[Rivervadas]

#34977

Hi Dr. Corenman
I have somewhat of on odd question. I’m in a forum on Facebook with other ADR and ACDR members and one of them just had a revision to fusion. The original ADR used was to large.

I’m wondering if this may be the possible source of my pain.
If the vertebral height is raised to an excessive amount, could this result in Facet problems up and down the neck?

I’m noticing in my X-rays pre and post op how much of a difference there is in the vertebral height. It seems like a very large space.

[Donald Corenman, MD, DC]

#34978

Too large an implant is one of the complications of ADR. This would stretch out the facet capsules and even the annulus to cause pain. However, a more common complication is that there is preexisting degenerative facet disease but it is quiescent due to the lack of motion of the degenerative disc, Removing the disc and placing an ADR allows more motion of the facets which leads to neck pain. A facet block with a pain diary would help to diagnose this condition,

See:
https://neckandback.com/treatments/facet-blocks-and-rhizotomies-neck/
https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections-neck/

Dr. Corenman

[Rivervadas]

#34979

If that is the case, would a revision to fusion and return to a more suitable vertebral height help with the facet issues?

[Donald Corenman, MD, DC]

#34980

Fusion stops the motion which stops the pain.

Dr. Corenman

[Rivervadas]

#34981

Thanks Doc. I think I may do a consult with you. Do you have experience with revisions of this kind?

[Donald Corenman, MD, DC]

#34982

I have revised many ADRs to ACDFs however I am only doing assist surgery. If you would like to have a referral, please call my 888 number and I’ll get you a name.

Dr. Corenman

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