CERVICAL STENOSIS RADICULOPATHY - PART 6 - CERVICAL DISC REPLACEMENT
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- Опубліковано 24 сер 2019
- This video discusses the surgical option for a pinched nerve in the neck called a Cervical Disc Replacement.
#thespineguy #cervicaldiscreplacement #cdr #spinesurgeon #spinesurgery #californiaorthopedicsandspine #cervicalradiculopathy #pinchednerveinthenec
Dr. Brian W. Su, MD
Spine Surgeon
Chief Development and Strategy Officer | California Orthopedics and Spine
Medical Director of Spine Surgery | Marin General Hospital
Director | Marin Healthcare District Board
Chairman | Marin Specialty Surgery Center
Yelp:
www.yelp.com/biz/brian-su-md-...
Contact two locations:
www.caorthospine.com/
415-927-5300
2 Bon Air Road, Suite 120
Larkspur, CA 94939
7100 Redwood Blvd, Suite 200
Novato, CA 94945
Curriculum Vitae:
www.caorthospine.com/brian-su...
FTC: This video is not sponsored.
Disclaimer: This video is not intended to provide diagnosis, treatment or medical advice. Information obtained from this video should not be taken in lieu of your own medical provider's advice and treatment plan. Please consult directly with a physician or other healthcare professional regarding any diagnosis or treatment plan options. Content provided on this UA-cam channel is for informational purposes only and should not be considered as a substitute for advice from a healthcare professional. The statements made about specific products throughout this video are not to diagnose , treat, cure or prevent disease.
Three level cervical disc replacement by Dr. Robert Byers and Brien Su - four years out - I can say I recovered 90 % of sensation and feeling in my hands and am pain free.Amazing outcome - thanks to these two great surgeons!❤❤❤
I'm so glad I watched your video. I had c6/c7 fusion surgery 10 days ago . I was feeling like my surgeon didn't think I was worth a disc replacement because I'm 72, or maybe because I have Medicare. Now I realize he did the right thing because I have
Arthritis and bone spurs and a forward leaning neck. .
You made a big difference to me, thank you.
I can’t thank you enough for the excellent education you provide on your channel! I’m a physician assistant and found myself needing a cervical disc replacement at 36yrs old. There is no way to provide this level of education and teaching in a 30 minute consultation but it’s the level of education and understanding I needed to be comfortable with my decision! I’m 1 week post op from a Simplify disc replacement and couldn’t be happier with the outcome. You really helped me feel informed when making my decision and for that I can’t thank you enough!
Absolutely phenomenal presentation with superior explanation. Excellent information!
Yes always!
These videos are excellent. I did a C6//7 posterior foraminotomy last September. Seemed improved but has flared up badly since March and I’m considering disk replacement. Can’t thank you enough for these videos.
“Radiculo-sly” fascinating. I loved this 6 part presentation. Explanations extremely well organized and delivered.
I had three levels of cadaver bones used instead of the disc replacements with 3 plates to stabilize. I am now 3/4 of an inch taller because of it. Had it done November 18/22 and I am so pleased with the surgery.
At 23, I have been recommended to have an artificial disc replacement for C3-C4 due to congenital cervical stenosis in combination with a bulging disc that has come up in this area. This has been super interesting and educational for me as I move forward in deciding whether or not to get the surgery as well as hearing multiple surgeon opinions. Thanks for this!
Watch video on central cervical stenosis.
Hi Dr. Su, thanks for the informative videos on CR! I watched all 6 videos. They have been very helpful for me in giving a lot more education about what I'm in for in my near future. I guess doctors do not go into detail in a 15-20 min visit. Though I think it's necessary because you find yourself searching for info; and help on the internet. Hopefully you find well doctors life yourself who give you a good education about what ever your health issues may be! I'm needing 2 surgeries. One on my cervical and the other on my lumbar. Thanks!!
Great in-depth information. Easy to understand. Thank you Doctor.
Appreciate the clear information.
A brilliant series. So informative and viewer friendly. I cannot recommend it enough. Excellent!
Thank you Dr. Su!
Thank you Doctor. That was a wonderful explanation of what I will be having done.
Thank you for both pointing me to this series and providing great, easy to understand information. It’s a shame the doctors I’ve seen don’t provide this information but I’m going to recommend they point their patients to your information.
Thanks very much!!
just watched all these series, thank you for amazing information! i've put up with pain since 2018 that has escalated to 20/10 instead of 10/10 (when pinched), and am off to see a surgeon soon.
Awesome video. Thank you for making these. I have ACDF C4-C6 and will be bookending these with ADRs at C3-C4 and C6-C7 using Simplify Disc, unfortunately due to those discs not holding up all that great since my fusion 6 years ago. Symptoms including some cord symptoms and shoulders and arm weakness. Scans indicate compression and disc degeneration.
Thank you
I’m having this exact disc replacement at C7,C6 on Monday morning May 22nd. Thank you doctor for a wonderful explanation of this procedure. Your video is such a Blessing to watch online. Thank you again
Update
What a well-produced and informative series of videos. Only niggle is that it's "ET cetera", not "ex cetera"
Wow wish you were here in Ireland.. I wonder if I could get replacement not fusion.. have a spur and it's causing issues
I'm enjoying your videos very much. I'd be interested in a video about cervical dystonia--which I have (car-accident induced) and am currently helped by bilateral Botox injections.
Cervical dystonia is a complex problem. Thanks for the suggestion. I will put that on the list of videos to work on.
Hi Dr Su. Your UA-cam is probably the best on this subject. Congratulations.
I have one question i hope you can address. I have a c6/7 protrusion. This is my second episode of pain, three years apart, lasting 6 months and counting. Would having this problem twice on the same disc for six months or more indicate surgery is more than likely to resolve my issues rather than prolonged conservative treatment which has thus far failed?
Basically, for all of us out there on their second problem of the same disc - what is the long term prognosis?
I would not treat based on the number of recurrent disc herniations but only on current symptoms.
Your videos are excellent. You gave me the confidence to go through a 3 level ACDF C2 - C6 last year . I recently have started having pain in my sholders and down my arms and found out that C5-C6 didn't fuse. My surgeon wants to replace using a piece of my hip bone , do you have any videos about this ?
Yes that is reasonable for people who do not fuse as well.
How often does a patient experience rejection from the metal or plastic?
Excellent video!
Thank you!
It is exceedingly unusual to reject the hardware
@@DrBrianSuTheSpineGuy ok.
Thank you for your time and reply.
Love this series thank you Brian! Myself I had two level surgery with the CP-ESP, which I know is not approved in the US. Nevertheless I would love to hear a discussion on the different hardware as all ADRs are not created equal, some have more study data, others seems to suggest better outcomes (from perhaps more limited data). I think the ultimate question would be if you yourself qualified for all ADRs and needed a 2 level replacement, do you go with Mobi-C or something else? Not sure if you want to reply to that though :). Thanks again!
That is a complex discussion but you are correct each disc replacement has different biomechanical properties. Some are better for stiffer segments etc.
Dr. Su. great video. When the disc fails, is it possible to replace it with a new one?
It will be very difficult to do so because removing the disc likely involves removing some of the bone above and below the implant. Typically revision from a disc replacement is to a fusion. Every case is unique and it all so depends on when the disc replacement fails. as a disclaimer this should not be considered medical advice and you should always consult your spine surgeon period
@@DrBrianSuTheSpineGuy do you use any other discs besides mobi-c?
Thank you for the information, it was well done
Idk if I ha e the mental capacity for this surgery, Dr Su. I do have radiculopathy, stenosis (due to injury feb22) and degenerative (preexisting) unbeknownst to me. My vertebrae is narrowing or like a tunnel as I've been told. Also it's collapsing. My recent injury in feb, is how all this was found out. Can surgery be avoided? I do have great range of motion w.ith the random tingling in the arms.
Dr Su I love the explanations and the video. However, I would like to understand if you have change your preference in you artificial disc . Mobi C is a ball and socket design that is unconstraint and has cobalt and nickel that could trigger more alergic reactions and to be frank I have had friends with so many migrations with mobi c that did require revision . I d love to learn what you currently use and how you value each disc that is available in US .I think that would be a good video that would teach patients which artificial disc they should choose and pros and cons of its designs
There are pluses and minuses for each type of disc. We've started looking at stiffer constrained devices for people that have more degeneration but continue to use mobi c in a patient with good preoperative motion
@@DrBrianSuTheSpineGuy sounds great . I think the most popular disc out there these days are the newer simplify . I have been personally wondering what the main difference is other than the fact simplify’s simpler design and mri friendly properties compared to mobi c .
Other than that M6c was used about 10 yr straight in EU before they switched to ESP disc ( probably stiffest disc out there) There is also axiommed’s freedom disc possibly coming to the market which is monoblock and as far as I understand has viscoelastic core. What do you think of those discs ? Also the prodisc s most implanted variant prodisc in EU vivo (with smaller keels than any other prodisc design )will get 2 level approval soon. Thanks a lot for the reply I appreciate it
Hey Dr. Su- I appreciate your information. What are your thoughts of retrolisthesis of approximately 2mm as a contraindication? Would a more constrained disc such as Prodisc-C be a better option than Mobi-C? Thank you in advance.
That would typically not be a contraindication
Dr.Su- Could a more constrained disc (e.g., ProDisc-C, M6) help remediate a mild unstable level? I appreciate your content!
There are several people talking about different types of discs for different constraints at different levels so yes I think that's a consideration
👌👍 Very informative,
thanks !!
🌹❇️#不宜人工椎盤置換:
1.椎盤已顯著退化致#椎盤高度術前#已扁窄了正常高度的50%以上、伴隨#硬骨贅生( 而非質軟的椎間盤 )在神經孔緣增生(長期逐漸形成) 3:00 #文字
2.#頸椎小面關節已有關節病變 3:22，頻道主還會在術前作Bone CT來觀察小面關節。
3.#長期頭前伸而致呈已反轉頸椎曲度( 呈倒反弧度:頸椎前彎 kyphosis )者3:59
🟣 #55至60歲以上的人有時便屬於上述三類了喔🥸！
🌹 6:28 6:42
置換[兩節]比[僅置換單節]人工椎間盤對#減緩發生(長期後,10年後)鄰近椎關節退化的加速變化 #較有明顯幫助。
7:16 adjacent level disease 術後鄰近椎關節退化加速症
10:45 Mobi-C CDR
I have 6 and c7 fracures and some d5 caused by and accident my symtoms are bladder and bowel i can control them but when its time is time i have double vision and ear noises just in the right pretty much. All the right is fuked up resulted in trouble walking and swallowing openning my full mouth my right jaw and speatch are slured prolem with contration i hope u can answer looking forward now its been 2 months nd half of the injery hopefulluly those sumptoms goes away im just texting you with the left hand hopefully i didnt make any .istakes also problems with erection my doc says just do u collar of the neck and back for 6 months and ull be fine but im not sure...
I live in NYC, I really would like your 2nd opinion on what my spine surgeon is recommending. How can I reach you ?
You can feel free to call the office and make an appointment with me. California orthopedics and spine.
Well do you think they are going to let you operate on their back again? You have set them in motion for future surgeries. So your 30% don't need surgery again is off.
why wouldn't they use neoprene instead of plastic? Must be a good reason..
Lots of surgeons are now doing arthroplasty on many more patients that before were considered "contraindicated." Many hybrid constructs are being done successfully, as well. Are you doing these things?
Yes. I just wrote a paper about that. I think people should be cautious about extending the indications because we don't really know the long-term outcomes. It does not mean that it's wrong to try though
Hello, Is this surgery for severe Cervical Radiculitis? I was diagnosed with severe CR disc bulge in c5-c6 ( 0.9 x 0.9 x 0.5 cm) concluding it will not heal on its own.
Im dont want surgery but I feel I have no choice.
It depends whether or not you have physical compression of the nerve. If you do and an epidural did not help you or only helped you temporarily, then surgery may be an option. if you do not have any physical compression and it's just nerve inflammation I would not recommend surgery. As a disclaimer this should not be considered medical advice and you should always consult your spine surgeon.
Is the mobi C disc titanium and why did you chose using this type of cervical disc benefits, when there are several other types of cervical discs out there?
That's a complicated discussion. I think it's very straightforward to put in and there's good day to behind it. There are other good discs and the risks and benefits have to do with their constraint and motion
Hello. I had double disc replacement with fusion 16 yrs ago. Now having issues with upper arm pain. Had mri shows narrowing above at c4 injections were recommended to to avail. Now what should be my next step. Any ideas 💡 thank you. Where in California are you
You can make a virtual appointment with me at California orthopedics and spine.
I was also surprised with your in my view pessimistic outcome of surgery of only removing half of the pain. Is there studies that back that and what is the background to that, waiting too long to have surgery? I thought a standard case as has been for myself that when pressure on nerve is released most if not all pain is gone, meaning in the range of 80-100% improvement
Most of the IDE studies that compare disc replacement to acdf will show those outcomes
Dr. Su - I had C4-C6 disc replacement done 2.5 weeks ago and woke up with my upper back shoulder blades area are now numb and the areas of the upper back that have feeling are sensitive touch with pain. Have you ever seen this? My doctor says he’s never had a patient wake up with this and he thinks it’s related to c6-c7 or c7-t1 but based on the MRI he doesn’t see any issues with those levels.
That's somewhat unusual but it could reflect facet joint pain. Watch the cervical facet joint video
Hi doctor, I would like to know if you might do a virtual consultation?
You can call Marin health spine institute 415-925 8200
Dr Su, I know knee, shoulder and hip replacements have a half life or a time frame where they need to be replaced. Doe that apply to the CDR? If so, please advise how long does on last?
It's a great question we don't really know yet. Right now we have 15 year data from the United States studies
@@DrBrianSuTheSpineGuy wow!
I didn’t know CDR has been going on this long. Is it that the MobiC is a newer replacement device vs previous devices? I hear raving comments about the MobiC.
Thank you.
Can patient’s have MRIs after the Mobi C disc replacement?
Yes it is harder to do but you can certainly do a metal suppressed MRI
What do you think of the MILD procedure?
I think if somebody cannot undergo a formal decompression then it is an option
Can you do three level cdr?
In certain cases yes. You can call 415-925-8200 for a second opinion with Me
If you have osteoporosis, is an anterior cervical fusion possible?
It depends to what degree. You should consult a surgeon.
What causes pinching in my right side of my neck
It could be a facet joint or a nerve. You should watch the facet joint syndrome videos as well as the radiculopathy videos
Hello doctor Su I have a few questions as was wondering on Criteria I've talked to two other surgeons about my issues an I wondered if you could help me break a difference of opinion an help me clear a issue as my every day life has been taken from me an I'm trying to get back to normal or as much normal as I can I wondered if you would be interested in having a look at a mri I got a Pars l5 s1 that is needing fusion but I'm kinda at ends over a neurosurgeon who says I'm a Candidate For cervical Disk replacement And an orthopedic surgeon who says I am not . It's around C5 As the problems in my neck generally give me headaches headaches numbness in the fingers And pain in the shoulders and surrounding areas It's been almost 2 years since my sense my accident I've been trying to push forward but it's been really hard my dad has cancer and I can't be down forever I just got illegally fired for seeing my doctor and I was told there's 3 mm of Movement in my neck that I found out this year due to the accident That was found thanks To flex X-ray I know one thing that continue It's not really an option I've went through a Physical therapy and pain management my case is currently in the judge's hands I know that I'm not at fault but I left with this decisions Of my quality of life I have to pursue My best options And naturally I kind of am curious about the overall cost for a disk replacement in your neck also compare to a fusion
All of this information is on some of the other videos but you can always make a virtual appointment with me at California orthopedics and spine
@@DrBrianSuTheSpineGuy how much normally does disc replacement coast from you as a guess on c5 because I've asked an not even been gave a ballpark of a high or low end
I am 38, and have bone spurs restricting the nerve in my C6 and C7. I want to keep leading an athletic life ( I do Brazilian JiuJitsu). Would a disc replacement or ACDF be more appropriate for somebody in my situation? Thank you.
For somebody that is extremely active we have historically recommended a fusion. However, this replacements have been done in select cases for highly competitive athletes.
where can i contact you. I live in the bay area
Is acdr suitable for cervical kyphosis and stenosis. C3 to c6 kyphotic with stenosis . Im 34
Significant kyphosis is a contraindication
@@DrBrianSuTheSpineGuy ua-cam.com/video/PMHD-Yp7_YA/v-deo.html can you please explain how can the 35 year old got 2 adr levels when there is kyphotic change ???? Im 34 and i dont want fusion . I live in Seychelles though
How about vocal cord injuries risk?
The risk of injury to the vocal cord while it can happen usually doesn't have a clinical effect because people only need one vocal cord. You would have to talk to your surgeon about that.
@@DrBrianSuTheSpineGuy Thank you very much for clarifying. My surgeon asked me to get an exam from an ENT so it scared me a little Thank you very much for clarifying. My surgeon asked me to get, prior to surgery, an exam from an ENT so it scared me a little.^^
Why can no more than 3 vertabras be fused?
Many vertebra can be fuse it is not limited to three levels
You talk about contraindications for CDR but you do not say why...exactly. For instance, I am 65 and going for disc replacement (c5-7) this week. I've done a TON of research and it appears that most doctors are WAY TOO conservative in selecting patients that qualify for CDR. This is typical of US-based medicine since insurance and lawyers run the show...not the doctors...IMHO. Thank goodness I found a doctor who would treat me like a relative.
There is a list of contraindications in all of the papers that were done. Most of them include osteoporosis, severe disc collapse, arthritis instability. There are quite a few.
Mobi-C is the worst cervical ADR. High failure rates. Avoid like the plague. Anyone doc who uses Mobi-C should be avoided. Simplify is a much better disc from what I've seen.
I'm a singer. And I'm very scared that i will lose my singing abilities.. your response would be greatly appreciated.
That is a concern although permanent voice change is highly unusual