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Answers about Controversial Trends in Spine Care

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

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@cbove2

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.

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Replies to "Thank you for your indepth thoughts. I am 75 years old in November and want to..."

I just saw more breakthrough spinal technology that I may need in the future for my lumbar disks 🙂 -https://www.beckersspine.com/spinal-tech/item/53538-empirical-spine-advances-motion-preserving-device-for-spinal-stenosis.html?origin=SpineE&utm_source=SpineE&utm_medium=email&utm_content=newsletter&oly_enc_id=8964C3039334A2C

@cbove2 You cannot recover from spine surgery in a few weeks. At age 75, your recovery will likely be slower, and dependent on your health and bone quality. This is something that takes some planning for your care after surgery as you may need help. Major surgery takes a lot of stamina out of you. I slept a lot for 3 months. It may take a year for complete recovery. That is an excellent question to ask the spine specialists that you will be consulting.

Spine surgery is a big surgery and it normally takes about 6 weeks to heal the incision, and bone fusion takes a lot longer. For me the bones were not fusing until 3 months post op when X-rays were taken and no movement was detected in the measurements. As for changes in motion of the cervical spine, your case is similar to mine in that turning your head is done by C1 & C2 mostly, and with help from C3 & C4, and very little from levels below that. You could have muscle tightness that will restrict movement, but physical therapy often helps that.

When a disc is removed during a fusion, it is done with a tool like a pair of nippers. The disc is flexible cartilage. If there are also bone spurs, the surgeon can clean those out. The surfaces of the vertebrae that were in contact with the disc also have to be prepared to accept either a bone spacer or an implant like a cage. The surgeon will grind them flat or shape them to match an implant before putting this together. There can also be arthritic bone growth in the foramen (spaces between vertebrae) where the nerve roots exit the spinal cord that will be opened up by removing extra bone.

You never want to be in a rush to do spine surgery unless it is an emergency situation to save function and prevent disability. One question I asked spine specialists was if they were using neuro-monitoring during the procedure. This is electric nerve impulse feedback so they know that the nerves are working and were not damaged during surgery. I hope that gives you a sense of trends in spine surgery. These are things a surgeon can explain during a consult, but they may not want to worry you with details that could be stressful. I had a single level fusion without hardware and stayed in a neck brace 3 months and that was worth it. You certainly can ask about that if you do decide on a fusion.

Many people don't qualify for an artificial disc because of some spine instability. Are you also a candidate for an artificial disc?

BTW - I saw an article last year that you may or may/not know about -
"California neurosurgeon reverses 3-level cervical fusion with artificial discs" Alan Condon - Thursday, August 19th, 2021
https://www.beckersspine.com/spine/item/52499-california-neurosurgeon-reverses-3-level-cervical-fusion-with-artificial-discs.html