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Answers about Controversial Trends in Spine Care

Spine Health | Last Active: Jan 16, 2023 | Replies (35)

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@jenniferhunter

@cbove2 Hello, I am a Mayo cervical spine surgery patient. May I ask a bit about your diagnosis and how a surgeon would address it? That matters a lot in what procedure is done and from what approach.

A Misonix tool is for cutting bone very precisely and I am sure it is valuable, but there will be situations where the tool is of little value that involves something other than bone. I looked at Dr Cantor's website, and he doesn't explain what his approach is. Promoting a new technological tool doesn't tell the whole story, and you need a complete picture to understand the entire problem and various solutions for it.

Fusions are not necessarily bad, and it depends on where it is and how much movement is normal in that part of the spine. Head turning is accomplished by C1 through C4 with very little assistance from C5 or lower levels. I have a single level fusion at C5/C6 and my movement is the same and in normal range with one exception. I cannot touch my chin to my chest, it's darn close though. I have no hardware; only a donor bone spacer. The advantage is the fusion bond is stronger than any hardware to be screwed in, there will never be an immune response to foreign materials place inside, there are no screws to become dislodged or migrate, and the bone retains some of it's flexibility. I know that may sound odd because bones are rigid, but they do flex a bit because of the protein matrix in them. I am over 5 years post op and all other levels are fine. Sometimes adjacent segment disease is going to happen anyway, and even to people who have not already had a fusion. Adjacent segment disease also happens with artificial discs, but possibly at a lesser rate. That is something to ask a surgeon about.

Motion preserving hardware can fail. The spine can try to stabilize it by growing bone around it. There can be allergic reactions to metals that are now part of the spine.

The decision you make needs to be based on all the opinions and information you get, and not just the opinion of one surgeon who loves a specific tool. As much as a new paint brush doesn't make someone a good artist, a high tech tool doesn't make someone a good surgeon. They bought a tool and are using that to market themselves. The tool can make surgeries better if it is in the right hands.

You need to learn the benefits and risks of each procedure and when is the time right to do it. In general, I think active young people tend to want artificial discs so they can get back to activities with shorter recovery times. Fusion healing and bone growth takes time. For me, it was 3 months until the fusion process began to set. Think about how an aging spine will affect the procedure that you choose, and will you have good bone quality as you age? For me, the choice to avoid foreign materials in my body was huge... and I was right about that because when I broke my ankle and lived with some internal titanium plates, it caused pain, inflammation, and I had chronic hives for months that no one could explain. I had them removed after I had healed for a year, and I have not had hives since then. I used to have pierced ears and had to give that up because I reacted to every type of metal that was used, so none of this really surprised me.

It is good to get a lot of respected opinions before you choose. I also watched as many presentations at surgical conferences that I could find online as they discussed different cases, how to solve problems and what to watch out for. Sometimes, the risks are not spelled out so clearly to patients, but when surgeons talk to each other, they are pretty honest about the pitfalls because they are there to teach. One thing to look at is how respected a surgeon is in his (her) own field. Are they presenting and teaching at the spine society conferences every year? Are the institutions they are affiliated with respected? Keep in mind, some surgeons are in this for profit and they may own their surgery centers. Take that into consideration when you are trying to decide if you are getting an objective or a biased opinion.

Can you explain what it means to use a Misonex tool early enough to avoid a fusion in the future? I don't know what that means. Has the surgeon fully explained why he thinks this tool has improved benefits and in what situations it is beneficial?

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Replies to "@cbove2 Hello, I am a Mayo cervical spine surgery patient. May I ask a bit about..."

Thank you for your indepth thoughts. I am 75 years old in November and want to maintain an active lifestyle. When I had the neurology consult with the Mayo PA she was pretty adamant that I would need 2 disks (C5-6 and C6-7) and some hardware with screws. Your mobility sounds excellent. I listened to Dr. Cantor's YouTubes and he indicated that with the Misonix (there are other ultrasonic bone scalpels - this seems to be the latest version with a curved head for better control). The ultrasonic scalpel permits bone work with less blood loss and it does not affect the soft tissue such as nerves, muscle, etc. - less post-op pain and better healing.
I agree that YouTubes and testimonials may not give an accurate picture of a specific individual's scenario. I have not heard from the website after uploading the MRI. I also plan to check with Hopkins and HSS about their protocols. I am not in a huge rush and have travel planned in the spring, so unless healing and recovery would be possible in a matter of weeks, this will have to wait until later and i will have to be careful with my neck and avoid further injury.