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in reply to: Curious Story of a Failed PEEK Cage #10854
A point of emphasis in my question was, as a Doctor who revises such a procedure, how often do you find extraneous disk residue laying between the very points of contact that were intended to fuse?
By the way, do you still have a video planned about revising PEEK cages? We talked about it last November, and I’m still looking forward to it. Hey, if you need any diagnostic test examples, give me a call and I’ll send the films.
in reply to: Revision of Failed PEEK Cage Fusion Video #10650Ah, the old PEEK cage / Ganglion Cyst double-billing, with two free popcorns and 3D glasses.
I periodically check your site, but am I correct that these two videos are not yet available?
Well, the PEEK cage that was in my neck I can now hold in my hand, or what’s left of it. In our phone consultation late last year, you said that I probably had not fused, and that you have an 80 per cent success rate diagnosing failed fuses by test results.
So bump it up to 81 per cent. The unwanted hardware was evicted from its cervical home three weeks ago. And then, it was old school cadaver bone and six weeks of a collar.
If time and inspiration allow, I’ll post my own case study. But until then, I hope to watch your videos.
I guess we in your old stomping ground in Detroit, frigid though we be, still cannot complain to anyone in Vail about the cold.
in reply to: MRI Finds "Disk Bulge" after Discectomy #8874Eventually I stop saying thank you because it seems so inadequate in light of your on-going help. I have been in contact with your office, and I intend to send you a package soon.
So, I spend the day getting an x-ray script, go to the diagnostic center, and the tech tells me that extension / flexion was not requested on the RX. My doctor’s office is closed for the day. So I get the pictures taken anyway, according to the script I have.
Dr. Corenman, would X-Rays without flexion / extension be of any value here?
in reply to: Can I Avoid Surgery? #7584I’m posting here because of the poster’s comment on the uncertainty of the doctor’s more aggressive diagnosis.
Recently I talked to a physiatrist who defended what I thought to be an aggressive recommendation from a surgeon for three level cervical fusion, C4 to 5, 5 to 6, and 6 to 7. “What your doctor is thinking,” the physiatrist explained, “is pay me now or pay me later.”
The answer brought little comfort, as I had chosen only the C6 to C7 surgery about 14 months ago. But the larger approach had a practical ring I admit. I am aware of adjacent disk syndrome. And on a larger existential plane, all bodies decay. Why not fix the whole engine as long as you’ve got the hood up now?
So the real question is, when cervical disks start going bad (objectively, as seen on the MRI’s) and the surgeon’s already going to work in the neck, could fusing the next two higher vertebra be seen as preventative measure? And what are the stats on single-fusion patients needing more work on adjacent vertebra over time?
According to some forums, man, ACDF is an eighteen month standing appointment. “Then I had this one done, and then that, and then those started to act up.”
Thanks.
(I know that motion is increasingly lost the higher you go. But it is less noticeable near the base of the neck.)
Thanks. What a gift you were in that unwelcome season of ACDF in September of 2011.
there any wisdom fusing the next two discs up from C7?
in reply to: Schedule of X-Rays after ACDF #5114Remarkable stuff. My surgeon’s unenthusiastic view of X-rays is coming into focus.
Stryker views the matter differently, it seems. Their website says “PEEK material provides good radiolucency for post-op visualization.”
One study notes, “The use of a PEEK cage is becoming popular because of better elasticity and radiolucency.”
In a discussion of Stryker’s performance in the market from 2007, it is noted, “The advantage of PEEK is that it is radiolucent, which allows the surgeon to better examine the progression of bone growth after a spine fusion is performed.”
Of course, “good” and “better” are relative terms.
It seems a little nutty to make an ACDF device that obscures (to any degree) the documenting of the very process (fusion) it is intended to produce. Perhaps there is a trade-off of the strength of the cage relative to its radiolucency.
And it makes sense that nothing can surpass an auto- or allograft for post-op fusion assessment, as there, nothing at all obscures the X-ray.
in reply to: Squatting after ACDF #5068Thanks Dr. Corenman. I can see how less “bone-on-bone” surface area can slow fusion.
My surgeon cleared me to train after three and a half weeks, but when I mentioned squatting, he said six weeks. That would be next Monday. Your caution will probably push that back further.
1. Are there any subjective warning signs that fusion is not happening, from the patient’s point of view?
2. Does plating (or lack thereof) alter rehab time frames?
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