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Cervical ADR vs Fusion

I am new to this forum, I was told to talk to other forums about disc replacement. Here is my story.

I am a 36 year old male, I woke up one day with a stiff neck and the following few days it started radiating down my arm and my fingers started tingling. I waited a few weeks for this pain to go away and it just kept getting worse and worse so my wife insisted I go see a dr about it. He did a few tests on me (pushed down on my head ) "OUCH" and told me that he thought I had a slipped disc, gave me a round of steroids and some anti-inflammatories said to call in 3 days if I wasn't better. I waited the 3 days and it was just as bad he sent me in for x-rays. They were normal...I guess no bone spurs. I was instructed to go to pt. I did 2 sessions and was released because they couldn't help me. They tried traction, made me worse, deep tissue masage, worked for 6 hours, estim with heat, made me worse. I self referred myself to a spine doctor (non-surgical). He ordered an mri and told me (sorry my results aren't in front of me) I had degenerative discs from c1 to t2 except for c4\5 it was normal, I had bulging discs at c2\3 c3\4 c6\7 and c7\t1 and at c5\6 I had a herniation-much larger bulge. It was in my thecal sac but didn't show that it was touching my spinal cord. I had foraminal narrowing in multiple areas (I can't remember exactly where) and I mild stenosis in multiple areas can't remember exactly where either). He wanted to try injections but said he didn't know if they would help. I found out his office where he did injections was 50 miles from my house so I found a pm doctor that would give me the injections.

To date I have had 2 cervical esi's, and 2 rounds of facet blocks. I have not had any relief from them. I have done nothing but gotten worse. I go in 2 days back to my pm doctor for a follow up about my last facet injections. She told me before I had those injections that she didn't think she could do anything else but these and I was looking at surgery.

I have made up my mind that I have no other choice and I have to have surgery. My symptoms now are I have constant tingling and numbness in my left arm, I have tons on muscle loss in my left arm, my neck kills me and my tricep area and my left shoulder blade area. I get migraines like no other and muscle cramps in my legs and feet more my left side than my right.

I haven't talked to my surgeon yet but I am hoping that I am a candidate for artificial disc replacement rather than fusion. I don't think multiple disc replacement has been approved in the neck (cervical) area yet but maybe since it is supposedly just 1 disc that is bothering me.

Has anyone here had disc replacement instead of fusion and what is your outcome, how long should I expect to be off of work? How long is the recovery? I am just worried about being off of work for to long. My job isn't very demanding, not exactly a desk job but very close to that. I run an automation cell which basically means I just supervise a few robots that do the majority of my job. I am hoping to have the surgery in March and be on the home stretch this summer. I know it takes time to heal but I would like to atleast have a pretty descent summer.

Someone on another forum told me that since I had facet blocks done that I may not be a candidate for adr anymore.



  • Has anyone had just a discectomy where they just remove the bulge without fusion? I know it is common with lumbar back surgeries but I don't know how common it is to get this done with cervical surgeries? My wife has had 2 lumbar surgeries both in the same spot and both discectomys. I could only wish it would be that simple.

    Just wondering what to expect...also I had my mri in October 2013 but I feel that there has been some changes in there since then, would the surgeon want another mri since its been a few months and since I feel that something has changed? I don't want him to do a surgery and then find out that more was needed.

    Sorry for the long post just got a lot going through my mind. Trying to stay positive about all of it though.
  • Hey jbnms99;
    Condolences about your problem, you seem to have a lot going on in your neck. You can now do 2 level ADR in the USA, it has been recently approved. The question is finding a doctor who will do it. I think with your issues that fusing one disk will just speed up the issues with the others. It is amazing what the doctors can now do. Good Luck

  • jbmns99, any talk about doing a mylogram ? Indention of the thecal sac could turn into more under weight bearing situation. The cervical is seeing higher success rates for ADR so that is in your favor , but usually in most cases evidence of facet degeneration excludes one from ADR in lumbar and I would guess in cervical to. Would they do a discogram to determine which disc is pain generator or would it be to dangerous in cervical?
    My symptoms are very similar to yours except in right arm and no headaches. Does your left arm feel dead?
    Have you had nerve conduction testing done?
    Herniated T6-7, multiple herniations in cervical, tears in T5-T8. Stenois at levels and smorls nodes from thoracic thru lumbar
  • I've had an ADR at C5-C6, and a microdiskectomy at C7-T1. Oddly enough, the ADR recovery seemed less painful, probably because it's done from the front, and the MED is done from the side/back, going through, or at least disturbing, muscles.

    Before you get too emotionally invested in the idea of disk replacement, check with your insurance. Despite FDA approval, some carriers still consider ADR "experimental" and they will not cover it.
    August 2013 C7-T1 MED
    July 2013 L4-L5-S1 TLIF
    December 2011 C5-C6 ADR
    April 2009 L5-S1 MED
  • jbnms99jjbnms99 Posts: 182
    edited 02/11/2014 - 2:31 AM
    Marlin, I have checked with my insurance (well I googled it) and they say they approved cervical adr in August 2013. Hopefully I am a candidate. I am also worried that a fusion will just speed up the process of the degeneration of my other discs and I would just have to keep going back for more surgery. Thats why I am going to push for the adr if I am able to.

    Anelson15, I have not heard any talk about doing any kind of mylogram, I have thought about asking about it because I believe because I am having leg problems also that under weight (even just standing holding my head) I am causing the disc to bulge more and it is hitting my spinal cord. And I haven't heard anything about degeneration of my facets, my pain doctor just put injections in the joints to try and ease some of my pain. I think it was just in the area of the joint and not actually in the bone so I don't think it would do any damage. Yes definately my left arm feels like it weighs about 100 pounds, I have a hard time doing anything with it, its like I have to tell it what to do before it does it if that makes any sense. I did have a nerve study done the one without needles and I think that was a waste of money. It said that I had carpal tunnel in both of my arms and my doctor tried to tell me that was what my tingling was all about. I have never had any symptoms of carpal tunnel in either of my arms before, not a single tingle. I had to explain to her very detailed that the test was wrong. I have a pain from the base of my head that I can follow all the way down to my finger tips. The headaches are awful. I had a migraine this past Saturday evening that made up my mind about this surgery, life changing or not, I cannot keep getting these migraines, they are absolutely awful.
    In the past I have been worried that this is going to be life changing, but it has gotten so bad in the past couple of weeks that I don't care if it is life changing anymore, I have to get it done before it gets any worse.

    Spine In Security, thanks for your inbox, and this post I really appreciate it, I didn't think that maybe the smaller bulges they could do the microdiscectomy and still do the adr also.
  • anelsen15anelsen15 Posts: 119
    edited 02/11/2014 - 8:57 AM
    This site has many people who saw things on mylogram that MRI did not catch, but there can be complications. I have nerve study and it said exactly the same, I did not buy it nor did drs. Manual testing was negative and often cervical issues give false positive for CTS. I recently had another one but with warmers put on my wrists prior, no CTS and Dr said if your hands are cold natured or cold could give false CTS positive result. Ive had a disc pressing on the spinal cord in thoracic, for me it was not hard to tell it was hitting the cord just by feeling. I dont have that same feeling in neck but many of same symptoms you have.
    They do have upright MRI machines also, you can also do extension/flexion recumbent MRIs. The upright usually have weaker magnets, but I had a 3.8 mm buldge and 3.6 buldge indenting thecal sac in lumbar that was non existant in recumbant so I do believe in them somewhat for certain things. What I am saying is that if you so indention of thecal sac without wieght and you know something not right may be worth considering. Add 3.8 mm with wieght to your herniation identing the thecal sac and it might hit spinal cord for example. Trust your body and knowing exactly what is causing pain will make surgury decision easier.
    Will the surgeon do a discogram prior ?
    Do you have a surgeon in mind? Make sure he has done alot of ADR and look on other forums dedicated to ADR for better information from people that had them done.
    Herniated T6-7, multiple herniations in cervical, tears in T5-T8. Stenois at levels and smorls nodes from thoracic thru lumbar
  • jbnms99jjbnms99 Posts: 182
    edited 02/12/2014 - 4:36 AM
    I do have a surgeon in mind, I am not sure if he will do a discogram or any other testing for that matter. My mri isn't even 6 months old and I wonder without me pressuring him if he would even order another mri? I know that things may not change expecially in a few months but I believe they have and I think that is reason enough to order another mri or other testing.

    When all this started I has some cramping in my arm pit and my tricep area and my shoulder blade. Now I wish I could go back to just that pain, I thought it was bad but now it is 10 times worse. I can't sit for any amount of time, I can't sleep without waking up with pain, I can't type, drive, watch tv, and forget about doing any chores, it takes everything I have just to take out the trash. I have a hard time lifting my arm to bring my coffee cup up to get a drink...I just use my right hand.

    I read somewhere, I don't know where now but it said that you most certainly can have leg symptoms with cervical spine issues (my doctor looked at me like I was crazy). It said if you have a disc pushing on your spinal cord then it will most definately affect your legs.

    I am thankful that my job isn't a hard job and I can still work and plan for a surgery, if I didn't have an easy job I would have been in surgery a few months ago.

    I had to cancel my pm dr. appt that was supposed to be today and it has been rescheduled for next Tuesday, I am going to tell my pm doc that I think its time to talk to a surgeon. Before the last 2 facet injections she told me that was all she was able to do and that the facet injections would probably not work. Now this visit is just a followup and I am going to tell her about my choice for a surgeon and where I go from there.

    I might suggest a discogram to her or my spine dr. just because I don't want to go through this again, I want it done once and done right I don't want to worry about the other discs that are bulging and maybe they were causing some of this pain too and it was all of them together and not just one.

    Thanks Anelson for your support, it is much appreciated!
  • I went for my follow up for my facet injections yesterday, my pm doctor told me she can't do anything else for me and I need to talk to a surgeon. I told her who I was wanting to see and she said great. I asked her about adr and she said she didn't know of that ever being done in the cervical spine ( but then again she isn't a surgeon just a pain doctor ). I told her I would talk to my surgoen about it. She told me it was obvious from the x-rays that she took during my procedure that I was out of align, but the x-rays I had a couple of months ago I was supposedly perfectly in align? I believe her! I am awaiting a phone call from the surgeons office today for an appointment. I hope I can get in fast and get this over with. I will update as soon as I know anything else.
  • anelsen15anelsen15 Posts: 119
    edited 02/19/2014 - 12:36 PM
    No offence but if she is a PM doctor and did not know an ADR has been used in cervical I would literally have trouble trusting her . That screams someone not well versed in new treatments and technology
    Herniated T6-7, multiple herniations in cervical, tears in T5-T8. Stenois at levels and smorls nodes from thoracic thru lumbar
  • LDR is the company in Texas that has received FDA approval for 2 level disk replacement, but the also offer a fusion product that is less disruptive than traditional fusion with plates and screws. Search ROI-C. Your post is timely as I just met with surgeon yesterday. I have herniated disk at C4-C5 and C5-C6 disk is bulging. Same symptoms. Burning pain in left forearm is awful at times as well is tingles and pins down left arm and left torso. Left thumb and pointer finger tips are numb. Been this way since November. Looking to get surgery too but investigating all options. Good luck.
  • jbnms99jjbnms99 Posts: 182
    edited 02/20/2014 - 3:06 AM
    I talk to a surgeon Monday.

    Anelson I understand where you are coming from, the way I see it is she is not a specialist of the spine, she is just trying to take some of my pain away. She said she has heard of disc replacement in the lumbar spine but not very many cases of it in the cervical spine. She thought it was still experimental. I have done lots and lots of homework and I am praying that I can get replacement instead of fusion. But I have always been told that my biggest bulge was at c5/6 and the injection she gave me was c6/7 and that was because she said that was how my symptoms that day were pointing. When she gave me that injection she either hit nerve or the meds did because it really ticked the nerve off, it took 12 hours or more to calm that nerve down. This is 2 days after the injection and I feel 0 relief. Now I wonder if I have 2 levels out and I don't think insurance will pay for multiple level disc replacement.

    Kevinmr8 I will look into this since I think I might need 2 level but I don't think my insurance will pay for 2 level. I certainly can't afford to pay for it on my own, I heard that a single level is upwards of $40,000. If my insurance would pay for it in Texas but not here then I would certainly be booking a plane.
    I have the burning pain in the forearm but also my tricep and my back shoulder blade and the side of my neck, but any pressure on my spine in my neck and I almost go to my knees. I can't hold my head up, I get migraines and all my fingers tingle but my pinky.

    I never thought I would be so excited to see a surgeon. I can't wait!

    Thanks everybody for the support!
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