Cervical Disc Replacement vs Fusion

Posted by quickray @quickray, Feb 8, 2023

I’m a candidate for surgery due to a bulging herniated disc at C6 C7 in my neck.

The challenge is I’ve met with three surgeons and each gave me a different opinion. Their opinions are outlined below.

Hoping someone can give me any feedback.

1. Perform ACDF at C5 C6 C7. Personally, I don’t like this option, seems a bit intrusive to a problem isolated at C6 C7. Plus I’ll lose range of motion and a 50% chance I’ll be back in 15 years for another surgery.

2. Perform ACDF at C6 C7. This sounds a bit better. This surgeon said I do not need a second fusion at C5, said it’s unnecessary.

3. Perform a cervical disc replacement at C6 and C7. Using the M6 technology, remove the old disc and insert a new one, surgeon said it’ll be a slam dunk for me and I’ll be done in an hour. I like this option the best.

The Number 2 surgeon told me I’m not a good candidate for the disc replacement, says my disc appears calcified on the MRI and that disc replacement is better for younger people (folks in their 30s), I’m 43. He also said he’s worried the artificial disc won’t fuse right.

Other than this disc I’m as healthy as a 43 year old can be. I’m active, run 4-5 miles three times a week, do Judo for over 10 years…

Looking for feedback on which route to go. I was all for the disc replacement until the one surgeon told me I’m not a good candidate for it and said I could encounter those problems.

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@wisco50

Ouch! You have mega allergies, it sounds like. That’s awful. I’m glad my jaw surgeon believed me and that I had no problems. I do know of someone who kept getting problems and as soon as they were removed her symptoms went away - but now she lives with no real joints! 😩
I feel for you on the ankle. Years ago I fell down some steps and somehow landed with all my weight upright onto a concrete floor, landing on one foot and then my leg promptly collapsed. First I thought I’d possibly broken my ankle or my leg in some spot as I couldn’t put any weight on the leg whatsoever. Got to ER and they were totally baffled after XRays showed no broken bones and my leg was already massively slowly from foot up to just above my knee. Still couldn’t put any weight on it.
Turned out I ruptured the ligaments between my two lower leg bones but didn’t break any bones - I was 64 at the time so we laughed at my good bones! I lucked out and with non weight bearing and a boot for quite awhile, it managed to heal up after a few months.

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Thanks, @wisco50 I suspect that the metal exposure of my dental work done at a fairly young age set the stage for metal sensitivities later on. I had the typical silver amalgam fillings. I had stainless steel crowns when I was 9 for a few years, had several root canals in the next couple years, and in my 20's, I got the first set of permanent crowns. Everything had metals in various mixtures back then of course. I think it was around age 40 that I started having trouble with metals in earrings, and since that time, I just gave them up. I do have a lot of other allergies too to pollens, mold, etc.

Your ankle injury sounds crazy. I'm glad it healed and you don't have continuing issues. My ankle is kind of like living with a sprain all the time that can be ok, but then fatigues and it sets it off. Sometimes the alignment of the joint slips a bit. I find if I pull my foot down away from the ankle (by grabbing my shoes) it helps ease it a bit and takes some pressure off. When I need some support, I use some vet wrap and high top shoes/boots. My injury happened falling off a horse that bolted, so it had speed increasing the impact with the ground. Luckily, I didn't injure my spine at all, but my ankle obviously hit first.

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I worked as a nurse and one of the Ortho PAs recommended a specific brand of ankle braces. Your foot and ankle go into them like a shoe or boot. You then lace them up and then they have 3 way Velcro straps that wrap around - I played soccer in my 40’s and early 50’s and I think I might break my lower leg bones before I could sprain an ankle with these on! LOL! I turn/sprain my ankles so easily that I always travel with at least one in my luggage at all times!

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I'm a bit befuddled because I have had disk replacements with fusions. Twice. I mean twice in two different areas. Worked like magic. I wonder if the previous surgeons simply left out that the two procedures were combined? The surgeon who stated your disc was calcified and replacement is unnecessary does not have the newest science or data, or skills or technology. They replace disks because they are calcified, amongst other reasons, anothwr of which is that disk calcification grows more and more spurs, which cut off and otherwise entrap more and spinal nerves, which is why the newer than his education has included the data showing that replacing the calcified disk(s) leads to better outcomes for the longest length of time. Another thing ... any placement of any prosthetic, from knee joints, to spinal disks, to the screws and anchors in shoulders, ankles, etc, are not you know, stock made. Like the heads in classic car motors, and the brake pads on our cars now, stock parts wear out, and so do their replacements. That goes without saying I guess. I am on year 13 of bilateral total knee replacements, and things like falling on ice, weight loss or gain can and will affect the length of my current set of knees, just like it does the knees I was born with so I do not understand why in tarnation a doctor thinks that is a reason to dissuade a patient, outside of he cannot do the procedure you need, so he is offering you advice to not have what you need, which is about his ego and/or practice, certainly not about the best interests of his patient. My personal opinion is to never see that physician again. His interests lie MORE about/with his something, and who knows what that something is, and LESS with what is best for your personal health. As far as the physician wanting to also fuse the other two vertebrae, next to the two where it's dire, that is not uncommon, because often, the two other vertebrae have been bearing the weight beyond what they were designed, because I think you stated c5 and c6 where the dire need exists, and for instance say, stress fracture was the cause of the bulge, or perhaps c5 and c6 were over run with bone spurring, (arthritis,) but whatever the cause, it placed what their duties once were, on their outlying neighboring vertebrae. Too confirm, ask to discuss your xray and mri film with the surgeon. If they can point out what is ongoing, if they can show you how the liklihood of having to go back in in the future is greater than half, because those two outlying vertebrae were not in the best position to have screws and hardware placed for the new disc, from the overstress they already born, then you can understand why the one wants to replace all 4, giving you the best chance for a successful recovery, future, all of the necessary information, with which you can then decide what works for you BUT that outdated old science surgeon? Erase their number from your phone book. Yikes!

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