[jacobw]

#6728

I have a cervical fusion from C5 to T1 (1995) I had an MRI and discogram done that showed the C3-4 and C4-5 levels are bad. I have tried conservative treatment for over 1 year and I simply can’t live with the pain anymore. My surgeon wants to do a 2 level fusion so that I am fused from C5 all the way to T1. Of course, I am doing my homework to see if there are other options besides more fusions. I understand that you can do 1 level artificail disc replacements in the neck but can you do 2 adjacent levels? Can 1 level be fused and the other get an artificial disc? and how is that determined? If I do the fusions what problems might occur in the future? Do adjacent levels just keep developing arthritis & pain?
Thanks for you time and thoughts.

[Donald Corenman, MD, DC]

#6730

You can have two artificial discs at adjacent levels. There are some insurance and technical problems however. Some insurance companies will not pay for an artificial disc and most will not pay for two.

The artificial disc works best for nerve pain (radiculopathy) without severe degenerative changes of the disc. If the disc is highly degenerative or if there is facet disease associated (degenerative spondylolisthesis), the artificial disc will generally not be effective.

Be careful regarding recommendations for artificial disc implantation. I have consulted with a number of patients on this board who have had these discs implanted for neck pain and have not had significant relief. The good news is that these discs can be explanted and converted into a fusion without much difficulty. That does require another surgery however.

Dr. Corenman

[jacobw]

#6737

Thank you. Dr Corenman. I really appreciate this information.

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