Michigan C5 C6

[PhysicistDude137]

Hi from Michigan. I woke up 7 weeks ago with a herniated c5 c6 disc. All the docs here in Michigan seem to be predisposed to fusions. Found Dr Fiani and he'll do ADR but he only uses the M6 and I'm a little bit worried that discs complexity could be an issue with lasting 30 or 40 or more years. Also M6 means of another level needs adr later you might be stuck with acdf because the m6 is only approved for 1 level. I'm not sure if another doc would put another disc brand at another level if it was ever needed.

The docs at beaumont will only do adr on the absolutely most perfect candidate. But then they only do 5 or 6 discs a year they told me.

The thing is all of my symptoms are almost gone. The mri tells another story about a big hernia pressing my spinal cord and nerve root.

I set out looking for a microdiscectomy surgeon but there are even less of them in Michigan than adr docs! I would gladly settle just to have the disc material removed but no one will even entertain that thought even though I see youtube videos of docs in other states doing exactly that.

Anyway hello forum.

[annapurna]

To start backwards, microdisectomies can leave the disk weakened and more prone to herniate again. I don't know if that's why your local folks are refusing to discuss them, though a blanket refusal with no discussion sounds more like a bunch of closed-minded docs instead of a well-thought-out reasoning for the refusal.

Second, 5-6 ADRs a year for your local hospital is simply not enough for them to retain competence, IMHO. If you were desperate and needed immediate treatment, they'd be an option. It sounds like you're doing well enough to seek a surgeon who does ADR regularly. It doesn't have to be hundreds per year but at least frequently enough that there's a feeling of maintaining competence.

While I tend to agree with you about the M6, I'd approach it differently: find a surgeon who you can trust to be competent in their ADR skills, then discuss which model of ADR they feel would work for you. I'd avoid the M6 but I wouldn't allow a incompetent surgeon to install a non-M6 over a competent surgeon who only uses M6s.

[PhysicistDude137]

I understand about the discrctomies but in my mind it's better to have a god given natural disc even if it's weaker from herniation than an adr which does have risks. At least it could buy time. I had a discectomy at l5s1 many years ago and still going strong even with doing squats in the gym (with proper form).

Your disc doesn't become weaker from surgery. Its not like doctors cut away the outer anulus that surrounds the nucleus. They remove the nucleus material that has extruded out of the disc. Discectomies just remove the stuff that came out and decompress the nerves. Once the disc is weakened from the tear and loss of some disc material, that's it. The doctors dont make it worse by removing the healthy disc material that is where it belongs. They do usually need to remove some bone and so sometimes depending on where the bone is and how much it may destabilize the spine a little in that area and cause a little more wear.

Dr Fiani is only in practice for about 1 year but said in his residency he did many adr surgeries including for Navy soldiers who would return to full duty. He's young but has experience and he's published over 100 papers. My only thing is I'm not sure about the m6 because I think simplicity is better.

The beaumont doctors just seem to be old fashioned. Wouldn't tell me why I'm not a candidate for adr and kept saying acdf is lifelong and will never need reoperation. But when they said that I nearly said what about the fact that in 10 years or less the surrounding discs will be failing? Even Dr Fiani said of a fusion that the surrounding discs will lose 20% of their integrity over 10 years. But I am very active and not a couch potato so 10 years is probably more like 5 in my case.

I have 1 more appointment with another doctor who uses the mobi c in a week or two. He's been in practice 20 years and I'll ask how many adr he's done. If that doesn't work out and he's another guy who prefers fusion then I guess it's Fiani and the m6. But I'm fearful i will need another level done sometime in my life because I have a small bulge at c3 c4... small bulges can be indicative of a disc starting to fail (hope not) which is another reason I won't entertain acdf because it will weaken the disc with the bulge and then they'll want to do another fusion.

Thanks for the advice. It's weird. 2 months ago I was in great health and in the gym 5 days a week and now I'm a cervical disc patient overnight.