Dr. Nick Nenadovich Discusses Cervical Fusion vs. Cervical Disc Replacement

[@gramps5157]

Got a Fusion at C5-C6. About two years later I needed Artificial Disc at C4-C5 and C6-C7 because the Fusion put extra torque on the Disc above and below the Fusion. When I got the Fusion I was in a Study, the Artificial Disc was in the process of being approved by the FDA. There was a 50% chance I would get a Fusion or 50% chance I would get the Artificial Disc. I was picked to get a Fusion, I'm so glad I didn't get picked to get the Charité artificial disc. I got the Pro Artificial Disc.

[@Questtt3]

Thank you - there are some very significant insights and pearls presented here in the debate between disc replacement and fusion.

[@devinramdihal8149]

A fusion is a compromise it does not cure the issue it masks it . if I fuse your knee how can you move your knee?? You get my point

[@blackfrost273industries4]

I am like the lady asking a question of ADR, there are results of like 40% of patients in the group failed and needed fusion soon after. Mobi c was one of them used, I think.

[@bigdaddymex2003]

Wow this is some good information. I wish they did disc replacement instead of exterior fusion L4 to S1 I wish they would’ve done full cage fusion because i have lose hardware that needs to now be redone because of it I am starting to have deterioration of my lower and upper discs from the fusion level. I just recently November 16 had a cervical Interior disc replacement at SCOI in van nuys I had a pinched nerve at my C6 C7 level, which was numbing my left shoulder, my left arm to hand. This has been the best if not the greatest surgery I’ve had to date!!

[@brians2328]

I have that issue with left arm shoulder at c5/6, going to Germany soon.. had L4/5 L5/S1 done with Lp-esp over there already

[@bigdaddymex2003]

@@brians2328 how has that L4-S1 surgery worked for you ?

[@brians2328]

@bigdaddymex2003 really well, about 10 weeks in. Viscoelastic discs like lp-esp are superior to ball and socket because of rebound and compression, the Germans are 10 years ahead of the US because of the fda and insurance companies unfortunately.. you should seek out hybrid with adr in your affected adjacent discs to your fusion. I'd consult Dr Lanman or Rasouli if your looking in US/Cali, Dr Schmitz in germany if your considering outside US.. Hopefully you can avoid more fusions!

[@luketimber4679]

@@brians2328 Hey Brians --I went to Germany in 2019 for two level cervical artificial discs (M-6) --now in 2023 --I'm worse off --seeing a surgeon tomorrow in NYC for two-level fusion-- above the disc which now has severe stenosis. (Stenum Hospital) I also have had two artificial discs in Lumbar from them year ago. I m no longer able to walk today, sadly.

[@pointenone]

Really wish this was the standard these days, but lots of insurance companies refuse to pay for replacement. Had cervical disc replacement at c6 c7 and was back to doing everything I used too at a week and a half. Replacement should be the go to instead of something as archaic as fusion.

[@963ag]

I was diagnosed with moderate to severe cervical spinal stenosis at C3-5. My surgeon wants to do an ACDF with a cage device. I wonder if disc replacement would be a better option. What are the things a surgeon would consider when choosing to do a disc replacement as opposed to ACDF? What are some questions I should ask? I am 57 and this would be my first back surgery.

[@Sketch1994]

Avoid a solid cage at all costs. After the 8 month mark I started having much worse pain than I ever had before the surgery (it doesn't even respond to NSAIDs like it did before the surgery), and after one year I already had severe adjacent level disease with new herniations as well as bone spurs growing all over due the bad movement mechanics of a fused spine! They turned me into a cripple at the age of 26 and now I can only wait for the next spine surgery to become completely necessary, while waiting in pain unable to work or do things that 26 year olds do, that I was actively doing before, despite a 7mm hernia in C3-C4 (that's was more than 1/4" worth of compression).

[@commmarine9547]

You can't have a disk replacement. Can't have any bone erosion or disease or pain.

[@SmedleyButler1]

What did you find?

[@Rollwithit699]

​@@commmarine9547 Why would anyone need a surgery at all without bone erosion, disease or pain?

[@ivansmiljkovic9097]

@@Sketch1994 Hi! How are you now?

[@glenntankard2534]

I had a cervical laminectomy C3-C7 3.5yrs ago with no follow up surgery. A recent scan showed natural fusion C4-C5 however arthritis C5-C6 is now very painful and I will go back to my neurosurgeon. Am I a candidate for a hybrid ?

[@Adriennewithane]

Why focusing on Mobi-C artificial disc, versus other options? Prestige LP, M6 etc?

[@SmedleyButler1]

@@devinramdihal8149 really,? thank.you! where does the recently fda approved Simplify disc fall?

[@crazyc99]

How much does this mobi-c cost roughly? I have an almost 4year old work comp case and I believe I have 3 destroyed discs in my neck and trying to figure out the cost so I can deal with Gallagher basset (work comp insurance company) properly... they have resisted every step of the way ...

[@LionHGH]

What about lumbar replacement? 2 levels approved for that as well?

[@davidvanbrunt4233]

Replacement won't work for arthritic spines, so I'm screwed...ACDF is only getting closer...🧐😪

[@Chiroman527]

david, Me too . Lots of OA on my Vertebrae and Facet Joints up and down my entire spine. The problems started long ago in my Lumbar Spine and SI Joints decades ago. That started as a result of a Trauma of a Fractured Right Femur in 1966 (age 15) playing HS Football. The right leg was over 1" shorter as a consquence of the healing of that fracture. Nothing was done for that - left unaddressed by my Ortho Dr and my parents never thought to ask what should be done. The troubles started about 15 years later with lower back stiffness and the rest is History. My Misery Index now is Off The Scales with Chronic pains, Terrible stiffness and cycled Anxiety from the pains. The amoint of pinching of my spinal cord with multiple sites of Mild to moderate stenosis, DDD throughout, and Dextroscoliosis from the Leg Length Discrepancy contributes to the overall Misery Index. A very specific point to all tthis is _ Drink Water - I never did regularly, do daily exercises / Move your body/ Stretching.

[@milanpintar]

is i true artificial disc actually have worse outcomes on the adjacent discs

[@brians2328]

Not true on any level.

[@akashjain5474]

Which one is better ACDF or Disc Replacement surgery Please suggest

[@mmecm]

It depends on how bad your injury is.

[@BlessTVjm]

@@mmecm Option #1 is Disc replacement but as you said, it depends. But if a choice has to be made given all things equal, Replacement is definitely the way to go.

[@lakeshorebonejointinstitut9551]

It depends on your symptoms and bone integrity.

[@gavinelliot3564]

I have 9 that need attention asap.my chances=0.T800Aust

[@MdRokibulHossainMukul]

Hi, I am Md Rokibul Hossain from Bangladesh, I am suffering with Ankylosing Spondilities from 14+ years. Didn't move my neck because My survical disc (c1,c2,c3) fused, want to know is it possible to resolve?

[@kaitlynwiggins2328]

Mobi-c is the worst one out there these days. Or so I hear 😬

[@punjabimonda8055]

Hi dr I'm Ahsan from Pakistan paralyse sam parable palace halp me

[@F.E.82]

I'd find a new neurological surgeon if he ever acted or said some crap like that. Timestamp 2:50