Facing 2 Level Cervical Artificial Disc Replacement vs Fusion

[Poncho]

Well, I have been down this road before with the lumbar spine, now the cervical spine. I believe I had mild symptoms with shoulder blade pain that would come and go for months, but had no idea at the time it may have been related to bulging or herniated discs in the neck. I appears C-5- 6 is ruptured and C6-7 bulging with stenosis at both levels. Mainly, left upper arm and shoulder blade pain extending down to the thumb, index finger and middle finger.

So, here I go again down the road of taking NSAIDS around the clock, 2 rounds of oral steroids which did not work, physical therapy that did help maybe a little, but only temporary, and now looking at epidural spinal injections in the neck, which I don't have much faith in. In the interim, trying to get an appointment with a neurosurgeon both locally and in Cincinnati, Ohio thus far, (due to insurance) but again have a bit of a wait to obtain my first appointment. September 28th is the soonest I can get an appointment locally unless someone cancels their appointment (I 'm on the cancelation list) and the one in Cincinnati - I have been referred, and I believe they just received my information, records films, etc. They have a process where they have the surgeon overlook the medical records and films and then make a decision on next steps before they even see you. For some, they will make an appointment to see the surgeon, for others, they make other conservative recommendations, then if those things don't work, then schedule the appointment to have face time with the surgeon.

The pain is hard enough to deal with, then the waiting which seems like forever. I know I can manage this, especially when I dealt with chronic pain in the lumbar region for at least 2 1/2 years before going overseas receiving a 2 level Prodisc ADR.

Anyways, this is where I'm at. I'm sure there are others out there that can identify with me.

If any of you know of any spine surgeon in the Ohio area (that performs ADR)Ithat seems to have good outcomes, I'm all ears. I may be looking at the Texas Back Institute as well. We'll see.

Sending less pain / pain free vibes out to everyone.

Sincerely,
Poncho

[Maria]

Hi Sue
Sounds like your cervical condition progressed pretty quickly or at least from point of symptoms to this point. I hope that you will be able to get in soon to see someone that perhaps does both ADR and fusion. That would be great and even more so if you're a candidate for either.

I'm guessing you've not yet not gotten hold of Mark tho if you have already hopefully he knows of someone and/or might be able to push you thru to someone not quite in your immediate area that you could see.

Meanwhile hoping your symptoms are manageable and will hang in there until you get the answers you feel necessary to make that next big step re surgery.

take care and keep us posted!

Maria

[Poncho]

Thanks Maria,

I appreciate your response. The surgeon I think I want to lean toward (we'll see) is the one in Cincinnati.

I have PMd Mark from here, but haven't heard back from him yet. Perhaps, because is out enjoying life finally after all he has been through too.

Hope you are well and not having continued or worsening symptoms with your back.

I will keep you and everyone on here updated. Hopefully, sharing such information will help someone else on here too.

Take care,
Poncho

[Maria]

Well re my back it's always touch and go.. like the week before last my back started giving me probs on a Weds, went out on Saturday and I was in bed for almost 3 days. Slowly but surely it started to improve and this weekend I managed to have a bit of fun tho while trying to do some very light yard work on Saturday my back was screaming at me. You know bending forward even if doing everything correctly. I didn't spend that long in this activity before going in and resting my back in bed for about an hour. Later in the evening went to a dance and yes I danced. I left very early to come home and put a Thermacare magnet wrap on and go to sleep hoping to wake up without any problems. Thankfully I have been fine!

Sometimes my back just goes.. sometimes it's super cranky and takes weeks on end to resolve. So it's pretty much the same only I feel I have lived with it all so long that I am used to what it's like. A strict departure from what it is and has been would definitely have me running to the doctor though (besides my twice annual OSS visit and my every 3 month PM visits). My neck is hanging in there. Seems not to bother me as much as it used to tho I can easily aggravate it by carrying a heavy package on my shoulder or holding the phone to my ear and shoulder while trying to multitask or falling asleep with my neck in a less than desirable position.

Thankfully I am hanging in there. I am reliable to do things on my own schedule pretty much that allows for all this (and my feet flare ups with bilateral posterior tibial tendonitis) so I feel good about that!

I do hope you're not in too much pain and I wish you the best with whatever the plan will be. I think you might have to give Mark a call as that is probably the best way to reach him. I have not spoken with him in a while now (months) and I too hope he is doing well.

take care!

[Poncho]

Maria,

I'm glad you are able to manage your pain well.

Anyways, here are the results of my cervical MRI:

Impression:
Bulging disc material with superimposed disc protrusions along the left lateral canal and left foramen at C5-C6, less so at C6-C7, resulting in significant left lateral canal and foraminal stenosis at both levels, possibly related to the stated complaints. No evidence of acute abnormality or convincing myelopathic signal.

[Maria]

Hi Sue,
Did the doctor who ordered the MRI have a plan re surgery for C5/6 and C6/7 based on results? Re the level of stenosis is it expected that your symptoms will progress/worsen? Just wondering what your pain level given the report findings.

Any luck reaching Mark?

Again wishing you the best with what's going on now and how you'll proceed. Would love to stay informed if you're so inclined..

take care~ Maria

[Poncho]

Thanks Maria, well where I live locally, I'm just looking for an opinion due for that date end of September. Now for the other neurosurgeon in Cincinnati, I sent my films to him. I have not seen him yet, though tentative speaking, he is recommending ADR at C5-6. No comment yet on C 6 - 7. I have a consultation with him October 20th - first thin in the morning. 0740 - I live in a rural area so will probably he hotel stay overnight the night before. In the interim, flexion / extension x- rays which we all know what those are for. Anyways, I'll see what ADR he recommends. Working through this and politics at work (yes, I'm considered administration now, but not liking the politics - eeewww!!! Sue.

[Poncho]

Well, I had a appointment with a neurosurgeon this past week. He has recommended a fusion or artificial disc at C5-C6 and C6-C7. He did admit to me though that he has not placed many artificial discs but would do it if I chose him. I really liked him and appreciated his transparency with this. I did admit that I was to have another appointment with a different neurosurgeon in a different market. That right now just looking at options/opinions.

I guess these levels must have been going south for some time because this neurosurgeon said that he did see spurs as well. First time that I had heard that. I don't recall that being on my MRI report. Interesting.

Now on to the next appointment in Cincinnati called the Mayfield Clinic. It appears that they do a lot of research / clinical trials. I will need to sit down and come up with a list of questions for him. That will be October 20th.

In the meantime so far, the medications I am on are helping me get through this waiting period. In the mornings, I don't feel so bad, but as the day goes on, the shoulder/shoulder blade / arm pain increases.

I will try to keep everyone up to date when I know more.

Wishing everyone on here less pain / pain free vibes.

Poncho

[Maria]

Thanks Sue for keeping us posted on your most recent consultation. I hope the next one will offer perhaps greater experience with ADR and/or hybrid surgeries as it sounds like from the consultation you posted about you're a candidate for either. Looking forward to reading how the next consultation goes!!!! take care! Maria

[Poncho]

Thanks Maria,

Ya know what's weird about this is my arm pain has settled down quite a bit over the last couple days (that's when I start thinking.....Am I bad enough for surgery yet?) However, the weather around here lately has been really nice and I do think that has something to do with it. I'm not completely pain free.

I will try to keep everyone posted on here. We'll see what happens between now and October 20th.

Take care,
Sue

[Maria]

I remember back before I had my 2nd discectomy and my low back wasn't bothering me as much as it had been for about 3 weeks prior to the surgery. I thought "maybe I should wait" to have another surgery... I really wish I had waited.. oh well.. that's many moons ago though it made me really pause when it came to my potential 3rd surgery which I've not had to date 16 years post when I started getting surgical opinions re 3 level global fusion, 2 level ADR, and lastly hybrid ADR and fusion. A rather long pause though one I'm glad I took!

When I lived in Fla. I had more trouble with my body in general re arthritic pain all over so I'm glad I live in SoCal as I'm sure I'd be a screaming mess with more severe weather.

I guess you'll figure it out with time re who, what, and where re surgery if you're going to do it. Meanwhile enjoy the good pretty much pain free days!

take care and be well!

[Poncho]

Hi Maria, well 2 level ADR it is at C5-6 and C6-C7. A waiting insurance approval. I haven't called Mark yet. I don't think I have his number anymore. I hope he's okay. Just haven't seen him much on here. Anyways, what I don't know is what device will be used. Mobi C or Prodisc C.

[Maria]

Hi Sue,
I had been checking back to see what update you might give re your situation and am glad to see you've got the decision made and are just awaiting insurance authorization/approval and then a surgical date.

I've not seen Mark on this forum at all and did send him a private message I think which I don't think he replied to. Haven't heard from him for a number of months although I did see him post something on Facebook.

I think I have his number.. it may be the same one that is listed here on the site? I'm sure he'd love to hear from you if you do call.

Looking forward to hearing more and hoping of course all goes smoothly and everything will be great for you!

take care! Maria

[Poncho]

Thanks Maria, I appreciate your responses. I hope that this will help someone else out there too. I may just have to try one of those numbers.

Now, the continued waiting.....

[Maria]

re helpfulness to someone else out there! There seems to be little action on this forum however I do see that people have written and I feel sad that I cannot give any response that would be helpful so hopefully if you are able to do so I imagine that would help "someone" out there asking the questions we have asked as we go along this journey!

take care and please keep us posted. Feel free to contact me via my regular email if you still have it (and if you don't if you'd like it I will gladly give it to you).

best with all!

Maria

[Poncho]

Hi Maria,

Well I finally sucked it up and had the 2 level cervical artificial disc replacement at C 5-6 and C 6-7.

Of course like the lumbar surgery I had was similar to the post -op pain that surgical night with the posterior neck hurting and arm pain.

My surgeon came in to see my husband while I was in the PACU and told him everything went well and that (of course you know this), to keep moving my neck. No collar needed at all.

Took approx. one week to see the changes for the better. Driving definitely sets off the left arm

This coming Monday marks 2 weeks and I don't want to jinx anything. The pain in the fingers is mostly gone and mostly gone in the upper arm until you come to the upper area of where the shoulder joint is where it is a bit achey. Still have some upper back issues on the left, but seem to be minor in comparison and the shoulder blade doesn't give me as much issues as I had before.

So I'm still early in recovery and this so far seems to be a good decision. If anyone is wondering, the ADRs placed were Mobi-C

I'm on minimal medication for pain now.

Had some insomnia last night awake till approx. 430 am then got up around 11:00am.

Time to run a few errands today.

Hope you and all out there looking at this either finds you pain free or with less pain today.

Also, anyone on this forum is welcome to PM me if they want more information. Though, keep in mind that I'm not on here that often.

Take care,
Poncho

[Maria]

Wow sounds like you're doing very well!! How wonderful!
Very nice of you to come back and post 2 week post op recovery so that hopefully anyone in a similar situation might gain some insight and possibly ask some questions!

As for me I have been doing quite well with the exception of a recent "tripping over a step stool" and doing something to the top of my left foot that I think may have strained a tendon or ligament type of thing. I stayed off the foot as much as possible for a few days and then was feeling better so of course blew that this weekend being on my feet (foot) more than I should have. Back to near square one it seems.

I have a $3K deductible on my health insurance plan so not motivated to go to a doctor until I've given the "wait and see" plan a few weeks. Might switch from my spousal PPO plan (that switches from Cigna to Aetna in Jan and goes up to $4K deductible) to Kaiser Senior Advantage plan. Not sure.

Anyway other than my feet which seem to be my most bothersome part of my body these days re posterior tibial tendonitis and then goofball injuries like this I'm doing very good otherwise! Thanks for asking!

Meanwhile keep up the good recovery & pls update us in the future re your continued recovery!

Happy Holidays!!!!

Maria

[Poncho]

Hey Maria,

Just wow in regards to insurance and deductibles. I *think* my deductible is somewhere around 5K. However, currently going back and forth with insurance for coverage on this procedure.

As for symptoms, still have the shoulder joint pain / upper deltoid area, sometimes goes into forearm on the radial side. Then, sometimes to the left shoulder blade. I guess each area needs to take it turn. I do remember that with the lumbar radiculopathy, it took 2 1/2 almost 3 months post op to go away. I hope that is the case with this.

[Maria]

Hi Sue,
Just checking back. Still with my foot pain.. flared foot up badly by initially staying off it only 2 days and then walking on it (limping) thinking it was Ok. Not! Ended up wearing crutches for a week re tendonitis in the ankle acted up from the limping I believe or maybe swelling around that area too.. anyway still hurts on top of foot where injured initially but not so much thru out foot when wt bearing. Have not seen a doctor. Am at hub's in SD county anyway so not near any of my doctor and not willing to put out $$ til I give the "wait and see" trial a bit more time. Meanwhile I called a Kaiser sales rep & left message re enrolling. No call back yet so will check back today. Next year have $4K deductible and of course coverage 80% in Network with new ins. co Aetna so am motivated to get off spousal plan.

Sounds like your recovery is going along Ok and working out the kinks hopefully! Thanks for the update and hope you'll continue to progress with time. When do you see your surgeon next? Have spoken with Mark by any chance? Ok be well and Happy upcoming New Year!

[Poncho]

Hi Maria, sorry for such a long delay. Well I had my post op visit and x-rays taken. So far I guess everything looks good. Still have the upper arm deltoid and shoulder blade issues. Hopefully, it will just go away. I'm trying to upload pics of it, but having difficulty using my phone. I hope your foot is doing better and didn't have to pay out a ton of money to get it fixed. Now to work on attaching pics of these ADRs....

[Maria]

Hey Sue,
My foot healed well finally.. took a long time! I did have an aggravation or flare up of my posterior tibial tendonitis once I started walking without the air cam brace .. in fact once the doctor pronounced the fracture healed in my left foot and said I was Ok to go about my usual business brace free I sort of went full force back into walking a lot and that brought about my bilateral ankle flare up again. I have had to hire a dog walker to walk Lola several times a day these last few weeks. I walk her every morning but she is a handful with her walks and she wants to go and go in the morning sometimes for an hour. I try to give her that because she will soon be not walking much once the weather heats up even in the high 60's or the sun is warm... she gets out of breath with her CHF and/or just tuckered out and tries to avoid the sun.

I do hope eventually that feeling in your upper back and shoulder blades will resolve and leave you feeling better! Glad to hear your visit went well. take good care now!

[Poncho]

Hi Maria,

I'm glad to see that your foot healed.

I can't believe that I have been off here this long. Well, December 5th 2016 is when I had my 2 level c-spine Mobi-C ADR and I'm doing okay. Keeping fingers crossed. I do get pings down my arm from time to time, but definitely not as bad as before surgery. I hope posting this can help someone out there.

[fuzzy]

Again another year later I am still walking on my 3 adrs for over 11 years and am actually quite active these days. Bertagnoli caused me some c5 root pain and constant cramping in my upper shoulder left to this days and years of uncertainty and remaining neuropathies and mean “phantom pain” which I am managing with high dose pot. Finally baumbach conceded on my 10 year anniversary of his diagnosis that I should start rehabilitation, work out. I had not looked at weights for 20 years but knew its a way to get fit. Last time I would constantly hurt my spine. Took 2 years and now am better then I was then! I can feel Active-L in my spine all the time. So far so good. The fusion hybrid worked great. I hope lumbar adr doesn’t break. So far so good.