Hello, cervical newbie here with questions regarding ACD without fusion...

[BJW]

Hi, I'm thankful to all of you who post and offer input/support on this site. I've done most of my reading and research on other sites (ADR Support, Health Boards...), yet I've read some good words here, for sure.

I am (have been) an extremely physical 43-yr. old man with bi-level herniations C5-C7. The diagnosis is DDD, though I'm not convinced that all of my discs are vulnerable to this type of degeneration. I definitely landed on my head at least once and bumped my melon numerous times over the years (construction, martial arts, etc.). My symptoms showed up over two and a half years ago, many years after some of the traumas may have occurred. I am able to manage my pain through a reduction in activities, but I'm not a happy camper and the motor loss is a real drag.

While I steadfastly resisted surgery in the first two years, I am now less hesitant about undergoing the knife as I would like to try and re-gain my strength before the motor loss becomes permanent. Conservative treatment (PT, traction, massage, acupuncture, chiropractic,yoga therapy, etc.) still hasn't corrected my condition. I am sincerely considering ADR with the M6 as an option over in Europe.

Recently I had a consult with a NeuroSurgeon in Calif. who says he can do an ACD without fusion. This doc is adamantly opposed to ADR due to the possible failure of the device and the difficult extraction process of these devices. He says I am not a likely candidate for CED (the minimally-invasive, endoscopic approach) due to the size of the spurs in the spinal canal. I've had 3 MRIs in the past 30 months, bit this doctor has ordered a CT to show exactly how bad my spurs are. I have researched the ACD without fusion to better understand the procedure and the likely outcome. The doctor himself was a recipient of this procedure nearly twenty years ago. He did a great job of explaining it all to me, still, I was unclear about what happens in the space where the disc was removed. He says that the body will fill the space with "cartilaginous" material in a matter of weeks. The studies I have read speak of fusion occurring in this space once the disc is removed. I would rather not have my range of motion decreased because of the body "autofusing" in the years following an ACD without fusion.

QUESTIONS:

1) Does anyone have input/knowledge about what occurs in the space once the disc is removed if no graft and/or fusion is performed during the discectomy?

2) Has anyone had an ACD without fusion and returned to a fully functional, highly active lifestyle for years following the procedure?

Thank you for your valuable time and may everyone be free from pain and suffering!

Brent

[Justin]

Hi Brent,

Welcome to the Spine Patient Society.

I'm sorry to read that you are having spine issues at such a young age. It sounds like you have done a lot of research on your own--this will serve you well when you ultimately decide to move forward with spine surgery.

1) Does anyone have input/knowledge about what occurs in the space once the disc is removed if no graft and/or fusion is performed during the discectomy?

When a portion of an intervertebral disc is removed, the body's response is to "replace" that area with fibrous tissue and/or fibrocartilaginous tissue.

Once again, welcome and we are here to support you!

[KBear]

Welcome Brent and sorry you find yourself in the spinal pain world. I'm not familiar with that particular procedure, but can offer you general advice. I would get multiple opinions, at least 3 or more, ask lots of questions and then make a decision. One doctor may just not like a certain procedure and not recommend it for that reason; but if several doctors say a procedure is not for you, then there is probably very good reason. ADR is great technology and the M6 looks very promising, but ADR is not for everyone. Best of Luck, Kathy

[Katie]

Brent, first of all, welcome to our site. It has been a life saver to many of us. I am not familiar with the procedure you are describing. I had significant problems at C5/6 and several surgeons, very good ones, said that my C4/5 was problematic as well. However because of several reasons, including a severe allergy to all metal appliances, I had a single level done at C5/6 with the Nuvasive NeoDisc in March, made of silicone and a poly webbing covering.

Since it is not embedded in the vertebrae, there should not be the serious problems with revision if it is ever needed. It is just one of many very good options out there.

Justin, could you explain why the space would fill with fibrous tissue and/or fibrocartilaginous tissue instead of laying down bone?

[Keano16]

Recently I had a consult with a NeuroSurgeon in Calif. who says he can do an ACD without fusion. This doc is adamantly opposed to ADR due to the possible failure of the device and the difficult extraction process of these devices. He says I am not a likely candidate for CED (the minimally-invasive, endoscopic approach) due to the size of the spurs in the spinal canal.

Hello and welcome.

I will not reply to your questions because I can't... However, I wanted to note that many surgeons use Ho:Yag laser in their endoscopic procedures, and they can cut or burn most of spurs and abnormal bones within a seconds. I know "burn" sounds dangerous, but this technology is used for past 15-20 years and its nothing now.

I urge you to get a second opinion, because ACD is a big surgery and there so going back after that, and maybe indeed you could be a candidate to more elegant minimally-invasive solution.

All best

[Gilbert P]

Hi Brent



Gil

[BJW]

Thank you to everyone for replying to my post. My attitude is already better in light of the heart-felt, insightful support you offer! I will keep you posted as I find out more about the ACD without fusion.

Much goodness to all.
Brent