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  • greenie
    Member
    Post count: 1

    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
    Post count: 8408

    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
    Post count: 1

    Any updates on how the M6C is performing?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8408

    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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