Looking for some help (Pro-Disc at C5-C6 and C6-C7, ongoing problems at C4-C5)

[Terese]

Hi Everyone!
I'm so glad to be a part of a site where people can truly relate to me. I'm a 46 year old female and was involved in a MVA in Jan. of 2008. (I T-Boned a car that ran a stop sign) I suffered Cervical, Thoracic and Lumbar spinal injuries. After a year of conservative treatments, (everything except accupuncture) I had a two-level ADR done using Pro-Disc at C5-C6 and C6-C7. This was done by an Orthopedic Spine Surgeon who told me this was the best route to take since a fusion would limit my motion and also cause the levels above and below the fused segments to eventually give me problems. This two level surgery took him less than an hour to do! From the minute I woke from surgery, I had horrible pain in the back of my neck going up into my head. The pain continued and I was told I needed to give it time. During the first year post-op, I was sent by my no-fault insurance company for an IME and of course the doctor (who was just an orthopedic surgeon who did NOT specialize in the spine) said I no longer needed any intervention. Although my private insurance paid the doctor who did the surgery for my visits, his office would give me a hard time because they said he didn't accept my insurance. Even after taking x-rays and feeling that the Artificial disc at C5-C6 was possibly moving, he would not do any surgical intervention until the insurance issue was settled.

In April of 2010, I went for a second opinion to a Neurosurgeon (my no-fault insurance paid him because he wasn't an orthopedic doctor) who said I never should have had ADR surgery, because my injury was caused by trauma, and with trauma you injure the ligaments, tendons, and muscles. He said with a fusion, the ligaments, tendons, and muscles are given the chance to heal and at the same time, the disc problem is also taking care of. After having a discogram in November of 2010, it was found that C4-C5 is now bad. (So much for the fusion theory) The Neurosurgeon feels I need to have the Artificial Discs removed and then have a three-level fusion.

In December of 2010, I had a Infix cage fusion, done by the Neurosurgeon, at L4-L5 and L5-S1. (These levels were confirmed with MRI and Discography) The surgery was done with both anterior and posterior approach. It was a 9 hour surgery and he took bone from my hip to fill the cages. He put screws in the facets to stabilize the spine. He said when he went in, my spine was very loose. For the first six weeks, I had to stay in bed and could only get up to sit in a recliner or to go to the bathroom. I had to use a walker for about the first three weeks. The worse pain was from the bone harvesting of the hip. Three months later, the only exercise allowed is minimal walking. I have to wear a hard plastic brace whenever I'm up and I'm only allowed to walk two blocks. If I'm standing for a long period, I do get an increase of back pain, which is normal, but unlike my neck surgery, I am hopeful that this lumbar fusion is going to work. I'm actually having more pain with my head and neck than I am my back!

I'm wondering if anyone has had artificial discs removed then have a fusion. I'm pretty nervous to have it done, but I also can't live with this pain anymore and they believe that one of the ADR's is moving.

[ajj1001]

no but I'm waiting to go in and attempt a second go at fusing over my ADR. the removal of lumbar ADR is very difficult, not heard anyone having cervical done but I know access is less of an issue in the neck.

alison x

ps welcome to the forum!

[KBear]

Welcome to the forum. Your lumbar surgery/ recovery sounds very normal. It took me 18 months to become completely pain and medication free after my 1 level ADR at that level. The usual healing time varies, but is generally 6 months to 2 years.
On the cervical, I have never heard that because of trauma you wouldn't be an ADR candidate. That makes no sense, and especially since a large percentae of us have back problems from trauma. I was in a wreck with an 18 wheeler and then in a head on collision. No doubt the trauma caused my problems. I've done fine with ADR. Now if your facets weren't good, or some other clinical contradictory reason, then I can see where you shouldn't have received one. Revision is major surgery, though cervical revision is supposed to be a lot easier and safer than lumbar revision.

Best of Luck,
Kathy

[Cindylou]

Welcome Terese, sorry for all the damage that the MVA caused though. In answer to your question, honestly, I wouldn't be pursuing any type of surgery on your neck just yet, given you just came off a second major surgery 3 months ago. Even if it was your lumbar, and not your neck, your body, in general, needs a lot of time for healing to take place. I would really try to give your body a rest from any type of surgery for at least another 12 months before considering anything, and who knows? In that time, your neck may begin to calm down. That's just my 2 cents. My best to you, Cindylou

[Justin]

Terese,

Welcome to the Spine Patient Society.

You have had quite a history with your spine; I do hope you find the SPS helpful.

Welcome to the forum. Your lumbar surgery/ recovery sounds very normal. It took me 18 months to become completely pain and medication free after my 1 level ADR at that level. The usual healing time varies, but is generally 6 months to 2 years.

I completely agree with the bolded statement above.

On the cervical, I have never heard that because of trauma you wouldn't be an ADR candidate. That makes no sense, and especially since a large percentae of us have back problems from trauma. I was in a wreck with an 18 wheeler and then in a head on collision. No doubt the trauma caused my problems. I've done fine with ADR. Now if your facets weren't good, or some other clinical contradictory reason, then I can see where you shouldn't have received one. Revision is major surgery, though cervical revision is supposed to be a lot easier and safer than lumbar revision.

I also agree with what Kathy has written above. ADR surgery for an acute, traumatic event would not be a good thing, but if I read your post correctly, you stated that your had ADR surgery after a year of conservative therapy. Thus, the ADR surgery was not done acutely.

Welcome Terese, sorry for all the damage that the MVA caused though. In answer to your question, honestly, I wouldn't be pursuing any type of surgery on your neck just yet, given you just came off a second major surgery 3 months ago. Even if it was your lumbar, and not your neck, your body, in general, needs a lot of time for healing to take place. I would really try to give your body a rest from any type of surgery for at least another 12 months before considering anything, and who knows? In that time, your neck may begin to calm down. That's just my 2 cents. My best to you, Cindylou

I agree with what CL has written above. I do have a question in regard to your proposed cervical ADR revision: are the ADRs causing pain at C5/C6 & C6/C7 or is your pain mainly from C4/C5?

It seems like removing the ProDiscs at C5/C6 & C6/C7 and doing a 3 level cervical fusion is a huge operation for your pain at C4/C5. Personally, it sounds like the neurosurgeon is being aggressive (explanting two ProDiscs) to fix your problem at C4/C5. I get the impression that he doesn't like ADR and would rather see you have a 3 level fusion, as that is what he/she believes you should have had done in the first place. My point is that if there is really no problem with your ProDiscs (from reading your post above), there is no need to explant them to do the three level fusion --> only C4/C5 needs to be addressed. Remember, I'm just posting my personal opinion.

What do you think should be done with your neck? I would try and think about this in light of the comments about having the ADR in the first place was the wrong way to go about things because you had an "acute injury," makes absolutely no sense to me to be honest. If you had surgery shortly after your injury (less than 6 months), then that would be considered an "acute" timeframe. However, you had surgery on your spine after 1 year of conservative care--thus, there's no way for the treatment you received after your injury to be classified as "acute." If I sound like I being repetitious, I am.

Are you having any problems directly related to your ProDiscs? Subsidence, subsequent facet hypertrophy, poor placement, etc?

I wish you the very best. It's better to really think things through than to "jump right in" to surgery again -- make sure you get at least 2-3 surgical opinions regarding your cervical spine.

Good luck!

[Katie]

First, I'm sorry for what you are having to endure.

My advice would be to send your MRI and X-Ray images out to a number of top surgeons, including International ones. There are a number listed here. I found out the hard way that one or two opinions just doesn't cut it as far as getting the best answer. I think I went through over half a dozen before finding what was right for me.

Can you try to get some pain relief with medication? Making decisions is much easier without having to deal with unbearable pain. Only you know if this is a good option for you, as coming off most drugs is not an easy thing...it is a personal decision, but can make life more bearable.

If you have any more questions, fire away ;-)