Cervical ADR Contra-indication/Indication with facet degenerative changes

[Chris G]

I am looking into a potential multi-level ADR procedure with Dr B in Germany and have shared my films and have a preliminary recommendation for a 2 level C5/6, and C4/5 procedure. I am 54 and am in great shape other then my cervical problem.

I wanted a second opinion and visited a leading ADR surgeon at Yale this week and he looked at my films and pain charts and he said that my facets may have degenerated too much to allow for success with ADR. He recommended have facet injections in 2 rounds Round 1 C3-4, C4-5, C5-6 and then round 2 C7-T1.

If I do not see any pain temporary relief from the facet injections then he said to have discograms at both C5-6 and C4-5 to see where the pain generator(s) are.

I have a 9 yr old fusion at C6-7 and have been pain free for 8 yrs up until early Dec 2009.

I have talked to several "reference ADR patients" who had 2-4 level ADR procedure with some facet degeneration and are pain free at 1-2 yrs out.

I have been told by one person that degenerative facet joints are not as important in the cervical area as the lumbar area due to size and loading differences. Is this true?

Will the extra height provided by the ADR ensure that most of the time the facets will not be touching?

Plus the surgeon will re-model the facets to remove the spurring/osteophytes (then coat with bone wax) and improve their morphology (too bad they cannot add a film of PTEX or teflon where the cartiledge has worn away)

Another question is how long are most patients pain free after a 2-3 level cervical ADR?

I got 8.5 yrs out of my C6-C7 fusion...

Thanks for any input from people with 1st hand experience with cervical ADRs and some facet degeneration prior to the surgery


Chris