Artificial Disc Replacement M6c

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greenie
Member

March 3, 2012 at 11:15 am

Post count: 1

#5703

Dr. Corenman,

I would first like to thank you for the wealth of information you provide on your web site and YouTube I learned a great deal of about my condition from you. I have multi-levlel DDD most prominent in C5/6, multi level spinal cord compression as well as multi level foremenal stenosis. I also have a congenitaly small spinal canal. I have had x-ray and MRI’s and have seen Neurosurgeon. My symptoms are lower neck pain and numbness and pins and needles than radiate down the left arm and in all fingers but my pinky. I am currently undergoing PT. Although the surgeon said I would be a surgical candidate he indicated I would need multi-level fusion which would obviously impact my range of motion. I researched artificial disc replacement on your site as well as others. The M6c appears to be the most advanced and replicates the properties of a real disc better than anything else I’ve seen. It also appears to offer multi level application as the keels are a better configuration than others that would compromise the structural integrity of the vertebra. I of course want to peruse any and all non-surgical options, but I am very concerned that my condition could cause permanent damage. If surgery is a must can you tell if this disc is approved for use in the US? It appears to only be approved outside the US, but this information might be out dated. I live a very active life style including snowboarding, cycling, kitesurfing and golf. Thank you for your input in advance,

Dave

Donald Corenman, MD, DC
Moderator

March 3, 2012 at 10:15 pm

Post count: 8660

#5704

First, before you consider an artificial disc (ADR), you have to understand if you are a candidate for this disc. Artificial discs work well for the individual who has a stable neck with a reasonably large spinal canal, no significant facet disease and a disc herniation causing radiculopathy.

You have spinal stenosis and cord compression. The ADR surgery can remove the spurs that add to the cord compression but cannot increase the diameter of the congenitally small canal. Any ADR will allow movement and movement can cause recurrent spur formation. Spur formation can then cause recurrent cord compression.

In addition, if there is translation (shifting) of the interface of the implant (as most implants are designed to do), an inadvertent shift of one surface on the other can cause cord compression. This makes the ADR less desirable for your condition.

That does not mean that if you have multilevel disc disease, you could not be a candidate for a hybrid construct of both ADR and fusion. That hybrid would depend upon your imaging studies and amount of cord compression.

The design of the M6c is closer to the normal disc with some attributes that make it desirable. It however has materials that are still untested and may fail under years of continuous loading or exposure to the internal body environment.

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.

Texas Scott
Member

April 10, 2014 at 3:58 am

Post count: 1

#10702

Any updates on how the M6C is performing?

Donald Corenman, MD, DC
Moderator

April 14, 2014 at 7:41 am

Post count: 8660

#10719

I have not implanted or removed this disc yet. I can tell you that I have seen two Synthes discs (Pro disc-C) and one of the Medtronics discs (Maverick) fail. These discs are somewhat similar to the M6C and all failed due to endplate fracture.

The endplate has to support the metal base of the disc. With significant impact, the metal endplate can overcome the strength of the bone interface and fracture, causing the disc to settle into the vertebral body. This obviously changes the dynamics of the disc mechanics and all three patients developed neck pain.

There is a disc (Medtronics Bryan) that has shock absorption built into the disc. The “cushion” between the two endplates will absorb some shock. This may be protective to an endplate fracture failure as the impact forces will be somewhat absorbed by this cushion.

Of course, this also means that this cushion on the Bryan, being active (it absorbs water) can fail over the years by this membrane becoming less absorptive. Only time will tell.

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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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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