Would you consider this Mobi-C failed and what would be the next step?

Posted by danylko @danylko, Sep 7, 2022

I don't want to get into a very long post but I'm have lots of hypermobility and instability issues going on. The pain isn't much of a problem more than it is that I'm not feeling stable and it makes it impossible for me to even sit in a car.

Anyway, I'm going to share my 3- month post op that my surgeon said "This looks fine and it's just a bad X-Ray"..... over a year later, still the same issues and other surgeons say different things.

Would love to know what someone here thinks. I have tons more images including more x-rays later on and a CT scan.

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@rball202

Good evening Jennifer
Sorry it took me so long to reply,work has been very busy.
I have tried physical therapy and see a chiropractor often. The chiropractor does help,with not only my back but my neck also. I have never heard of MFR therapy. I will certainly do some research on it. My issue is if insurance doesn’t cover it I can’t afford it.
As far as horseback riding it sounds like an excellent way to work on core strength. I will check on that also. I am retiring on November 1st so I will have more time to work on different ways to help my kyphosis.
Do you know anyone that has had spinal fusion surgery to fix kyphosis? I would love to talk to someone who has had it done. Actually I was reading that more elderly patients were having a lot of success with it.
I really think mine is been like this for so long surgery might be the only thing to fix it. But something tells me the surgery is way too risky so I just need to live with it.
Thank you for all your advice.

BTW I saw the video about the portrait of your surgeon. You are a very gifted artist.

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@rball202 Jeff, thank you very much! I loved painting the portrait of my surgeon and he loved it too! It has a place of honor in his home. I had been losing the ability to control my arms until I had spine surgery at Mayo. It was life changing for me. It was a lot of work putting the video together and I like to watch myself paint it when I need something uplifting. I like the music too!

I don't know anyone who has had surgery for kyphosis. Perhaps there will be some other members who can share that type of experience. It really would be a big surgery with a long recovery time, and not something to rush into. I do understand financial issues and needing insurance to pay, but it may be worth it to pay for some sessions of MFR to see if it helps. If you can avoid surgery, wouldn't that be worth it?

The way that chiropractors work with direct force to the spine makes me question the safety of doing that if there is a problem with a disc. All I had to do to rupture my disc was turn my head, and I heard it pop and my head turned further. It had been bulging for several years. When a disc gets injured, it can develop small cracks, and then they dry out with aging and those cracks can open up and the disc can herniate. Once that happens, there is inflammation, and it can start the growth of bone spurs. That happened to me, and the bone spurs were growing into my spinal cord. That became a problem that needed surgical intervention. You could have disc issues related to your kyphosis.

My husband just retired, and there are lots of things that need to be addressed with insurance and Medicare, etc. We made sure to select real Medicare rather that a plan that replaces Medicare and that may not be accepted at Mayo. I actually called the Mayo billing department about which Medigap plans would be accepted, so I know I would be covered if I should need to come back for treatment.

The picture on my avitar is my older horse. I have a younger horse that I ride and I had a custom saddle made for him. There is a nice trail about 5-6 miles long near where he is boarded that is a nice ride. For safety, I always ride with others.

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@jenniferhunter

@rball202 Jeff, thank you very much! I loved painting the portrait of my surgeon and he loved it too! It has a place of honor in his home. I had been losing the ability to control my arms until I had spine surgery at Mayo. It was life changing for me. It was a lot of work putting the video together and I like to watch myself paint it when I need something uplifting. I like the music too!

I don't know anyone who has had surgery for kyphosis. Perhaps there will be some other members who can share that type of experience. It really would be a big surgery with a long recovery time, and not something to rush into. I do understand financial issues and needing insurance to pay, but it may be worth it to pay for some sessions of MFR to see if it helps. If you can avoid surgery, wouldn't that be worth it?

The way that chiropractors work with direct force to the spine makes me question the safety of doing that if there is a problem with a disc. All I had to do to rupture my disc was turn my head, and I heard it pop and my head turned further. It had been bulging for several years. When a disc gets injured, it can develop small cracks, and then they dry out with aging and those cracks can open up and the disc can herniate. Once that happens, there is inflammation, and it can start the growth of bone spurs. That happened to me, and the bone spurs were growing into my spinal cord. That became a problem that needed surgical intervention. You could have disc issues related to your kyphosis.

My husband just retired, and there are lots of things that need to be addressed with insurance and Medicare, etc. We made sure to select real Medicare rather that a plan that replaces Medicare and that may not be accepted at Mayo. I actually called the Mayo billing department about which Medigap plans would be accepted, so I know I would be covered if I should need to come back for treatment.

The picture on my avitar is my older horse. I have a younger horse that I ride and I had a custom saddle made for him. There is a nice trail about 5-6 miles long near where he is boarded that is a nice ride. For safety, I always ride with others.

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Jennifer. I can only imagine what you were going through. You are very lucky that mayo was able to resolve this problem. I am very worried that one day something like that might happen to me. I know when the spine keeps curving forward a lot of bad things can happen.
I am not in a big hurry to have surgery. Now that I am retiring I have more time to address the problem. It just years and decades of this is weighing on me. I know when people look at me that’s what they see. That’s what I see when I look in the mirror. The only natural thing u want to do is what will fix the problem quickly. I know the surgery is very very risky and probably at my age too late but it can’t hurt to dream.
Sounds like horseback riding is your getaway. I would love to have a horse and ride every chance I get. My getaway is I love to walk. Played competitive racquetball for years. Now I love to play the fastest growing sport in the world Pickleball. I just like to stay active. I’ve heard a lot of stories about people who retire get very depressed. Sorry I’m kinda rambling now. Anyway I think I’m going to see someone here soon to evaluate my condition and go from there. Thank you for all your advice! Jeff

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@jenniferhunter

@danylko I am a spine surgery patient from Mayo, and I had to decide between artificial disc and fusion of one level at C5/C6. I had read a lot of research before I made that decision. I wasn't a great candidate for an artificial disc because I had 2 mm of slipping of my vertebrae past each other. In clinical trials, having 4 mm of slipping disqualified patients from getting an artificial disc. Other things that can happen are that the spine can grow bone around an artificial disc to try to stabilize it, and mechanical devices can fail. There can be immune responses to foreign materials in the body. Screws can pull out and devices may migrate.

I chose fusion over an artificial disc.

Here is some information on case reports of failure of the Mobi C artificial disc. This link to an abstract in the Journal of Neurosurgery allows you to download a PDF version of the article for free.

The Journal of Neurosurgery
https://thejns.org/spine/view/journals/j-neurosurg-spine/33/6/article-p727.xml

The Nerve
This case literature from Korea describes mechanical failure of the Mobi C that caused paraplegia in the patient that was addressed with emergency surgery.
https://www.thenerve.net/m/journal/view.php?number=237

Seattle Science Foundation
Here is a surgeon's presentation at the Seattle Science Foundation about Mobi C failure:

It helps to first understand a little bit of terminology when the doctor talks about the "ALL" and the "PLL".
That is the "Anterior Longitudinal Ligament" and the "Posterior Longitudinal Ligament" and these stabilize the spine running the entire length of it in front (anterior) and back (posterior). He discusses that part of these ligaments that were removed during surgery may be a possible cause of Mobi C failure.

This link shows the anatomy of ALL https://radiopaedia.org/articles/anterior-longitudinal-ligament?lang=us
This link shows the anatomy of PLL https://radiopaedia.org/articles/posterior-longitudinal-ligament?lang=us

The annulus is the fibrous outer layer of a spinal disc.

ADR is the name of the "artificial disc replacement" surgical procedure.

Video
"Mobi c failures in cervical arthroplasty patients Varun Yadav, MD"

https://www.youtube.com/watch?v=Q_35A1pa9kI

I agree with Amanda, that an opinion at a different facility with a spine specialist would be a good idea. To my eye, your imaging looks similar to what is presented in these cases on Mobi C failure, but because this is a patient forum, no one can give you a diagnostic answer. That must come from a specialist in the field. Not all surgeons do disc replacements. Some only do fusions. My surgeon at Mayo (Jeremy Fogelson) did both fusions and disc replacement and he was a valuable consult for me a few years back. I have not had any other spine issues and I am 6 years past my spine fusion surgery.

https://www.mayoclinic.org/biographies/fogelson-jeremy-l-m-d/bio-20055624

Do you have a spine specialist in mind for an opinion about your Mobi C disc?

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@jenniferhunter So how is your neck now? I have Mobi-c since 2019 and actually think to revise it since I never felt good since the surgery plus I seen some bone growth around it.

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@robson78

@jenniferhunter So how is your neck now? I have Mobi-c since 2019 and actually think to revise it since I never felt good since the surgery plus I seen some bone growth around it.

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@robson78 Thank you for asking. I has been 6 and a half years since my one level C5/C6 fusion and I don't have neck pain related to the fusion. My head turning is full range the same as it was before surgery because C5/C6 doesn't do much toward head turning. Periodically, I feel the scar tissue tightness from the incision, and take my hand and stretch that out. The problems I do have are because I also have thoracic outlet syndrome which makes one side of my neck too tight, and a muscle spasms can actually start turning my vertebrae. As long as I keep all that aligned properly, everything is fine. If things start to twist, I get a one sided headache on the back of my head, or jaw and ear pain until can stretch and get it realigned again. I have worked with a physical therapist o this. I think it is importation to keep my neck lined up correctly to reduce wear and tear on adjacent discs as I do not want to need another spine fusion.

Do you have a surgeon who is going to revise your artificial disc surgery and perhaps do a fusion instead? I know that bone growth around an artificial disc is a risk of that surgery.

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Thank you for your response. I hope I will find one that can revise it. Do you have low profile fusion or one with plate?

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@robson78

Thank you for your response. I hope I will find one that can revise it. Do you have low profile fusion or one with plate?

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@jenniferhunter forgot to tag you in my reply

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@robson78

Thank you for your response. I hope I will find one that can revise it. Do you have low profile fusion or one with plate?

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@robson78 I had a fusion with no hardware. It was done with only a bone disc spacer and a neck brace. That was a good decision for me to avoid hardware. It took 3 months in the brace for the fusion process to begin.

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@jenniferhunter

@robson78 I had a fusion with no hardware. It was done with only a bone disc spacer and a neck brace. That was a good decision for me to avoid hardware. It took 3 months in the brace for the fusion process to begin.

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@jenniferhunter oh wow I don’t think I ever seen that before. I wonder if there is anything special in to that. Thank you for letting me know about that.

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@robson78

@jenniferhunter oh wow I don’t think I ever seen that before. I wonder if there is anything special in to that. Thank you for letting me know about that.

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@robson78 This is the way they did fusions before the plates were invented with no hardware. Not all surgeons will do this, and they have to be able to trust you to follow directions and stay in the neck brace 24/7. It wasn't that hard and it went by faster than I thought. I mostly slept a lot. The plates give the surgeon some peace of mind that his work will be stable while it heals, but the plate isn't needed anymore after the bones are fused. After that when you wean out of it, your neck is weak and you need some physical therapy. I had concerns about allergic reactions to metals in hardware because I had so many issues with pierced earrings that I had to give that up years ago. This was a great choice, and I don't have hardware problems like others describe or pain when weather changes, etc. Given that you've already had bone growth around an artificial disc, I'm guessing you would heal well with a fusion.

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@jenniferhunter

@robson78 This is the way they did fusions before the plates were invented with no hardware. Not all surgeons will do this, and they have to be able to trust you to follow directions and stay in the neck brace 24/7. It wasn't that hard and it went by faster than I thought. I mostly slept a lot. The plates give the surgeon some peace of mind that his work will be stable while it heals, but the plate isn't needed anymore after the bones are fused. After that when you wean out of it, your neck is weak and you need some physical therapy. I had concerns about allergic reactions to metals in hardware because I had so many issues with pierced earrings that I had to give that up years ago. This was a great choice, and I don't have hardware problems like others describe or pain when weather changes, etc. Given that you've already had bone growth around an artificial disc, I'm guessing you would heal well with a fusion.

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@jenniferhunter Thank you for letting Me know all this info. I appreciate it.

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