[hbutler87]

#28556

Hello. I came across your forum while searching for patient stories concerning problems with the prodisc c and/or artificial disc replacement. I am a 31 year old who is almost two years (to the date) post-op cervical adr c5-c6 with the prodisc c. Anyway, I suppose I have done fairly well for the most part. Initially, immediately following surgery I was in unimaginable pain and I thinkeveryone, including my surgeon,was a bit surprised. I kept hearing stories from people who had fusions in the c spine that started they basically “woke up pain free.” This was not the case for me. My husband did say, however, that right after the surgery, my surgeon told him I would “probably be a little sore” because he had to “stretch my spine some” as he had some “trouble getting the disc “far enough back.”
As the months/year went by I continued to have extreme hoarseness of my voice and chronic sore throats. I knew this would be expected but I didn’t expect it to continue up to approx. 16 months post-op. During this time, I was dx with three ear infections and laryngitis (both of which I had never had in my entire life); a long with throat infections numerous times. I went through five rounds of ATB therapy total and each time my sx would disappoint only for a very short period of time, only to return. During one of these episodes, I presented to our local urgent care and they did a cervical spine xray just to ensure here was nothing pressing on my laryngeal/esophageal nerve. No acute abnormalities were noted, but the physician informed me that my “implant was anteriorly protruding by 4 cm/mm? I can’t remember” and that I should contact my surgeon. Upon evaluation by him and reassessing my during surgery and 6 week f/u stays, the disc was approx. In the same place as it was during implantation. This brought by surgeon to reveal to me that he had “difficulty getting the disc to go any further in the spine,” stating that he even drilled extra bone trying to fit it and that it just wouldn’t go. So, needless to say, he didn’t see any cause for concern and denied this would be contributing at all to my continual throat issues. I was referred to ENT and he confirmed there was no nerve injury and other than my throat being red, no signs of anything causing my sx. He dx me with acid reflux and advised me to try omeprazole, avoid spicy foods, etc.
Anyway, my reason for posting is to see if you have ever heard of a disc being anteriorly displaced and if so, if it could be cause for concern or possibly the culprit of my issues.
As far as my neck pain, I go through intermittent periods of pain, about every 3 months or so now. My pain, however, has moved locations and now seems to be closer to my hairline and radiates bilaterally on the lateral sides of my neck. I get a lot of “knots” and pain almost directly beneath my ear lobes down to my collarbones. (Lymph node areas perhaps)?
I have several copies of imaging taken over the past two years if you would like to see.
Any advice/comments/suggestions is greatly appreciated. Thanks in advance!

[Donald Corenman, MD, DC]

#28568

One of the issues for artificial disc replacements (ADRs) is they have to be placed in an acceptable disc space. This means there cannot be more than 50% collapse of the height of this space before the disc is considered. If the space is 50% or greater collapsed, the ADR will not be effective due to contractures of the annulus and facet capsule. I will assume that you disc did meet the criteria for an implant.

ADRs are designed not to be placed under tension. This means that there should not be much pressure to keep the vertebra apart when the disc is placed. If the surgeon had difficulty placing the ADR and could not “Get it back far enough”, the ADR should have been converted to a fusion (ACDF). If the artificial disc is protruding out in front by 4mm, I would then assume that there is 4mm of uncoverage in the rear of the disc space as the disc is designed to fit immediately in the very back of this disc space. This might explain some of your neck pain.

A 4mm protrusion in the front may very well impinge on your esophagus and cause difficulty swallowing and sore throat. You can ask the ENT for a barium swallow study to see if the lip of the ADR impinges on the esophagus with swallowing.

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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