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Neurology  (Expert Forum)
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Cervical Spine Artificial Disc Replacement Surgery
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MedHelp Member's Question

Cervical Spine Artificial Disc Replacement Surgery

by gdean, Dec 07, 2005 12:00AM
I have been suffering with neck and upper back pain for several years now. I recently had an MRI done which showed bulging discs at 2 levels and effacement of the thecal sac at C-5. I was referred to a neurosurgon who sent me for a myleogram and post myleogram CT scans which showed bone spurrs at C4-5 and C5-6 with severe neuro foramenia narrowing of the left and mild to moderate narrowing on the right at both levels and stenosis at one level. They also noted slight spinal cord compression and decreased filling of the nerve root sleeve at C 5-6. I recently saw my neuroseurgon for follow up and he advised me that surgery would do more harm than good and any benefits from surgery would only last 12-18 months. His advise was to call him back when the FDA approved an artifical disc for use in the cervical spine.  Should I get a second opinion? I know clinical trials for the artificial disc are taking place but are they close to being approved for use in the United States?

Any advise would be greatly appreciated.
Doctor's Answer

by CCF-Neuro-M.D.-PW, Dec 09, 2005 12:00AM
THe main aim of this type of surgery is to prevent progressive neurological disability - so if you have no symptoms or neurological signs such as loss of bladder control, weakness, or incoordination, surgery may not be indicated, and a conservative approach is reccomended.





Artificial disc replacement is still indergoing investigation so is not scientifically proven yet, but promises to be a more natural method of operating on degenerative joint/disc disease. The same reasons for surgery apply as above.



Good luck
Member Comments (13)

by mike1105, Dec 07, 2005 12:00AM
To: gdean
don't make the mistake i made. i assumed my problems were disc/spin/hard (bone) tissue related and quite frankly my symptoms were more severe than yours seem to be. i had severe upper back and neck pain with radiation sometimes to the shoulders, chest, and even arm muscles. my mri/ct myelogram read like yours. just because there are abnormalities does not mean your pain is from those abnormalities. bone spurs, stenosis, narrowing etc are actually "normal" as we age. I had 2 shoulder surgeries and even a minimally invasive neck surgery (foraminotomies at 2 levels that were "abnormal" on my MRI/scans) that did nothing fo me. especially the neck surgery. in fact it may have worsened my pain. I am now 3-4 days into a myofascial release program with a  man named john barnes and now feel better than i have in 5 years. look it up on the internet and do some reading about myofascial pain. even if your spinal "abnormalities" are surgically addressed does not mean your pain will go away. the surgery did squat for me.......myofasciail pain syndrome is "outside the box" for most physicians. do dome research.....

by JoniGO, Dec 07, 2005 12:00AM
Mike,



I went to a massage therapist who specializes in neuromuscular and myofascial release... something like that.  Anyway, it's all out of pocket and I only went twice.  I was not noticing any improvement, but then again, I only went twice and she said it would take several times.  How many times? I don't know.  I sought medical opinion after diagnostic tests--EMG and MRI.  I see the orthopedic DO tomorrow to see what he says about the MRI exam (which DOES show herniation and spurs at C5/6.)  



We'll see what he says and go from there...

Thank you for sharing your experience.



Joni

by mike1105, Dec 08, 2005 12:00AM
To: joni
again, a huge number of people have herniations and spurs. it seems like an AHAH !!!! when you read the report.... hey I have herniations and spurs so that's why i have neck and back pain........ well that ain't always so. in fact I'd bet it is rarely so. Nerve root compression is usually not diagnosed by these tests, but rather confirmed by them. the dx is made by the exam and history, which would show weakness, numbness, in the extremity and even in certain fingers..... neck and back pain alone is not really diagnostic for nreve root compression or disc disease as a culprit in my experience. i have also learned that cord compression is usually painless, and manifests in dysfunction (walking, bowel, bladder for example) so i would doubt the "thecal sac" struff has anything to do with your pain. You could take 100 healthy pain free adults and a large # of them will have compression of the sac, spurs, herniations etc.  i have been at the myofascial center for 3 days and am getting treated 4-5 times per day. once a week for a few weeeks is not enough in chronic cases in my opinion. don't make a mistake. research yourself......

by gdean, Dec 08, 2005 12:00AM
To: Mike1105. JoniGo
Thanks for your input and I will take your advice and do some research. I've already been to the chiropractor and that helped some but then I reached a point where it stopped helping. I have also had physical therapy and several deep tissue massages and benefited from both briefly. I do have tingling, burning and weakness in my shoulders, upper back and occasionally down my arm as well as headaches on a daily basis. I am frustrated that I can't enjoy the things I use to. My husband has suggested trying accupuncture therapy.

by mike1105, Dec 09, 2005 12:00AM
To: gdean
again, my symotoms were worse than yours. i actually laid in bed and did nothing for a year-- the pain was that bad. i began steady, daily stretching one month ago (it hurt ALOT) and it helped-- it made me 25% better. I went to the myofascial release clinic in paoli pennsylvania--- after the first week of my 3 week program 90, yes 90% of my pain is gone. i woke up today pain free for the first time in 3 years. you should at leasst call there and get an information packet. again-- just google john barnes.  i bet you have some sort of protracted (hunched) posture where your shoulders are rounded. waht is your line of work?????   ps. this sounds less and less like a disc problem.... my symptoms were exactly like yours, withthe addition of a very tight and painful chest....  that's my opinion any way. call and get the literature.it can't hurt.

by gdean, Dec 09, 2005 12:00AM
To: Mike1101
I took your advice and checked out the John Barnes website. It sounds like something I could definately from. Unfortunately I live nowhere near Paoli, PA. There are two centers in neighboring states and both are approx 4 hours away from where I live. I hope the treatment works for you and you remain pain free for many years to come. Good luck

by gdean, Dec 09, 2005 12:00AM
To: Mike1105
I took your advice and checked out the John Barnes website. It sounds like something I could definately from. Unfortunately I live nowhere near Paoli, PA. There are two centers in neighboring states and both are approx 4 hours away from where I live. I hope the treatment works for you and you remain pain free for many years to come. Good luck