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What is the MED Procedure?
Who is a candidate for this procedure?
How is the MED different from cervical fusion?
If I am out of state, how do I go about finding out if I am a candidate for MED?
If I am found to be a candidate and live out of town, how best can I be evaluated by the doctor and schedule my surgery?
What should I expect during the surgery?
When can I drive and return to work?
If I live out of town, whom do I follow up with after surgery?
How recent do my films need to be for surgery evaluation?
What is the MED Procedure?
The Microendoscopic Discectomy (MED) was developed in 1997 for the treatment of lumbar disc disease. In September 1997, the MED system was adapted to the cervical spine by Dr. Tim Adamson. Traditionally, most cervical spine disease has been treated through the front of the neck (anterior fusion) or the back of the neck (posterior laminoforaminotomy). With both of these approaches, the patient was out of work for several weeks following surgery and experienced more postoperative pain. The increased pain was due to muscle stripping during surgery as opposed to muscle splitting with the endoscopic technique. Although both of these procedures are indicated for the treatment of cervical spine disease, the MED can be a benefit for appropriate patients. Click here to view a short video describing MED. (Windows Media Player required). You can also go to our video library for additional information on MED and herniated discs.
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Who is a candidate for this procedure?
The cervical MED approach is appropriate for patients experiencing neck and unilateral (on one side only) arm pain/ numbness. Imaging studies such as an MRI or CT scan, obtained within the last 6 months to a year should confirm a lateral canal or foraminal disc compression in order to qualify the patient for the endoscopic approach. However, it should be noted that not every patient is a candidate for the endoscopic procedure.
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How is the MED different from cervical fusion?
A cervical fusion is usually preformed through the front of the neck. The fusion is accomplished by removing the entire disc material and replacing it with a graft of bone. To protect the fusion process, the patient may be required to wear a hard cervical brace for 4-6 weeks. You usually spend one night in the hospital following surgery. Recovery from this procedure is longer and returning to full activity is much slower (approximately 4-6 weeks depending on the patient).
In the MED procedure only the material pressing on the nerve is removed leaving the rest of the disc space intact. Because of this, a cervical brace is not required in the recovery period and the patient will usually return to full unrestricted activity in 7-10 days.
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If I am out of state, how do I go about finding out if I am a candidate for MED?
As a courtesy to you as the patient, we would be glad to review your films and give you our recommendations for surgery. However, to help to facilitate this we require that:
*You have a referral from a Doctor and notes included from previous visits.
*You have had an MRI or CT scan within the last 6 months to a year.
*Include a detailed description of the location of your pain (i.e. Neck pain running down my right arm to my thumb.), any treatments or surgery you have had in the last year, and a summary of medications you are taking for your condition.
*Please include a contact name, address, and telephone number to reach you.
*Mail your films and summary to our office at:
Carolina Neurosurgery and Spine
Attention: Dr. Tim Adamson
225 Baldwin Avenue
Charlotte, NC 28204
*Allow 2-3 weeks for review of your information. We will contact you with our recommendations.
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If I am found to be a candidate and live out of town, how best can I be evaluated by the doctor and schedule my surgery?
An appointment for your initial consultation with the Doctor can be scheduled for you the day before your surgery. You will also be given an appointment with the preoperative clinic at the hospital for consultation with an anesthesiologist. Any questions you have regarding your anesthesia or your hospital stay will be addressed at that time.
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What should I expect during the surgery?
The MED procedure is performed using general anesthesia. An incision is made (1/2 inch) and the endoscope is used to visualize the targeted area. The compression on the nerve is then removed.
Surgery takes approximately 45 minutes to an hour. You will then be transferred to the recovery room and remain for the next 2 to 3 hours until you're fully awake and functioning normally.
After this time, you may be discharged home. A follow up appointment will be made for you before leaving the hospital for 1-3 weeks. If you are from out of town, arrangements can be made to follow up with you doctor at home.
If you are from out of town make arrangements to stay overnight in Charlotte. You will also need someone to drive you home. If traveling by car, you may need to get out and walk around every hour for 10 minutes or so.
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When can I drive and return to work?
You may drive 3-5 days following your surgery. You may return to work when the neck soreness subsides, typically within one week. It is best to check in with our office to let us know how you are doing prior to releasing you to work.
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If I live out of town, whom do I follow up with after surgery?
Arrangements can be made to follow up with your regular family physician or a local neurosurgeon in your area. This physician can then keep us up to date on your progress.
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How recent do my films need to be for surgery evaluation?
Any recommendations regarding surgery need to be based on films obtained within the last 6 months to a year.
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