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Artificial Disc Replacement over ACDF?

Hi All,

I have spoke to 2 surgeons about my herniation at C5-C6 . Both are ranked as "top docs" in my area. They have both recommended that if conservative treatment does not work, the best course of action for me is ADR which is a more modern procedure and does not pose the risk of damaging other "healthy" discs down the road (which is the case with ACDF). I have also read the article on this site comparing the 2 procedures. Frankly I am surprised how a procedure from the 1970s is still around today when it limits mobility and could cause faster deterioration of healthy discs. However reading the forums here, I get these sense that the vast numbers are doing ACDF even today? Pardon my ignorance but is the main reason for still going with the ACDF over ADR the fact that it's been around longer and has more success stories? Also is it cheaper and easier to get approved thru insurance vs ADR?  Both my docs were pushing me towards something called a mobi-C saying that ACDF is just not suited for my active lifestyle - I am 39 and before my herniation, I was working out 5 -6 times a week - weights, swimming and running. Now I can barely work out at all w/o significant pain - just doing dishes or driving to work is a chore. Would love to hear your thoughts.


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Comments

  • dilaurodilauro ConnecticutPosts: 13,526
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
  • heaparsohheaparso IndianapolisPosts: 2
    I too am weighing the options.  I spoke with one friend who's wife had the fusion and he had the replacement in two locations in the neck and his recovery was faster.  Her fusion didn't take and they had to re-do it.  That said, I think the surgeons are just more experienced in the fusion but I am like you.  My herniated portion measures 8mm and I get an injection today, hoping to buy a little time before surgery (it's a busy season at work in September).  But I was the same way, very active and now, I am suffering for terrible headaches, nausea and it's all I can do to not want to lay down at all times.
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  • Thanks Ron, I will check these articles out.

  • heaparso said:

    I too am weighing the options.  I spoke with one friend who's wife had the fusion and he had the replacement in two locations in the neck and his recovery was faster.  Her fusion didn't take and they had to re-do it.  That said, I think the surgeons are just more experienced in the fusion but I am like you.  My herniated portion measures 8mm and I get an injection today, hoping to buy a little time before surgery (it's a busy season at work in September).  But I was the same way, very active and now, I am suffering for terrible headaches, nausea and it's all I can do to not want to lay down at all times.

    Thanks for sharing your experience. Your case seems very similar to mine (and yes I get those headaches quite frequently, especially when looking downwards. I am starting to lean more and more towards ADR as well, as long as my insurance approves it. However in a perfect world I'd like to avoid surgery altogether. Do keep me update on your progress. 
  • maehaleymaehaley PennsylvaniaPosts: 322

    I am curious about both surgeries. A recent MRI showed that I have also have herniations at C5/C6. I have terrible, constant headaches/neck/shoulder blade muscle pain and spasms. Medication has been keeping this under control up until recently. I also did not know about the herniations until last week (have been treated for tension headaches for 3+ years). The Neurologist said he would not recommend surgery because I am so young (38). My PCP has referred me to a pain management doctor and to physical therapy. I will wait and see what happens.

    I definitely want to avoid surgery but also want relief from the pain. A few people who I have talked to said don't do a fusion. They regretted it. I see many stories in these forums of failed procedures and more pain.

    What conservative treatments did they recommend for you to try before opting for surgery?

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  •  maehaley said:


    I am curious about both surgeries. A recent MRI showed that I have also have herniations at C5/C6. I have terrible, constant headaches/neck/shoulder blade muscle pain and spasms. Medication has been keeping this under control up until recently. I also did not know about the herniations until last week (have been treated for tension headaches for 3+ years). The Neurologist said he would not recommend surgery because I am so young (38). My PCP has referred me to a pain management doctor and to physical therapy. I will wait and see what happens.

    I definitely want to avoid surgery but also want relief from the pain. A few people who I have talked to said don't do a fusion. They regretted it. I see many stories in these forums of failed procedures and more pain.

    What conservative treatments did they recommend for you to try before opting for surgery?


    I was asked to try PT and pain injections first.
  • itsautonomicitsautonomic LouisianaPosts: 2,561
    edited 08/24/2016 - 3:22 PM
    The reason's fusions are still around is ADR is excluded for many reason's such as facet degeneration ( one of the biggest reasons for ADR failure) , metal allergies, fractures, instability and other issues. Also lumbar ADR is a much more complicated surgury than cervical ADR and the revision can life threatening. But cervical ADR are really stepping up and doctors I have talked with are having good results with them compared to lumbar ADR.  A cervical ADR can be transformed into a fusion if things go wrong alot easier than lumbar.

    If a doctor told me we can try ADR first and if it goes wrong can fuse it with no issues, I would be all over that compared to fusion first if I was not excluded by issues.  That's just me.  Do your reasearch and make sure they have done alot of ADR before operating.

    M6 I hear is the most life like version of ADR, but I cannot verify.
    Do your due dilegence, trust you know your body and question everything if it does not fit. Advocate for yourself and you will be suprised what will be revealed trusting your body and instinct.
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