Hello Everyone from a new member (ACDF at C5/6 and 6/7 recommended, now looking into Spinal Kinetics M6)

[dabourne]

This is my first posting. I've spent a lot of time on the site for the past several days and the information you all have provided has been invaluable.

My current situation is that two surgeons here in Raleigh (NC) have advised ACDF at C5/6 and 6/7 and to do it very soon. This is due to nerve issues mainly below the waste on my left side - hyperreflexia, burning, numbness etc. These things are annoying but tolarable in the short run; however, the docs warned that things will get worse and spinal cord pressure should be relieved soon to stop the progression.

Last week I learned about the Spinal Kinetics M6 on this site and read several threads. I then contacted Dr. L in Beverly Hills (who has conducted M6 trials), Stenum in Germany and Dr. B in the UK. Dr. L said "ADR is NOT indicated for stenosis", Stenum and Dr B said ADR may work and to send MRI' and images. Dr. L did not elaborate on his response and I'm waiting for another reply.

Presently, I'm looking for additional firsthand knowledge about the pros and cons of using the M6 at adjacent cervical levels when moderate to severe stenosis is present. Any information will be appreciated.

Regards,
David

[Justin]

Hi David,

I just wanted to welcome you to the Spine Patient Society.

I have run out the door right now, but I will answers your questions later tonight.

[TSH]

Hi David,
I am 7 weeks post op of ACDF C5/-/7, and had similar diagnosis. I did a lot of research, more than most probably as my wife was diagnosed with cancer again when I was diagnosed with the stenosis and we needed her disease treated before my neck. I read a lot of stuff and was concerned about 2 things, adjacent segment degeneration and loss of mobility if I had fusion. I found dr todd albert at the rothman institute, he is 5 yrs into long term clinical trials on the rate of adjacent segment degeneration with fusion vs artificial disc replacement, and so far he has found no increase in ASD with fusion over the ADR participants. He did not rush me into any decisions and answered any and all question I came with (it was my second opinion). After thorough discussions on my 2 big issues I took the info he gave me and I was able to corroborate all of it. I was a candidate for single level ADR with fusion at the lower level but with xrays he explained and showed me the amount of mobility that I had at those levels and that even if I lost 2-5% mobility that I wouldn’t be able to tell. And he explained that at these levels that fusion with allograft vs autograft (that’s using donor bone from a bone bank) that the fusion will be stronger than with ADR and fusion with NO possibility of failure. If in the future (10+ yrs) I have problems they would use ADR at the upper level. I went with his recommendation of 2 level ACDF and I am doing great, I’ve walked up to 8 miles, I’m using my concept 2 rowing machine, I’m back mowing my lawn and feel better than I have in 8 yrs, he told me no high impact sports until my 12 week follow up but I feel good enough to participate in a trail run and kayak race in late june, I’m waiting for the PA’s call back on what he thinks. I hope this first hand story helps you make a decision, I am very happy with the decision I made and with dr alberts expertise with the cervical spine. Good Luck!

[dabourne]

Hi TSH,

Thanks for your reply and taking time to share the details of your experience. The information was very helpful and I'm glad you're doing so well.

There's just one statement I'd appreciate your clarifying: "If in the future (10+ yrs) I have problems they would use ADR at the upper level." Does this apply to C5/6 and does it mean they would be able to replace the graft with ADR?

Thanks,
David

[TSH]

Hi David, no problem. i'll clarify the best i can, i have (or had) stenosis at 4 levels (discs) of my cervical spine, thats c3/4 - c6/7, both the c5/6 and c6/7 also had more severe disc degeneration and from my neuro test dr albert could tell the nerves affected were coming from both of those levels. both discs were removed and donor bone was inserted which will fuse into one bone, this involved 3 verts and 2 discs. unfortunately once it's fused it's permanent, reversal is not impossible from what i've read but once it grows into one bone nerve damage is nearly impossible at those levels again.

Dr A showed me that at the levels i will be having fused there is very little mobility. i was a candidate for hybrid surgery (fusion at 1 level with ADR at the adjacent level), but he pointed out that the low mobility at the c5/-/7 i wouldn't benefit from ADR to retain mobility and that the risk of failure to the ADR could bring me back to him before the adjacent segment degeneration would.

in our discussion regarding adjacent segment degeneration he said so far there is no higher risk of ASD with fusion than with ADR (he is doing the long term clinical trials on this, started in 2006). he said that the higher level c3/-/5 discs looked normal showing no advanced degeneration and that even at an accelerated rate of degeneration 2 1/2% per year, that i probably will never be back to see him but in the event that i would he would put an ADR at the c4/5 disc level in the future.

so if that happens i will have 2 levels fused and 1 level with an artificial disc. i hope this helps, don't count out fusion, it's easy to get caught up in the appliance discussion but they may not be the best solution for every issue. i'm very active in sports of all kinds and very fit for 53 yrs old, i can tell you that my neck has as much mobility now as it did before, i'm not fully healed yet but i'm very excited over how well i feel, i'll be back bike racing and teaching kayak safety by july!

[dabourne]

TSH,

Thanks for the quick response - your explanation makes complete sense. Once again, hearing your success story has been a great help and I appreciate your advice.

Best regards,
David