Anyone know about Spine Nevada?
 

It is looking like I'm finally going to have to bite the bullet on my c-spine problems after 4 years. But there are still so many unknowns to ADR that I hoped might be answered in that time.

I am confident in the surgical skills of the european docs, but I might prefer to stay in an english-speaking country not so far from home.

Plus I'm concerned about artifact on MRI with the european disks, given that my whole spine is degenerating faster than normal.
So I'm wondering if it might be worth consulting Dr. Lali Sekhon at Spine Nevada, who has done tons of cervical ADR, much with the Bryan disk which doesn't obscure MRI too much.

Any input on this subject would be much appreciated.

Hope in Canada

Hi Hope:
I don't know about Spine Nevada or the surgeon you are thinking of seeing.
And I am certainly not an expert on the pluses and minuses of the various cervical disks--so I hope Mark and others will chime in here.

I just had a Prestige ST implanted by Dr. Regan in Los Angeles and I am very impressed with him and with my recovery so far. I did call Medtronic to inquire about future MRI's and was told that there would be artifact at the implanted level but it would be still possible to see adjacent levels...I hope that is true. Although the Prestige ST cannot be implanted at two adjacent levels because it has a flange, Dr. Regan is confident that he could implant the Prestige LP if needed at the next level. Dr. Regan is also involved in the Cervitech trials now.

I do have some concerns about the Bryan. Apparently there have been more problems with heterotopic ossification with the Bryan--which may be addressed with thorough foraminotomy and with NSAIDs post-operatively--and with increased kyphosis. The research literature raises questions about whether the Bryan is only appropriate for a subset of patients.

Just a few thoughts to complicate an already difficult process!:(

Hope... I'm sorry that you need to move forward. I don't know too much about Spine Nevada. Dr. Sekhon has done some interesting surgeries that have gotten a lot of attention (revision of fusion to ADR). Please let us know how it goes with them if you decide to pursue them as an option.

For me, the Bryan disc is a non-starter. As an early cervical ADR design, it was great. However, many of the issues with the Bryan have been engineered out of the newer designs. The need to do such extensive milling of bone not only increases HO rates, but it also makes the surgery very complex and unforgiving.

Having said all that, I do know Bryan patients with excellent results. As with other ADR's... there may be advantages and disadvantages to all... but, properly implanted in a properly selected patient, they are all likely to be successful.

All the best,

Mark