The short answer is, "Yes." This is an "off-label" technique of reversing cervical fusions and replacing them with artificial discs. The procedure enables patients to regain motion in the spine and to live an active and more functional lifestyle.
I met a patient from Texas who already had a three-level cervical fusion. Predictably, another disc failed below the fusion at C6-C7. On our first meeting, she opened with a question, “Can you save my neck?”
A previous surgeon recommended fusing C6-C7, which would have wholly immobilized her neck. She was an avid golfer, a very active lifestyle, and too young to be looking at this kind of situation.
We spent a lot of time talking. Golfing was her life, but she also led a very active social and family life. Her burning question was about the herniated C6-7 disc and whether she could have an artificial one instead of fusion. She also wanted to know if one or more of the previous cervical fusions could be replaced with additional artificial discs. All good questions.
My initial assessment confirmed a severely herniated disc at C6-C7, and that she was a good candidate for cervical disc replacement. Then I began my assessment to remove one or more fusion (C6-5/C5-4/C4-3). I was guided by the knowledge that by revising even just one of the fusions, she’d regain almost 60% of her original natural range of motion (turning, twisting, bending) in the cervical spine. However, there could be some complications if the facet joints (the bony extensions of the vertebrae) were either removed or fused.
A CT scan revealed she had open facet joints. I could remove one level fusion by drilling it out and replace it with an artificial disc. This was an “off-label” procedure. While not expressly approved by the FDA, it is not prohibited. It opens a way for surgeons, such as myself, to customize treatment for unique situations. It is also entirely appropriate considering my background as a research clinician.
She was very eager to do this and agreed. The surgery was a success, and her post-op experience was complication-free. She was up and out of bed within days. Two years later, instead of having FOUR cervical fusions (three existing plus a new one), she only has two fusions and two artificial discs. The best part is that she regained motion that the previous fusions took away and is leading the life she wants to live.
Dr. Lanman is a board-certified neurosurgery specialist practicing medicine for 25 years with a private practice in Beverly Hills, CA. He specializes in the treatment of spinal disorders and is a leading clinical advocate for artificial disc replacement surgery. He is a professor at the University of California Los Angeles, and a member of the Cedars-Sinai Institute of Spinal Disorders.
As a leading innovator in the treatment of spinal disorders, as well as a media educator and contributor, Lanman has published more than ten peer-reviewed articles, as well as book chapters on topics relating to neurological surgery, and has presented more than two dozen papers at national and regional medical society meetings. He has been tapped by colleagues to be the principal medical investigator on a broad swath of clinical trials for motion preserving surgeries and artificial disc replacement devices, most recently the Prestige LP and M6, with the former recently receiving FDA pre-market approval in 2016 with his continuous support and advocacy.
Part of his constant advocacy for patients stems from his own experience as a patient. His unique insights helped him develop a program called "4D Health Process." The "process" helps him guide patients to think about their health more comprehensively and holistically. The process also incorporates some different factors including one’s age, daily lifestyle, nutrition, hormone status, physical exercise routine, and of course spine and joint health to paint a complete picture of one’s health from a four-dimensional perspective.
The "4D" program relies on his meticulous analysis of each patient's current physical condition, their lifestyle, and treatment goals. He uses his decades of knowledge and expertise to shift the emphasis for how we view healthy living, aging, and the treatment of spinal disorders. His unique medical treatment approach helps him map out an entire preventative and forward-thinking strategy to help his patients live an active, healthy life, with the full natural movement of their spine. His stated goal is to help patients be greater than "better."
For more information about Dr Lanman, please visit www.spine.md
CREDITS
Editing: Ray Wyman www.raywyman.com
Management: Brandi Kamenar www.brandikame...
5 авг 2018
