[OswaldOtte]

#33764

I had an acdf c6-c7 with Peek implant in february 2020. CT scan 1 year post acdf shows no fusion. I am having a lot of pain in my neck. Surgeon says this pain might be from incomplete fusion, but also from the herniated disc between c5-c6 or even from my facets that have arthritis. He wants to redo the c6-c7 and also do c5-c6. I very much regret having the 1 level acdf. Getting a 2 level acdf to me sounds completely crazy. Especially since c3-c4 is also bulging.
I would like to hear your opinion on 2 things:

1)Stem cell therapy for c5-c6, and maybe even c3-c4. Is this a therapy that works? And what are the risks? If it goes wrong, I can still have the level fused. So to me the risk seems low?
2)Replacing the c6-c7 fusion with an ADR. I have read that this has been done by some surgeons already. What is your opinion? What are the risks?

Thanks in advance.
Oswald

[Donald Corenman, MD, DC]

#33765

“Stem cells are stupid” is one of my favorite sayings. Stem cells need a “trigger protein” to turn into the cell line you want and base to attach to so there is growth and blood circulation. This is asking a lot for a cell injected epidurally.

I don’t think you should consider an ADR to replace a pseudoarthosis. The segment has been too stiff for too long and trying to regain motion can generate local pain. If you would have another surgery, I would use your own bone (ICBG) to give you the greatest chance to fuse that level.

There is not enough information to indicate what you need done. I would look into facet blocks and possible RFA (radio-frequency ablations) to diagnose and control pain. See:
https://neckandback.com/treatments/facet-blocks-and-rhizotomies-neck/ and
https://neckandback.com/treatments/epidural-injections-and-selective-nerve-root-blocks-diagnostic-and-therapeutic-neck/

Dr. Corenman

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