Artificial disc surgery for the cervical spine
 

Has anyone had this surgery or been evaluated for it? Stability without fusion - sounds kind of interesting!

Hello diane54, can you elaborate on what type of surgery this is, or show a link? I know I have no idea what artificial disc surgery without fusion means. After having a 3 level ACDF with donor bone and plate I believe that is what has given me the stability I have today.
Thanks Bunz
Bunz

Hello diane54, can you elaborate on what type of surgery this is, or show a link? I know I have no idea what artificial disc surgery without fusion means. After having a 3 level ACDF with donor bone and plate I believe that is what has given me the stability I have today.
Thanks Bunz

Artificial disc replacement
 

This is a relatively new technique. I believe Medtronic has an artificial disc they are using in the cervical spine. Not sure if all insurances are covering it yet. This will eventually take the place of a fusion. The artifiicial disc gives stability and no need to fuse.

My pain management doc told me to wait on a fusion and just get the foraminotomy for now as fusions will be done less and less as this new technology develops.

Here is a link. Looks pretty exciting.

http://www.prestigedisc.com/

Bunz, I know a person who works with my hubby that had the artificial disc done with dr. Dang at hotel dieu. He had a one level disc replacement last November and is doing great. I asked dr. Jhawar about it before my surgery and he doesn't perform them. So there is still controversy in our area, but it is being done. My dr. thought the tried and true ACDF was my best route, but they are being done here in Ontario. Interesting to see how different drs vary their opinion, even in the same office.

Cathie

Artificial disc
 

It is so interesting to see how different doctors approach things. Thus, the need to shop around and get different opinions. I have found the "old school" doctors stick with fusions. If you find someone from 5-15 years out of medical school, they seem to be trained in the newer, less invasive procedures.

As for me, I have been told by one doc that she would do a posterior foraminotomy and the second NS said he would do a fusion, as the posterior foraminotomy would not relieve my neck pain.

So, Monday I am going to a third NS for a tie-breaker opinion. This doc does perform the artificial disc replacement and I may be a candidate for it. So I'll keep you posted after my appt on Monday.

Seems like there is a lot of new stuff on the horizon for spine surgery. Exciting stuff and much less invasive. Also the artificial disc at this time is only for one level surgery I believe.

Diane54, the Spine Group that did my two cervical fusions was the Indiana Spine Group. The first in North America to perform a cervical ADR. I had mine done in 2004 and 2006. But I was not a candidate at the time for an ADR. It really depends on precisely what you have going on. You need to have the surgeon to be upfront with you. Mine own NS was. He told me even with continued ROM and an ADR there could be problems with nerve pain or rather nerve roots. So, just make sure they explain everything to you. Having said that much, they have made great strides with this. Good luck! :)

[QUOTE=diane54;757730]This is a relatively new technique. I believe Medtronic has an artificial disc they are using in the cervical spine. Not sure if all insurances are covering it yet. This will eventually take the place of a fusion. The artifiicial disc gives stability and no need to fuse.

My pain management doc told me to wait on a fusion and just get the foraminotomy for now as fusions will be done less and less as this new technology develops.

Here is a link. Looks pretty exciting.




Thanks for the link Diane, it does sound interesting and promising

I have a Bryan Artificial disc in my cervical spine and it is just wonderful. The disc itself is like a very small rollerblade wheel that sits between to metal shells. It has a central spindle that allows for movement. I ruptured the two discs beneath it 19 years ago and the two levels were fused which put pressure on the remaining discs and was no doubt a factor in the level above rupturing.
It has made a big difference to my life. The surgery was horrible with a major retraction of my throat and I couldn't swallow for a long time after without food going up instead of down and it ached terribly. But it is so much better now than it was. For me to have fused another level would have been wrong but at the same time I couldn't function through the pain of the 3/4 disc having ruptured. I can hear the artificial disc creak when I move but it is wonderful technology. If you are giving the option to have one instead of a fusion
the benefit outweighs the discomfort of the surgery. It maintains natural movement and function. That is my opinion and I have had mine for 9 years now.

hi, i am completely new. I need info regarding the ADR for cervical disc.
 

Hi. I live in New Brunswick Canada, and desperately need info regarding Ard. I joined this support group, but don't really know if I am doing this the right way. I read this post and I can't tell you how happy I am to see someone from Canada. My disc has sequestrated at C6-7 and so far I have been offered only fusion which I do not want, and also been told by another NS that nothing could be done. There are many horrible aspects to my story, but I now need to find out how to get adr. The last NS I saw claims that the adr technology is being dumped, and that it is not available in New Brunswick, Canada. He claims any positive studies are being promoted only by the disc manufacturers, and no independent studies. Hard to believe. I would volunteer for a study, but don't know how to find who and where there is one available in Canada. Thank-you and apologies for anything out of order as this is my very first ever reach out.

Hi Hasmag, Welcome.

It's possible and likely that your doctors are correct. I've been told pretty much the same things myself, though my condition is not identical to yours.

A quick search turned up this study from 2011, which essentially found that cervical total disc replacement (CTDR) is no better than fusion in alleviating symptoms related to disc degeneration in the cervical spine, and this study from 2012 that found cervical disc implants consistently produced polymeric and metallic debris, which was typically accompanied by inflammation. Hypersensitivity to metal may increase risk for device failure.

I would encourage you to search further for other articles and studies pertaining to ADR. One tip to aid you in searching is to insert the term "scholarly:" (include the colon) before your search criteria. ;)

May we ask why you want this procedure and why think ADR is a better procedure for you than fusion?

If you'd prefer, you might start another thread introducing yourself, and telling us about your specifics (symptoms, diagnosis) and your journey thus far (tests, treatments, etc.) ;)

Doc

How are you managing with the artificial disc now?
 

Dear Ejwblibby;878706; You have been through a lot of spinal interventions,and I really admire the positive attitude you give out. How are you finding the artificial disc now? I have a sequestrated disc at c6/7 and they are saying fusion or nothing, and do not acknowledge that artificial disc is going anywhere here. I also have bone spurs, and bits of the disc are floating around. Much pain and many odd symptoms. Did the artificial disc deal with the pain in your neck and arms to fingers and all that? They tell me that even with a fusion it will not cure the pain. So I get pretty confused. What will happen if I do nothing? Do you just stay on pain meds, or is there a way to get an artificial disc? Compared to your fusions, how to you rate your artificial disc? I so hope that everything is working out for you. Take care!hasmag.

FWIW, Ejwblibby has not been active on NT since January 20, 2013.

When replying to a specific post/poster, it's sometimes not a bad idea to check if they are still active (especially on older posts). You can do this by clicking on their handle, then "View Public Profile". This will tell you (among other info) the Date & Time of their Last Activity. ;)

Doc

Too new to this! and Tech. limited!
 

Dear Dr. Smith; Thank you again! I am trying to learn how to properly move through this support system. I did a brief intro into the new members area, after requesting and receiving the information on how and so on...which I am sure is clearly posted somewhere, but as I say, I am not the brightest light when it comes to using the 'net or the other tremendous resources that seem so easily found by those who know what they are doing - usually from long term practice! The reason I am looking into adr is that there seems to be a long term net benefit, which, I see, is being challenged by the acdf community for lack of better term. I have been told that fusion will clear the pain and all the other complications resulting from the sequestration of the c6/7 disc. However, a lot of people seem to see no clear pain or symptomatic reduction with fusion - some are worse. If I can avoid any surgery that would be great, but I have then no idea what happens over the long term with no disc at c6/7 and the bits floating around, lodging into nerve outlets and here and there. Do you stay on pain medication and continually modify your life - because that's how I have been managing thus far, while seeking a different opinion. My resources are also very limited. I have seen the two supposedly 'top' guys in NS in this province, and have two completely opposite views. One insists on fusion asap, the other claims that none of any of my pain or symptoms can be coming from this disc sequestration, and yes, the MRI showed a large disc sequestration and all those fragments. The whole matter is very confusing and frustrating, there had also been a long term misdiagnosis of this condition - until one very bright and wonderful doc ordered an mri and also recognized what was going on from all the symptoms and PAIN. I've had the injection in joint with lidocaine or similar and steroid, which helped for a very brief time. I've had some trigger point injections which helped the surface area and in a minor way, but any relief... I've done the physiotherapy which made matters much worse. There are also significant bone spurs, and many smaller ones too. The one NS would also like me to do nerve transmission studies (I can't remember what the proper term is) because he finds some of the symptoms unexplainable. However, I have had plenty of time to work on some answers, and have discovered what triggers some of these 'unexplainable' symptoms i.e. when I run or jog, especially down hill, both arms, hands, shoulders, all that area becomes numb and sometimes tingly, and I develop a massive headache, and, of course the pain in the neck goes through the roof. Lifting very heavy things, like bales of hay (I am an organic farmer) causes me to loose the ability to, pardon, pee properly, and creates pain and some other things. Sleeping on my back freezes everything up and I loose sensation of get pins and needles down both arms and a very particular burn/pain only in the right heel. (the disc exploded laterally to the right, by the way,). I have not been able to sleep on the right side for a long time. I am a writer as well, and cannot sit and write at the computer or by hand for any length of time - major neck pain. But the NS did not care to listen, and just decided to investigate things like MS, and do these nerve conduction studies, which, he says, will likely just show that all my pain and other symptoms are muscular. He also doubts the pain. It's very difficult, as he also said he would be willing to go with the fusion as the gold standard, but like the other NS said too, the fusion would not likely help with the pain in the neck or other damage that is already done. So, I read up on the adr, and it seemed like a much better option, but even better would be no surgery, but what to do about no disc and all the pain. If I did not have pain meds, if I had to go through not having any pain medication like I did for the first few years and especially right after it exploded, I would not survive. I do not want to go there.

Sorry, I had to delete the links, they would not let
 

PS. I had to delete your links because they would not let me post a reply with the links in because I am too new! Apologies.

Not being familiar with what you've seen/heard/read, (and being known as somewhat skeptical :rolleyes:) I can't help but wonder if the ADR community isn't engaging in their own proselytizing/propaganda.

Others here will attest that when it comes to spinal surgery of any kind, it can correct mechanical problems, but if they promise it will alleviate/eliminate pain, they're... overly optimistic -- No-one can guarantee that, and the track record with regard to pain (from everything I've read/been told by my own surgeons, and all we know here) is poor (50/50 at best).

I've already provided links with studies indicating ADR has its own list of complications.

ADR vs fusion

Caution: I would weight credible studies much higher than blogs or opinions by patients. Same goes for anything I say as well.

I'd be very surprised if the situation were any different with ADR.

The reasons many surgeons are now taking a much more conservative approach (forgoing surgery except in the most dire/extreme cases) is due to results of studies of long-term results. The body has an amazing ability to heal/protect itself when allowed to.

If you keep searching for the opinion you want to hear, I have no doubt you will eventually find/get one. The question then becomes, are they telling you what you want to hear to get you under the knife?

IMO & experience, this is a life-altering event no matter how you slice it. Regardless of surgery or not, your level of activities will never be what they were, and modifications will be necessary. If you were perfectly sound, this would still be the case with normal aging; the difference is that your spine (like many of ours here) has aged prematurely, and there is no way to turn back the clock, or replace a human spine (which is what I'm told I need).

Medical opinions differ because they are just that -- opinions, i.e. educated guesses. Thats' why it helps to have mutiple opinions, with tie-breakers whenever necessary, and the best we can do is go with our guts and/or the concensus view.

There's an old joke... Patient goes into his/her doctor and says, "Doctor, it hurts when I do this!"

"The don't do that," replies the doctor.

I've actually experienced this firsthand. :o My point is, most jokes are funny because there is a measure of truth in them. Pain is the way your body tells you something is wrong, and not to do whatever it is that causes the pain, so please... stop doing those things, or at least ease up.

IMO, this guy was being straight, and it sounds like he wasn't crazy about cutting either. ADR isn't going to help any damage already done either. As I've said, I don't know what you've read.

What to do? Adapt. Easier said than done? Indubitably. What would you do if you'd (God forbid) been hit by a truck and paralyzed? You referred to it as an explosion; it is a life changing event/occurence. Adapting is not easy -- no change is, but you are not alone. Spinal problems are too common in our species. Engineering-wise, it's part of the price we pay for walking upright. There are many, many support groups like this one.

You've been at life's crossroads before, you're at one now, and you'll be at more in the future. Life is a journey, and unfortuantely, this is a part of yours (and ours). One step at a time. (More posts/discussions ahead.)

Doc