for driving since Im doing so well so far. My only worry at this time is to have a successful fusion.

[mmglobal]

Steve, I'll be interested to see more about your new configuration. Sadly, the language of the surgeons is not always precise. Some surgeons use terms differently and it's frustrating to know what the terms are, but still be unable to decipher what was done.

I'm wondering if someone is referring to a partial corpectomy as a corpectomy? Is the entire vertebral body removed or just part of it? The hardware required would be completely different.

It sounds like you are making great progress. Keep it up and keep us posted.

Mark

[steve55]

Excellent point!! Maybe it was only partial. I'll email the asst doc and see what she says. I've bombarded her with emails lately so I'll wait a while before asking. Hey mark, maybe you can ask dr b for me the next time you run into him. Dr b knows I share everything with you, maybe you'll understand what they did to me better than I can. You're good at translating these medical terms into English for us. : )

The paperwork says c5 c6 corpectomy with iliac bone graft harvest and vectra cervical plate from c4-c7.

A partial corpectemy would make sense cause I swear I heard dr b tell me that the good news was that there was no corpectomy done and that I got a 3 level fusion.

[dshobbies]

Hey Steve,

Way to go. Glad you're feeling so good. It's been a long time coming.

A 70+ friend broke her arm in 7 places. She wasn't healing well until using the bone stimulator. Then she kept on getting infections and had to wear an intravenous anti-biotic machine for 24/7 until she starting sitting in the sun for 10-15 minutes daily. Just a thought.

Dale

[Bill1961]

Steve,

Glad to here your still doing well. Stay positive and do the right things so you heal properly.

[Joe56]

Note to those considering older ball in socket designs which can get a bit out of control in multi-level cases, consider the M6 implant, it appears the new designs will have controled motion to help with this. I am looking at Stenum Hospital for 2-3 levels.

[JKDE302]

^ Joe56 do you know anyone who has the M6 implant...

[mmglobal]

Joe, I disagree with the concept that the M6 provides stability that is not present with the ball and socket style ADR's. I presume that the theory is that the woven 'annulus' provides additional help here. I've seen the M6 and it's a very interesting design. In theory, I do like what the pseudo annulus does... presumably providing some dampening of the motion at the ADR levels. However, I do not see this helping the 'out of control' concept of multi-level ADR.

The M6 is a mobile core device and, in practice, I see it having the same problem as other mobile core devices. If something provides some off-kilter loading, the core gets pushed to one side and it stays there. Search this forum for the word tiddly-winks and you'll find what I've written about mobile core devices. I have seen several M6 configurations that have this problem. It is a problem in single-level cases too but gets exaggerated in multi-level cases, especially if there is incorrect placement. (I have 3 clients who have had m6's explanted and know more.)

The ball and socket designs that have mobile cores (including the M6) will have this problem more than the stationary core designs. Having said that, I spoke to a friend tonight. He is the first patient in the world with a 4-level Mobi-C (highly mobile core) and is several years post-op with no stability issues at all.

I'm going to COPY the M6 posts to the M6 vs. ProDisc thread (http://www.ispine.org/forum/ispine/1...s-prodisc.html) that was started a few days ago. This thread is very long and involved and devoted to Steve's ordeal.

All the best.

Mark

[ans]

I don't stop by enough but read your nightmare story and am glad you're on the mend.

I never thought that bone stimulators' efficacy was questioned.

Good luck to you.

Best, Allan

[Joe56]

Mark,
I understand your concerns. What I have learned is that the Spinal Kinetics guys studied the physical characteristics of the human disc and placed these parameters into their test computers, then they began the process of prototyping an implant that replicated these characteristics. The result was a disc that might just be the first to actually deserve the name “artificial disc”. The goal of course is to return the spine to normal function. Now we both know that as the damage from years of degeneration progresses the other structures and tissues become unable to respond normally. The selection of candidates is critical. Surgeon placement errors and patients whose bodies just can’t keep the implants in place will always come up, but overall I think the goal of returning to a normal function is attractive. These guys at Stenum seem to have done the most and should have it down.

Joe