[artman]

#24679

To Dr Corenman

Neck and arm pain of a year. Pain level at 5

Disc protrusion
3.0-4.5mm at c6-7
2.0-3.0mm at c5-6

One surgeon wants to do an anterior discestomy w/ fusion. Another posterior foramotomy and disectomy no fusion. My insurance only covers these two mentioned.

Q: I rather have the mobi-c & prodisc-c. If u were in my shoes, which one would u choose ?

[Donald Corenman, MD, DC]

#24682

Your information is incomplete. Are the disc herniations on the same side as the arm pain? Where are they in relation to the foramen (the radiological report findings)? Do you have motor weakness? If not, have you had a selective nerve root block to reduce pain? What are the heights of your discs? Do you have any slips or kyphosis? Many questions need to be answered before any path is outlined.

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.

[artman]

#24683

the disc herniations on the same side as the arm pain?

Yes

Where are they in relation to the foramen (the radiological report findings)

C5-6: mild-moderate left and mild right side foraminal narrowing

C6-7: moderate-severe left and mild-moderate right foraminal narrowing.

Do you have motor weakness?

No

If not, have you had a selective nerve root block to reduce pain?

No

What are the heights of your discs?

Don’t know, report doesn’t give a number.

C5-6: mild to moderate disc height reduction.

C6-7: moderate disc height reduction.

Do you have any slips or kyphosis?

No

[Donald Corenman, MD, DC]

#24684

If you have a significant degenerative disc (disc height reduced by 50% or greater as it sounds like for C6-7), an artificial disc is contraindicated. An ACDF would be called for.

The C5-6 level might not be symptomatic (“mild-moderate left and mild right side foraminal narrowing”). The way to find out is with a selective nerve root block at C5-6 left. If it is highly selective and you obtain no or minimal neck or arm pain relief, you could leave this level alone.

By the way, an epidural injection could give you long term relief and can be considered prior to considering surgery.

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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