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Need Some Right Answers

StingerSStinger Posts: 5
edited 06/11/2012 - 8:42 AM in Neck Pain: Cervical
Like many of you I am frustrated by the answers I get form doctors. I am beginning to believe none of the know much of anything when it comes to spine problems. he science seems lacking at best and the reported outcomes do not seem to jibe with what most patients say.

I for one am sick of the double talk and being told I should not be in pain and other crap like that.

I have problems from C3-4 to ^C6-7 with C5-6 being the worse.

I have ddd at all levels and some foraminal stenosis at all levels. There is compression at C5-6 nerve root and contact with the cord. I suspect that C5-6 is the main culprit. Doctors give me dumb looks and vague answers. I only wish they could feel my pain for a few years.

They are talking about doing RFA. I was on this site and RFA seems to be a very bad thing. About 6 people reported bad stuff and no one reported anything good. That makes sense because burning a nerve sounds pretty stupid to me. It sounds barbaric and unscientific. What the MD tells you and what really happens are often 2 different things.

I asked about ADR for C5-6 as I know 5 people who have had fusions and only one had a good outcome. I have seen fusions done and i lookk more like carpentry than cabinetry. The doc I saw does not to ADR and says that ADR's over rotate and that will make things worse although he did not say why.

I asked him about cleaning the bone growth out of the foraminal spaces and he said that if he did that they bone would grow back even worse. Is that true? That is what LSI does. I contacted them and they sounded too much like a sales pitch and a fast food surgery franchise.

I was told many years ago that traction does not cuase reducibility of a bulging disk. I think that may have been a lie. http://radiology.rsna.org/content/225/3/895.full

I looked into non surgical decompression but that sounded like a scam although there are 5 people in my area doing it. 3 are DCs and two are MDs. I looked for unbiased data on non surgical decompression and could find none. I did speak to a DC who showed me an MRI of one of "his" patients who had an L-5 herniation totally resolved but when I did more research I saw the same MRI on a DXR 9000 site, so he lied.

I am fed up with the dog and pony show. I want real data from real studies. I want medicine to enter the 21st century.


  • Hi Stinger,

    First let me say welcome to spine-health. Did you speak with a doctor about letting a cord compression go? I have yet to see anyone not need surgery and use alternative methods for a cord compression, but then I am no doctor. With cord compression you are going beyond the scope of nerve compression and it can cause other nuerologic issues. Have you spoken to any doctor about the risk of not fixing that level could be? Be careful comparing the cervical spine to the lumbar spine as there isn't a cord after L1. Also there is more room to work in the lumbar spine, so you will see different approaches than with the cervical spine. As far as ADR, that is true some doctors are not using them. However in Europe they have been doing them for quit sometime. I also may mention some people are not candidates for ADR, depending on the condition of the remainder of the neck. As far as the laser procedure, we seldom see anyone in the cervical side who do those. But we have seen more in the lumbar whom have had good results. You won't find many places using that technology and I have yet to see a insurance program pay for it.

    As far as finding data to support which way to go, the data is all over the place. A large part is due to the fact those who do well typically don't stay in the studies. Which is typical of what happens here, those whom do well with surgery are out living normal busy lives. But I can say I have seen plenty of members come here do well with fusion surgery and are long gone. Surgery is not a magic bullet and comes with no guarantees. Most surgeon will give you odds based on what they see as to the amount of relief they can give someone. But then there are the risk of surgery and things can go wrong. If you can manage the pain and are not at risk for paralysis i always encourage members to try all conservative approaches first, using surgery as a last resort. Keep in mind what may work for one person may not work for someone else.

    If they are talking about surgery I would assume it would be a ACDF. The question to be asking the doctor is the risk associated with it and the need for future surgeries. They can do frominatomies to open the other spaces up, but then I am no doctor and there maybe a reason they suspect it may not work in your case. One of the most important things I always suggest to be afraid to get multiple opinions. Spine surgery is unique, in that it does change the structure and mechanics of the spine. You are be a smart consumer looking at all your avenues. So I would keep working with a doctor who can help you collect all the data you need to make a decision.

    Anyway just thought i would stop by and welcome you to spine-health. If I can be of any assistance don't hesitate to pm me. Keep us posted and take care.
  • TamTam,

    I don't know why the are saying the can't open up the spaces. Maybe this guy only does fusions. My bones are healthy.

    This started out as on herniation at c5-6 and now I have problems form 3-4 to 6-7. The T and L spine is fine. I suspect that if the disk fairy cam along and fixed 5-6 I'd be OK. I asked this doc how he thinks I would be if 5-6 were normal and he hemmed and hawed and said I would probably be OK. 2 DCs told me the same thing. They also suspected the 5-6 is the main problem. One says a bit more disk height and I may be OK in spite of the other stuff. Just a couple of millimeters and less pain and spasms. I believe that because I am often pain free after an adjustment but is is short-lived.

    ADR make the most sense to me. The M6 acts like the real thing but the US won't allow it. Maybe it works too well.

    I'm saving my pennies in case something good come along like regenerative medicine for disks and reducing the osteo in a safer and less bar barbaric manner. In the meantime I pray to God that the Dark Ages will end. Give us a break God!
  • Hey Stinger,

    My thoughts are it is adjacent disc disease. One level is not working well so the other disc move wrong to compensate for the bad one. Which also happens to be a negative effect of fusion is adjacent disc disease. Anyway that is my thoughts.
  • Stinger what part of the country are you located in? You seem to have done your research so now you need to find the right doc. That might be easier in a larger city. Finding the right doctor is never easy.

    Good Luck
  • tamtam said:
    Hey Stinger,

    My thoughts are it is adjacent disc disease. One level is not working well so the other disc move wrong to compensate for the bad one. Which also happens to be a negative effect of fusion is adjacent disc disease. Anyway that is my thoughts.
    If an ADR can act like a real disk then it seems to me that ADR should be the treatment of choice. The call fusions the gold standard. Why?

    I really don;t think doctors today put the patient's best interests first. This is not rocket science. It is restoring the joints of the spine to near normal function. Why can't they simply prepare the vertebra for an implant that mimics a real disk?

    Maybe the pain is clouding my thinking but it seem that every time a read about this or deal with a doctor I'm smelling a rat. I don't know if it because they are ignorant or crooked. I suspect a little of both.
  • Kris-NY said:
    Stinger what part of the country are you located in? You seem to have done your research so now you need to find the right doc. That might be easier in a larger city. Finding the right doctor is never easy.

    Good Luck
    I have been looking. What get me is my PCP should send me to the right one instead of the local hacks.

    The thing is no matter who you go to you end up rolling the dice unless you have some inside info. Fining out how good or bad a doc is is not really possible. I cannot even find out what the infection rates are in our local hospitals. That info is unavailable. I do know that the odds of getting a hospital infection in the US are 1 in 20. My hospital may be better or it may be worse. I have no way of finding out.
  • There are reasons that some people are not candidates for ADR. We have seen a few that the ADR had issues. Some one with Soft bones the ADR could sink into the bones. In another person the bone attached onto the ADR and making it no different than a fusion except it created more stenosis. So while ADR maybe the right choice for you it may not be for someone else. Another example I can think of is ADR with stability issues. The rods can sure up a larger section where as ADR would only fix that level. You have to realize that medicine is science. Each person is not going to respond to each condition the same as the next person. Also you have each person having vary degrees of stenosis other things like congenital spaces being small where as someone else may have more room.

    If you know what you want and whom you want tell your PCP to send you to that doctor. If you want ADR call the ADR manufacture and ask them whom in your area does the surgery. They know who they have sold ADR's to, so they have the list of doctors. A large issue that came up with ADR after it was approved in the U.S. is that the FDA found the numbers were skewed and some of the doctors were given high incentives to do the trials. When we look at ADR's in other countries and the success rate it is hard to tell, because they don't use the same measurements we do. I am not saying for ADR or against it. I think each case has to be discussed on it's specific merits. When we get into fusions one level fusions are pretty straight forward and you have some elite athletes whom have returned back to professional sports. But there are still failure rates in those procedures. When we get into multi-level fusions we see failure rates a bit higher, due in large parts to the bone material being used, of course this my opinion. However there is plenty of data to support it. But no matter what kind of surgery there is out there on any part of the body there is always a down side to it. For example I have RSD that I got after a foot surgery. The surgeon didn't do anything, was just a risk of surgery. Stinger you will just have to research and make the best decision based on your condition. I doubt you will find any doctor that will ever make any guarantees as to surgery. For one they are relying onto much none scientific data. They rely on the information the patient gives them to be accurate and many patients withhold information, for a hoist of reasons to it is not relative or they are just not open. So while you are open the person before you may not have been. Hopefully you will find the doctor that will help you and can answer all your questions, they do exist just keep searching.
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