ISPINE.ORG Forum - Multi-level cervical procedures (6 and 4)

I've recently been asked about the possibility of multi-level cervical ADR procedures. I've seen some pretty incredible procedures over the years and have documented them in writing on the forums. Unfortunately, we still have not recovered the archives since the braintalk forums crashed in July. I'll be trying to recreate some of the more important topics here.

Last November and December, I had 2 cervical clients with huge procedures. In his early 40's Bradly was facing total disablility. Here is what I wrote about his surgery while I was still in Germany:

Quote:

On 22-November, 3-weeks ago tomorrow, a man from San Diego had a 6-level cervical procedure performed by Dr. Bertagnoli in Straubing. It has been an arduous road getting here. This is certainly what Dr. B refers to as 'expanded indications' when he gives his talks.

I just spoke to Bradley's wife, Donna for the OK to post their story. While they don't post here, their story is on their own website. See www.fluteguy.com and click on Germany. If you need to chill-out, listen to some of his music. He is a jazz musician and his music is fantastic.

Bradley's upper c-spine was destabilized by a C1-3 laminectomy done 18 years ago. His symptoms were profound. At 41, he was facing a fusion from his skull to his thoracic spine. He'd been to many doctors in the San Diego area with similar recommendations. We went to see the most experienced cervical ADR surgeon in the US and also to the chief of spine surgery at UCLA. Some would stop at C7, some would stop at T1, and some would stop at T3, but all would fuse from his skull to bottom of the c-spine or into his thoracic spine. He would spend the rest of his life as if he was wearing a halo, unable to move his head in any manner up, down, left, or right. His head would do what his shoulders would do. All recommendations included an anterior procedure to implant interbody spacers, and a posterior procedure to implant screws and rods.

Dr. Bertagnoli's recommendation was to fuse C1-4 with an anterior plate, and to implant ProDisc-C at C4-7... 3 levels fused... 3-levels w/ADR. No fusion of the skull to the c-spine, preserving the most mobility there. This is a remarkable procedure for several reasons. Fallback to the big fusion is entirely possible if necessary, as the posterior approach has not been touched. The approach to such a high level was still done through an incision in the neck, not going through the mouth (which increases the infection rate and healing pain dramatically.) Watching the surgery (over 6 hours) was absolutely incredible. Watching Bradley's neck go from crooked to straight was amazing.

When you read his story, you'll find that everything was difficult... he even had a re-operation less than a week post-op. With all the trials and tribulations, he flew home at less than 3 weeks post-op. When I spoke to Donna, he had friends over and I could hear Bradley laughing in the background. At 2 weeks post-op, he played some Christmas carols as a thank you to the staff.

I got to see Bradley and Donna in June when he was playing at a club in Hollywood. See what I wrote about it here. Note the picture of Bradley and Jenni with Dr. B. Jenni had a 4-level cervical disc replacement about a week after Bradley's surgery. 2 smiles... 10 levels of hardware! Jenni arrived in Bogen with her own cervical collar. It was funny how loose it fit after she have disc height restored to 4 levels.

I don't want people to think that I'm sugar coating the option of multi-level spine surgery. If you need spine surgery, you are in trouble. I do know people with unsuccessful surgeries and I hope they'll come here to post as well. But, for many of us, we have very few options... all bad. At least we do have some hope and there are many excellent stories out there.

Mark