Tell me about your cervical neck artificial disc replacement?
I have moderately-severe C5-C6 herniated disc and bone constriction around the spinal cord (congenital spinal stenosis and narrow / ovalized spinal canal)
I have INCESSANT burning pain between my shoulder blades, that is killed by riding and physical therapy for the surgery I had in my low back.
Planks, cross cable work, elliptical trainer usually leave me hurting for 4 days)
Doctor suggest we can be conservative OR do an anterior fusion, or possibly a disc replacement.
Mt Shasta and Whitney
Cat 3 road racer in cycling crazy Sonoma county, Ca
19th at Sea Otter XC
2nd age group at pacific grove triathlon )lost to course record holder!)
I'm not going to tell you about my surgery, although I have had treatment for C5 and C6 radiculopathy at times. This web address discusses lumbar disc replacement surgery, but it will help.
Meticulous patient selection makes disc replacement safe, effective | Orthopaedics Today Europe
I'm posting it because I refer to Matthew Scott-Young and I have seen one of the disc replacement prostheses he designed. That was 4 years ago and since then newer devices are being made. Among them would be cervical disc prostheses.
The reason disc replacement has become mainstream is that discectomy and intervertebral fusion offer incomplete remedies as follows. Before you prioritise your treatment options, please consider your own case in detail and know that cervical disc replacement is far less established than lumbar disc replacement (for now):
If you have local pain from a disc tear or disc instability, it needs to be fused or replaced because it is the source of pain. Prolonged instability will eventually contribute to adjacent joint injury and arthritis. Bone spurs develop causing more physical compression of nerve roots, or even the spinal canal dimension itself. Note that some of us have congenital or "normal for us" spinal stenosis. New surgical procedures for spinal stenosis are coming along, but for the purpose of this thread, spinal dimension as relevant to disc surgery is all that matters.
If you have referred neural pain (radiculopathy) caused by proven herniation of disc contents, with or without extruded hard disc-casing (annulus) physically impinging the nerve trunks as they leave the spine, then you need that nerve compression relieved. Severe nerve compression usually causes loss of power and function as well as pain and altered sensation and delaying appropriate surgical management may lead to permanent physical impairment.
However, radiculopathy is not usually due to severe nerve compression, but more likely from nerve irritation or inflammation. If you have bone spurs impinging nerve outlets as above, you may be able to relieve the referred pain by reducing the compression with an over the door cervical traction device (a cheap mechanical bag of water, neck traction system you control). In more severe cases some oral steroid can help (there are significant risks using oral steroids so this is just information, not recommendation of any kind) to remove swelling and therefore the referred pain. While that sounds like a half-hearted and temporary treatment, most of these cases have had anatomical pathology for years before the symptoms develop. If your referred pain has been a recurring problem over time, without any causative injury and you have not lost muscle bulk or power, then surgery should not be at the top of the option list until your local and referred pains are proven to be from the disc.
Discs are bonded to the vertebral bodies above and below. Removing bony spurs way back near facet joints is not likely to be possible via an anterior approach discectomy, but however they are nibbled away, stopping regrowth is optimistic. Spurs will certainly not be removed during microdiscectomy. Microdiscectomy also cannot prevent the extrusion of remaining nuclear disc material and recurrent impingement in an active, young person, with consequent recurrence of symptoms.
Mate, what you need to do is have a really hard look at the history of your problem. If it is acute and loss of function is the problem, then surgical treatment may make a huge difference to your future function. If it is chronic or recurrent and pain is the main problem, then surgery must follow conservative treatment options.
While this may seem out of left field, not all radicular symptoms are due to nerve irritation and impingement. Some can be due to compensatory or protective responses within your body precipitated by primitive reactions triggered via residual foetal anatomy. Myotherapy can "relax" responses in systems distant to the site of disability. Sciatic pain may have a ligamentous origin in the pelvis and arm pain may be referred from central chest structures responding in chain to postural and injury warnings from the upper abdomen.
Disc replacement surgery makes real sense compared to available options, but is not always the best option. Regardless, it will not fix symptoms caused by anything other than disc pathology. Cervical (neck) disc replacement is far less established than low back disc replacement. The neck is so mobile and self-repairing that intervening surgically has to be the correct option and as with any part of the spine, surgical intervention is not always going to improve physical function, just hold the rot.
Having said all that, recovery time after anterior disc replacement is fast. Post-op function seems to be as good or better than lesser surgical options in my experience and if you have a good surgeon you will know that disc replacement is the treatment option best suited to you. Just remember that riding up steep hills, swimming and other activities will continue to take your neck to an extended position that will impinge nerves if you have pathology other than a buggered disc.
All the best
I am a physical therapist, but, I want to hear how you recovered
I am 14 years a physical therapist (physiotherapist), and have had lots of complicated cervical fusion patients, but want to hear from healthy/athletic, non-smoker, non-diabetic disc replacement recipients.
How was the first week, month, 2 months etc.
Tell me your good or bad experience.
Star stevenson MSPT
I had cortisone injections at C7,T1 in the center and one through the side of my neck 2 days ago to relieve hand numbness and tingling between between my shoulder blades.
A surgeon who looked at my MRI said I have disc herniations at C34,56, and 67. Bone spurs also present.
His only suggestion was a 4 disc removal and fusion with plates front and back.
No discussion of disc replacement, micro surgery or anything else.
I sent my MRI to North American Spine, who I found on line. They said they could do a laser repair and cauterization of the disc bulges. I don't know if they are reputable and need to do more research on the doctors involved.
Right now I am hoping to control symptoms with the cortizone injections, home traction, foam rolling and other stretching.
I am 53. I'll probably need surgery sooner or later but will put it off until it is really necessary.
Star, how old are you? You sound like a younger guy, and I would think that would be a consideration in what choice you make.
It also seems like getting multiple options is important, as there are a lot of different approaches and philosophies on this.
41 year old and did receive temp help from injections
I am 41, I did enjoy temp relief from epidural injections, but mostly I now have to avoid: my bike, doing pull ups, swimming, elliptical trainers, push up and planks (essentially arm use or prolong sitting will make the area between my shoulder blades hurt for 4 days)
Originally Posted by smilinsteve
I'd be interested to hear your explanation for pain between the blades after those activities. Midline pain from those activities sounds mechanical rather than radicular.
C5-c6 HNP often refers pain to sub-scapular and peri-scapular area
Originally Posted by Ridnparadise
Google clowards signs
Thanks for an informative post. I misunderstood your pain as being midline.
You seem pretty certain you have discogenic pain. That makes disc replacement or fusion logical, but you have concerns re cervical disc replacement despite knowing that it offers advantages over fusion. Please explain!
My concern would be whether surgery was indicated at all. It takes years for significant spinal pain to reach steady state. Pain outcomes seem almost independent of treatment pathways. Often that steady state is not terribly painful or disabling, as you know. You must have other concerns from your posts.
Can't say enough good things about Dr. Pablo Clavel and the Barcelona Spine Center at Hospital Quiron. First class operation blows the US hospitals I have been too out of the water.
I had my lumbar done for 40k, massive problems walking were totally fixed! From what I heard cervical is way less painful and far more effective ( since the neck carries much less weight ). When I was researching I read about an extreme skier who had two M6-C s put in. He said he took a fall straight on his head and the discs just soaked it up .. I believe the M6 cervical adr is 10x more durable than natural human discs.
Best to go outside the US though, as thanks to the FDA and patent BS we are 10 years behind the rest of the world. The extra 20k or so beyond what you would co pay here is well worth it for something that is built to last and minimize irritation/reaction. The M6 has been used for 5 years and implanted over20,000 times, it is accepted as the best adr in the world.
Dr Clavel should review your x-rays/mri free, I believe stenosis can be a problem with the procedure if it is too advanced.
I would say pay to have a video consult with him, if surgery is an option, and see if you are better off waiting till its crippling. btw, the spainish nurses are dolls!!
I am the OP on this thread:
Cervical Fusion Recovery TImes?
Lots of good info in there about my surgery and that of several others. Mine was C5-C6-C7 anterior double fusion with artificial discs. Hard to believe that was 6 years ago. Edit: After re-reading, it sounds like you might be considering the discs that are jointed so you don't need a fusion? Just to be clear, mine are solid and I have a titanium plate fusing my neck. The jointed disc replacements were in clinical trials when I had my issue six years ago - I didn't want to be a guinea pig.
I have had to make very few concessions. I ride XC/DH/Enduros. I do weeklong road bike tours, ride a motorcycle, hike, basically do everything I did before except lift heavy weights over my head, which is a no no becasue of the pressure that puts on your neck.
I have a favorite pillow and sleeping position, and I suffer a little if I sleep wrong.
Knock on wood, I hope to never have an issue like that again, but as you probably know, anyone with a cervical fusion is more likely than average to need another one, and since I have a two level fusion, I have heard the probability of me having another disc issue at some point is about 35%.
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