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  • musicman45
    Member
    Post count: 2

    Dr. Corenman,

    I have cervical damage from C-2 down to T-1. It all started from a car crash,where C-5/C-6 were ruptured,and I had a failed anterior cervical fusion,where my bone graft popped out two weeks after surgery,and the surgeon decided not to put in a new graft bone,stating my body would absorb the bone graft.Basically,I walked around years with no fusion,as no doctor would touch me after seeing the failed surgery.Consequently,the discs above,and below began to degenerate due to pressure,and I now have ruptured disc from C-2 ,down to T-1.I am disabled with pain & numbness in my head,neck,arms,hands,and now have frequent episodes of Basilar Invagination. Doctors in my area suggest a solid fusion all the way up,which will result in a total loss of range of motion,or fusing C-5 to T1 using (rhBMP-2),which I’ve heard many bad things about,as it is not an FDA approved method for cervical fusion.

    To the point. I’ve been researching patients who have had ProDisc-C multilevel cervical fusions with good results.I have moderate to severe narrowing of the foramen,spurs,anterior,and posterior herniation from C2- down to T1.I know this can not all be repaired.However,I’m asking if ProDisc at multilevels,and a combination of standard fusion with plates,& screws would be a viable option to get some relief for me ?

    As for the bouts of loss of balance,I have read your post on Basilar Invagination,and know that that is a separate procedure.Any help or advise would be greatly appreciated.I have recent MRI’s and reports.

    Thank You

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    You have different pathologies that can cause various disorders. You note a pseudoarthrosis from a prior surgery at C5-6 that you have lived with. You note multiple levels of degenerative disc disease. You note “frequent episodes of Basilar Invagination”.

    Basilar invagination is a disorder in which the dens (the head) of the second vertebra pushes against the spinal cord at the foramen magnum (the exit of the cord from the skull). This causes very different symptoms (Arnold Chiari syndrome) than lower cord compression. Do you really have basilar invagination along with everything else?

    Fusion of “everything” in the neck is normally ill-advised and only rarely necessary. Prodisc C at multiple levels is rarely necessary and not FDA approved at this point. Insurance companies will not approve multiple levels of artificial disc replacement at this time.

    Balance issues could originate from myelopathy secondary to lower cord compression or from inner ear problems as well as from basilar invagination. You might need a second opinion to understand your diagnosis and options.

    Dr. Corenman

    musicman45
    Member
    Post count: 2

    Thank you Dr. Corenman,

    To answer your questions,It was suggested by a local neurologist,and neurosurgeon that I could possibly have Basilar Invagination,due to the presence of large spurs,or other unknown bone formation protruding from the top of C-2 detected by the MRI.That along with episodes of losing total balance led them to this conclusion,after checking the inner ear,with negative findings .

    The question I can’t seem to get answered is, if any of the compression from the C-5 to T1 could be causing the frequent loss of balance,which usually occurs after upper body, arm activity from lifting,or pushing etc. ? I have a lot of pain at times in the back of my head at the base of the scull around the Sternocleidomastoid,or just the mastoid muscles .Only seems natural that once these muscles get into extreme spasam,that it could possibly have some effect on balance,as the mastoid connects to the scull near the ear ? Just guessing on my part ?

    At any rate,thank you very,very much for the info relating to ProDisc,and the lack of Insurance companies willingness to cover such procedures.You’ve been a great help,and I will save my money for the ProDisc surgery !
    Thanks Again !

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    Basilar invagination should be obvious on MRI scan. Symptoms are somewhat similar to myelopathy but there are other potential symptoms somewhat different such as headache, dysarthria, among others. Your physical examination should display hyperreflexia, Hoffman’s sign, clonus, imbalance among other signs to confirm irritation to the cord.

    Imbalance is generally not specifically related to neck pain. I have patients walk into my office with severe imbalance from cord compression and not even know they have a neck problem. On the other hand, severe degenerative changes of the neck can cause both neck pain and cord compression leading to balance issues.

    Hybrid procedures such as an artificial disc at one level with fusion at other levels seems to work well but the time to the disc wearing out is still unknown.

    Dr. Corenman

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