He phoned me for a quick 20 minute follow-up to go over my facet concerns and a few other things. He is a very understanding and compassoinate individual. I can’t even get a surgical referral in Canada!
1) My facets are on the big side of normal and still have 2 visible layers of articular cartilage on them. My facet size is not uncommon for someone 6 feet tall.
2) My ligamentum flavum is not thickening, rather it is bulging/buckling from the redundancy resulting from the 2mm loss of disc height. This is contributing to the mild central canal stenosis and left lateral recess stenosis. Proper disc height will fix this.
3) The ALL is divided and no effort is usually made to fix it, because it will turn into scar tissue with no benefit to the rest of the spine. This was an issue in older model devices as they were unconstrained, so they had to keep part of the original annulus in place to prevent pop-outs of the prodisc and charite in extension. The annulus of the M6 makes the ALL redundant and flexion/extension are not an issue. He did offer to stitch it up for me if I would prefer!
4) He reiterated that my surgery is fairly straighforward and I have a good chance of a good outcome and like every major surgery, there is always a chance of a bad outcome. That’s the nature of the business.
5) If I run into any issues with follow-up care in Canada, he will gladly review my scans if I pdf or email them over to him.
6) L3/4 and L5/S1 have big facets too – my big problem is the bulge.
The long short is that the M6 should work and make me active again, but there is a small chance it will mess me up further. Ultimately, it’s a gamble. Han shot first and made it out alive, right?
I’m really hoping I can get some stem cells or genetically engineered protein in this disc before I have to roll the dice on surgery. If/When that fails, I’m now comfortable with the device and my surgeon. I have no reservations about the device or his recommendations and expertise. I can stop researching now! 🙂 Realistically, this is my best chance at a decent outcome as of today.