I will be having this exact surgery in a few weeks , I had so many questions, thanks to this video my question were answered, Thank you Dr. Blessings 🙏🏽
I have similar issues and few question what about the cushioning effect is it still there or its feels like solid ? what about daily activity are you able to walk, jump, jog, run, swim, gym or limitation on activity..
Dr., thank you for such a concise breakdown of the surgery I am to have in the next three weeks. This is very helpful. Do you have a video on recovery process? My surgeon gave me 2 neck braces to use, a soft one and a hard one. I have just printed out neck exercises to strengthen my neck muscles before I have surgery. Any answers will be greatly appreciated. Thank you. Debra
great video. very informative. Is a disc replacement something that is recommended if the facet joints at the replacement level are moderately arthritic? 33 year old male asking. Thanks
Thank you for such a detailed information, Dr. Armaghani! I am 41 y.o. and got diagnosed with cervical radiculopathy after whiplash car accident related injury a year ago. I was told that my c6-c7 is herniated but does not compress the spinal cord. However despite physical therapy and 2 epidural steroid shots I am in constant neck pain, this treatment only affects my range of motions. How many steroid injections are considered as a usual protocol before thinking about a surgery if any surgery is even appropriate in such cases?
hello Dr. thank you for the informative videos. I have two questions if you don't mind: is this procedure appropriate for multi-level disease? is cervical myelopathy an indication for this procedure ? thank you for your time.
Thank u for the very clear discussion/explanation about my illness radiculopathy. I am greatly enlightened and i was given a positive ensignts with a chance to recover from sufferings from pain. At this point in time, i am now on my 10th session on my PT but still i fell discomfort, can i proceed to esteroid injection? Whose doctor can do this?
سلام دکتر،من سی و چهار سالم هست و سه تا از دیسک،های کردم پاره شده دکترها می گن باید جراحی کنم و دیسک مصنوعی بذارم بعد از این کار می تونم ورزش کنم؟ بندسازی و مویتان کار می کنم
Woooow; Fantastic, I have this surgery on coming month of October; I have in C4, c5 and C5, c6. Thank you for all this presentation and clarification 🙋🏻♀️🌺💞
Hi Dr. Armaghani - I will be having a disc replacement for C4 ,C5, C6 and C7 stenosis. There is significant pinching of the spinal cord. I also have Normal Pressure Hydrocephalus and those associated problems. We are all hoping that this is the obstruction preventing Spinal Fluid draining and in repairing it, it will resolve the NPH. Any thoughts? And thank you, your video is outstanding.
Is it required to cut through the anterior ligament to remove and replace the discs? Is it required to remove the PLL if there is cord compression? How much does the disc replacement add stability to make up for cutting the ligaments? I wonder because it seems these ligaments are very important to maintain stability after surgery. The research seems very conflicting on whether the ligaments should be cut.
Poor people don't qualify for this, I wanted this procedure done but medicaid only approved the old version where my neck is now stiff, now I wonder if I could afford this one day , can my old surgery be removed and replaced with this one?
Very precise and detailed information and an honest evaluation of the procedure. This was very helpful. Thanks. Can you do the same surgery on lumbar discs?
Similar to any bone spurs removed at the anterior aspect of the vertebral body, are bone spurs at the posterior aspect of the vertebral body also removed? At the front, how do you deal with the anterior longitudinal ligament in order to remove any bone spurs? Is it pushed aside, cut/dissected? Thanks.
Fantastic questions. Yes, we do remove the posterior bone spurs and those are most important as they are the culprits in terms of compressing nerves. As for the ALL we do remove that in the process of removing the disk. There is also a posterior longitudinal ligament which is the last covering from the disk to the spinal cord and that is typically removed as well to ensure the spinal cord and nerves are adequately decompressed.
Hello Dr. which one is better ACDF or ADR for C5-C6 disk bulge or herniation, which already once gone uder the surgery now after 4yrs same pain, tingling, on shoulders and in between shoulders started also stress on face and head region.
Very good question and that is a question many surgeons argue about which is better. In my opinion, I think getting a cervical disk replacement is preferrable to an ACDF. However, not all patients are candidates for a replacement. They can't have as much disk degeneration, arthritis, and their bone needs to be reasonably strong. That would be a good conversation to have with your local surgeon.
Hi Doc... what are your thoughts on bookending an ACDF with ADRs at the levels where the discs are starting to degenerate due to adjacent disc disease from the fusion? Have you done a surgery like this? Any feedback would be greatly appreciated.
@@ArmaghaniSpine I’m getting ready to do this I had c5-6 fused now going to have c3-5 done with the mobi-c . Didn’t really want to do it at all but at least I’m able to use the artificial disc this time insurance company okayed it to FYI
Hi dr, i had c5/c6 spinal cord compression and same level nerve root compression for about 2 years as i started with conservative treatment. My symptoms got slightly worse and worse and i decided to have a disc replacement. The good news was that although my cord was been compressed a lot on the mri scan showed that their was no evidence of myelopathy or any white lesions on my spinal cord. I have no bowel issues or balance problems. I had some arm pain and headaches. After surgery i see a big improvement already after 2 weeks, its possible to make a good recovery as no sign of cord damage? And when nerves heal does the pain signals go away? To your brain?
I'm glad you've had such a good result! Complete recovery of nerves takes about 1 year so how you feel at 1 year will be how you feel long term. Usually pain improves pretty quickly after surgery but weakness and numbness takes a lot longer to get better. Hang in there!
Thank you much for this great video! I have c4-C6 fusion but now having c7 and C8 nerve root impingement. Can I do disc replacement below a fusion? Also, what are your thoughts about cervical traction at physical therapy using saunder cervical traction?
traction works great as a nonoperative measure. if that an PT fail, injections are possible. you can do a disk replacement below a fusion but some insurances (Cigna in particular) do not allow it as they see it as "experimental"
Hi Doctor Armaghani, great video as usual. I am experienceing neck pain as well as feeling pain that goes into the front of the head should this be of any concern? I had a brain and cervical MRI around 3 months ago that showed nothing sinister was present? Any thoughts please?
Thank you for the kind words, Mr. Smith. Without a structural issue which would show up on an MRI of the cervical spine and brain, it is unlikely that a surgery would reliably fix those kind of problems. This could be a type of headache possibly as well which maybe should be evaluated by a neurologist. There are some people with pain like you experience who have seen good results with botox injections in those areas and the good thing about that is that it isn't a surgery. good luck!
Yes, absolutely. That is part of the work we do before the disk replacement is placed. We remove all the bone spurs and material that could be touching the spine.
Patient satisfaction as measured by asking patients at 1 year 2 questions: 1) Are you happy with your outcome and 2) If given the chance to do surgery again would you. Satisfaction is about 85-90%
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?
ankylosing spondylitis is, unfortunately, not a condition that can be alleviated effectively by surgery, however, medication through a rheumatologist can help in preventing further progression.
If you want to chat with me about AS I have it too for many years. Am going to see Dr Armaghani in 4 weeks. My AS is not a severe as many others but just at age 47 I had imaging and it shows DDD in the Cervical involving C2-C3-C4-C5-C6 but not 7 or 1. I lost most of the mobility of my neck. I have some idea what you are dealing with. My Rheumatologist says the neck likely isn't related to the AS. Im not so sure. I only have one conclusive fusion of the SI joint from 2005 but suffer a lot of oddities which all could pint to the A.S. If you'd like to communicate, send me your FB page or email and we might be able to share helpful info.
That's a very good question, Leon, and one that we are learning a lot about recently. What we have found is that within the first 6 months of this procedure, many patients may have osteolysis but do not get the main worry we have with the procedure and that is bone collapse around the disk replacement. We also know that after a year or 2 the osteolysis resolves and returns to its original density. This is why we take frequent x-rays and follow our patients closely to keep checking on if there is any collapse.
@@ArmaghaniSpine So The only difference from the ACDF procedure to this one is the fusion? My surgeon is recommending the AC DF procedure however I continue to hear that fusions are the worst thing to get in your spine but that’s just hearsay.
@@rosannapaluski2184 Yes. Fusions cause bone spurs and damage to adjacent vertebrae segments. My previous fusion of C6/C7 caused bone spurs and misalignment to C4/C5, therefore causing cervical stenosis, a narrowing of the spinal cord. I have electrical surges down my arms and legs, neurological issues, vertigo, and nerve issues, such as I can't feel my stomach, so I rarely eat. Thid has ruined my life and surgery is the option after exhausted attempts. But who knows what permanent damage will remain. I had a second opinion and I only wish I found a Dr like this one who could do disc replacement.
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I will be having this exact surgery in a few weeks , I had so many questions, thanks to this video my question were answered, Thank you Dr. Blessings 🙏🏽
How did you do?
Thank you for these videos. Im scheduled an ACDF and ADR a week from tomorrow.
good luck!
Great video! Do you use that burr to remove the rear bone spurs as well?
Just had this done a month ago. I’m feeling a lot better now. Thanks for this wonderful video 😊
I have similar issues and few question what about the cushioning effect is it still there or its feels like solid ? what about daily activity are you able to walk, jump, jog, run, swim, gym or limitation on activity..
@@safwanmohammed372 following
Dr., thank you for such a concise breakdown of the surgery I am to have in the next three weeks. This is very helpful. Do you have a video on recovery process? My surgeon gave me 2 neck braces to use, a soft one and a hard one. I have just printed out neck exercises to strengthen my neck muscles before I have surgery. Any answers will be greatly appreciated. Thank you. Debra
Thanks for explaining, I’ll be getting the same surgery & im very scared
How did the procedure go for ya? Happy with outcome? Thanks
great video. very informative. Is a disc replacement something that is recommended if the facet joints at the replacement level are moderately arthritic? 33 year old male asking. Thanks
Thank you Doctor, you are so precise with the procedure.
Thank you for such a detailed information, Dr. Armaghani! I am 41 y.o. and got diagnosed with cervical radiculopathy after whiplash car accident related injury a year ago. I was told that my c6-c7 is herniated but does not compress the spinal cord. However despite physical therapy and 2 epidural steroid shots I am in constant neck pain, this treatment only affects my range of motions. How many steroid injections are considered as a usual protocol before thinking about a surgery if any surgery is even appropriate in such cases?
Excellent over view! Thank you
Glad you liked it!
hello Dr. thank you for the informative videos. I have two questions if you don't mind: is this procedure appropriate for multi-level disease? is cervical myelopathy an indication for this procedure ?
thank you for your time.
Hi doc goodmorninv. Watching from the Philipines. My question is that, at what condition you have to perform this way of surgery?
How many replacements can be done at one time? I have 5,6,7,8 budged disc and degenerated.
Thank u for the very clear discussion/explanation about my illness radiculopathy. I am greatly enlightened and i was given a positive ensignts with a chance to recover from sufferings from pain. At this point in time, i am now on my 10th session on my PT but still i fell discomfort, can i proceed to esteroid injection? Whose doctor can do this?
A PMR (Physical medication and rehabilitation) or a pain management doctor is capable of providing injections.
Would you consider this for an older patient with scoliosis and nerve impingement?
you are a very good teacher. You said your patients take pain medications for a few weeks. Do you mean tylenol and nsaids, or prescription pain meds?
Thank you for this information 📝🔥🔥
سلام دکتر،من سی و چهار سالم هست و سه تا از دیسک،های کردم پاره شده دکترها می گن باید جراحی کنم و دیسک مصنوعی بذارم بعد از این کار می تونم ورزش کنم؟ بندسازی و مویتان کار می کنم
Thank you for this information
Woooow; Fantastic, I have this surgery on coming month of October; I have in C4, c5 and C5, c6.
Thank you for all this presentation and clarification 🙋🏻♀️🌺💞
Good luck!
Hi Dr. Armaghani - I will be having a disc replacement for C4 ,C5, C6 and C7 stenosis. There is significant pinching of the spinal cord. I also have Normal Pressure Hydrocephalus and those associated problems. We are all hoping that this is the obstruction preventing Spinal Fluid draining and in repairing it, it will resolve the NPH. Any thoughts? And thank you, your video is outstanding.
How are you feeling after operation ?
Please share how are you feeling after surgery?
What determines a fusion vs artificial disc replacement ?
Is it required to cut through the anterior ligament to remove and replace the discs? Is it required to remove the PLL if there is cord compression?
How much does the disc replacement add stability to make up for cutting the ligaments?
I wonder because it seems these ligaments are very important to maintain stability after surgery. The research seems very conflicting on whether the ligaments should be cut.
Poor people don't qualify for this, I wanted this procedure done but medicaid only approved the old version where my neck is now stiff, now I wonder if I could afford this one day , can my old surgery be removed and replaced with this one?
Very precise and detailed information and an honest evaluation of the procedure. This was very helpful. Thanks. Can you do the same surgery on lumbar discs?
yes but we have a bit more difficulty getting insurance approval than with cervical disks.
Similar to any bone spurs removed at the anterior aspect of the vertebral body, are bone spurs at the posterior aspect of the vertebral body also removed? At the front, how do you deal with the anterior longitudinal ligament in order to remove any bone spurs? Is it pushed aside, cut/dissected? Thanks.
Fantastic questions. Yes, we do remove the posterior bone spurs and those are most important as they are the culprits in terms of compressing nerves. As for the ALL we do remove that in the process of removing the disk. There is also a posterior longitudinal ligament which is the last covering from the disk to the spinal cord and that is typically removed as well to ensure the spinal cord and nerves are adequately decompressed.
@@ArmaghaniSpine Thanks; much appreciated!
Hello Dr. which one is better ACDF or ADR for C5-C6 disk bulge or herniation, which already once gone uder the surgery now after 4yrs same pain, tingling, on shoulders and in between shoulders started also stress on face and head region.
Very good question and that is a question many surgeons argue about which is better. In my opinion, I think getting a cervical disk replacement is preferrable to an ACDF. However, not all patients are candidates for a replacement. They can't have as much disk degeneration, arthritis, and their bone needs to be reasonably strong. That would be a good conversation to have with your local surgeon.
Hi Doc... what are your thoughts on bookending an ACDF with ADRs at the levels where the discs are starting to degenerate due to adjacent disc disease from the fusion? Have you done a surgery like this? Any feedback would be greatly appreciated.
I love the idea and would do it much more frequently but insurance (especially commercial insurance) will almost never approve it.
@@ArmaghaniSpine I’m getting ready to do this I had c5-6 fused now going to have c3-5 done with the mobi-c . Didn’t really want to do it at all but at least I’m able to use the artificial disc this time insurance company okayed it to FYI
Hi dr, i had c5/c6 spinal cord compression and same level nerve root compression for about 2 years as i started with conservative treatment. My symptoms got slightly worse and worse and i decided to have a disc replacement. The good news was that although my cord was been compressed a lot on the mri scan showed that their was no evidence of myelopathy or any white lesions on my spinal cord. I have no bowel issues or balance problems. I had some arm pain and headaches. After surgery i see a big improvement already after 2 weeks, its possible to make a good recovery as no sign of cord damage? And when nerves heal does the pain signals go away? To your brain?
I'm glad you've had such a good result! Complete recovery of nerves takes about 1 year so how you feel at 1 year will be how you feel long term. Usually pain improves pretty quickly after surgery but weakness and numbness takes a lot longer to get better. Hang in there!
@@ArmaghaniSpine thank you, however I might need a fusion as my neck pain had not gone away?
Thank you much for this great video! I have c4-C6 fusion but now having c7 and C8 nerve root impingement. Can I do disc replacement below a fusion? Also, what are your thoughts about cervical traction at physical therapy using saunder cervical traction?
traction works great as a nonoperative measure. if that an PT fail, injections are possible. you can do a disk replacement below a fusion but some insurances (Cigna in particular) do not allow it as they see it as "experimental"
Hi Doctor Armaghani, great video as usual. I am experienceing neck pain as well as feeling pain that goes into the front of the head should this be of any concern? I had a brain and cervical MRI around 3 months ago that showed nothing sinister was present? Any thoughts please?
Thank you for the kind words, Mr. Smith. Without a structural issue which would show up on an MRI of the cervical spine and brain, it is unlikely that a surgery would reliably fix those kind of problems. This could be a type of headache possibly as well which maybe should be evaluated by a neurologist. There are some people with pain like you experience who have seen good results with botox injections in those areas and the good thing about that is that it isn't a surgery. good luck!
@@ArmaghaniSpine thank you very much for the prompt reply,
Kind regards,
Graham
I am new here,please what test should I get for my C4 C5 that sticks out and causing me burning pain?
MRI of the cervical spine is the best test to evaluate the disks, spinal cord, and nerves.
Smart presentation
Glad you think so!
Can (during ADR) posterolateral bone spurns be removed?
Yes, absolutely. That is part of the work we do before the disk replacement is placed. We remove all the bone spurs and material that could be touching the spine.
Hey doctor what is the sucsess rate of of cervical DR surgery bcs my age is just 21 years and i have problem on c3,4 c4,5 c5,6
Patient satisfaction as measured by asking patients at 1 year 2 questions:
1) Are you happy with your outcome and 2) If given the chance to do surgery again would you.
Satisfaction is about 85-90%
Hello Doc,where r u located?
orlando, FL
Appreciate it 🇺🇸
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?
ankylosing spondylitis is, unfortunately, not a condition that can be alleviated effectively by surgery, however, medication through a rheumatologist can help in preventing further progression.
If you want to chat with me about AS I have it too for many years. Am going to see Dr Armaghani in 4 weeks. My AS is not a severe as many others but just at age 47 I had imaging and it shows DDD in the Cervical involving C2-C3-C4-C5-C6 but not 7 or 1. I lost most of the mobility of my neck. I have some idea what you are dealing with. My Rheumatologist says the neck likely isn't related to the AS. Im not so sure. I only have one conclusive fusion of the SI joint from 2005 but suffer a lot of oddities which all could pint to the A.S. If you'd like to communicate, send me your FB page or email and we might be able to share helpful info.
how big is risk of osteolysis with this procedure?
That's a very good question, Leon, and one that we are learning a lot about recently. What we have found is that within the first 6 months of this procedure, many patients may have osteolysis but do not get the main worry we have with the procedure and that is bone collapse around the disk replacement. We also know that after a year or 2 the osteolysis resolves and returns to its original density. This is why we take frequent x-rays and follow our patients closely to keep checking on if there is any collapse.
@@ArmaghaniSpine So The only difference from the ACDF procedure to this one is the fusion? My surgeon is recommending the AC DF procedure however I continue to hear that fusions are the worst thing to get in your spine but that’s just hearsay.
@@rosannapaluski2184 I had this surgery 20 years ago. I have no problems with the fusion. So glad I had the surgery. Hope you're doing well.
@@rosannapaluski2184 Yes. Fusions cause bone spurs and damage to adjacent vertebrae segments. My previous fusion of C6/C7 caused bone spurs and misalignment to C4/C5, therefore causing cervical stenosis, a narrowing of the spinal cord. I have electrical surges down my arms and legs, neurological issues, vertigo, and nerve issues, such as I can't feel my stomach, so I rarely eat. Thid has ruined my life and surgery is the option after exhausted attempts. But who knows what permanent damage will remain. I had a second opinion and I only wish I found a Dr like this one who could do disc replacement.
👌10:31 11:47