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I recently met with a Neurosurgeon to review my MRI findings. In a nutshell, he said my cervical issues were fairly advanced and that if I wanted to remedy my issues his recommendation would be surgery, specifically ACDF of C5-C6, C6-C7. I asked him about ADR, specifically I have been looking at Mobi-C, and he stated that I was not a good candidate for ADR if you follow the guidelines. He said, and I’m paraphrasing (incorrectly, perhaps), that the ADR can cause hypermobility and would accelerate the formation of bone spurs. It should be noted that he does not perform ADR surgeries as he said there is not yet sufficient statistical data to support that it is superior to traditional ACDF. I’m 30 years old, 5ft 8in 220 lbs and lift weights 5-6 days weekly. I bench ~385lbs, squat ~465-475lbs, and deadlift 500 lbs. I understand that whichever route I go, fusion or replacement (I do intend to get a second opinion), heavy lifting is not advisable if I wish to stay active and lift at all well into my 40s, 50s, and beyond. My question is, with the information above and below, am I indeed a poor candidate for ADR? This Neurosurgeon stated if I proceed with ADR, in his opinion I would be ‘asking for trouble’ down the road.
Here is the summary of the MRI:
1) Central posterior bulging disc at C4-C5 with signal changes suggesting an annular tear
2) Broad-based central/RIGHT paracentral posterior protrusion of the C5-C6 disc with signal changes suggesting an annular tear. There is associated cord remodeling and severe narrowing of the RIGHT neural foramen
3) Broad-based central/LEFT paracentral posterior herniation of the C6-C7 disc with signal changes suggesting an annular tear. There is associate cord remodeling with severe narrowing of the LEFT neural foramen at this level.There is not enough information you provide to predict whether or not you are a candidate for an ADR vs. ACDF. See the thread https://neckandback.com/treatments/artificial-disc-replacement-adr-for-cervical-spine/ to understand the benefits and limitations of an ADR. You need more than just an MRI to predict what is more beneficial (ADR vs. ACDF). You would also need cervical X-rays with flexion/extension views and what disorder is present you are doing the surgery (central stenosis, neck pain, radiculopathy).
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books. -
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