Where in U.S.A. are the state-of-the-art spine surgery centers?

[spinches]

I live in Oregon and was diagnosed in February, 2011, with moderately severe-severe stenosis at both levels between C 5-7, with moderate to severe constriction of the foramen on the left side at both levels. I have numbness in my left forearm, mild pain from the base of my neck to my left shoulder, and my neurologist said my EMG studies indicate loss of innervation in my left upper arm. She said the results are bad enough to indicate damage, not just irritation, and she thinks that the damage is severe enough to be irreversible.

I have since consulted 4 local surgeons and obtained 4 completely different opinions. None of them want to fuse or replace a disc at both levels from C 5-7. One surgeon offered to replace C 6-7, and another offered to replace C 5-6, but neither would do both, on the grounds that the surgery would be "excessive." A third surgeon said a two-level fusion was required, but he won't do it until I develop clear evidence of myleopathy, and I don't have that. I do have some symptoms (dizziness and dropping things) that may be from spinal cord compression or from other causes. (I have carpal tunnel syndrome in both hands). This guy warned me that I am at risk of being paralyzed if I fall or get into a car accident. He thinks I may have myleopathy in six months to two years, at which point he would recommend a fusion surgery as urgently needed.

I consulted a fourth surgeon last week. He doesn't agree with the radiologist, the neurologist, or the surgeon just mentioned about the severity of the stenosis. He thinks it is "moderate," that I won't develop myleopathy for several years, and that I don't need a fusion or a disc replacement. He offered a foramenotomy to address the symptoms of cervical nerve compression in my left shoulder. He said that it is difficult to differentiate symptoms of C-6 versus C-7 radiculopathy, so he couldn't say for sure which level was generating the pain and numbness. (Another of the surgeons told me that my forearm numbness is from C-6, while the upper arm problems are from C-7).

I feel like none of the doctors will look at the overall picture and discuss a solution that addresses cervical nerve damage and spinal stenosis at 2 levels. They all talk about mimimizing risks from surgery, but most of the solutions they propose will force me to have more than one surgery. None of them really seems very interested in the possible cervical nerve damage, and none of them is willing to act to prevent myleopathy, only to respond after it develops. They all admitted that, once the symptoms develop, they won't be completely reversible with the surgery, but they are philosophically opposed to what they call "preventative surgery."

I am wondering if there are centers in the U.S. where I might receive an overall evaluation and recommendations from a team that is not afraid of multi-level disc replacement, or whatever combination of interventions I might need to address all my nerve issues. If any of the members have information about centers of this type, I would be grateful if you would share it.

Sandra

[KanRunMo]

I'm sure there will be several people who will reply to you about having multi-level ADR in the USA. I know many have mentioned the Texas Back Institute in Austin, Texas. USC and I think another California university were mentioned. Also a place in New York state. I have found the American doctors very reluctant to do much until you are in very severe pain and then unlikely to do anything but fusion or some of the temporary procedures. I hope you get some answers soon.

[spinches]

Thank you for your response to my post. All of the local surgeons I have consulted have told me they won't operate until a disc is clearly shown to be the source of symptoms, and most of them specified "loss of function or severe pain." They have ignored or dismissed what I told them about feeling dizzy a lot, and most of them ignored what I told them about dropping things. I thought maybe their stance was due to their training at Oregon Health Sciences University, as all of them either attended medical school or completed their residencies there. It is interesting that you have observed this surgical philosophy to be national in scope.

Dr. Bertagnoli has offered me a two-level ADR, and I have also contacted Mr. Boeree. It looks like I will be headed to Europe this year.

[KanRunMo]

Your responses received from U.S. Spine surgeons is about what I have found. There are a few in the U.S. who more readily suggest ADR but not many. It would be great to hear from a few of the people on this site who were heading to U.S. surgeons for ADR or have recently had ADR surgery in the U.S.