One level fusion after two level ADR (Charite) anyone?

[AJ]

Hi, I'm looking for experiences from anyone who has had a fusion after adr. I am scheduled for a posterolateral gutter fusion on L5/S1 charite. I have a L4/L5 adr and have since developed a L2/L3 bulge. The level to be operated on has severe facet degeneration which was not present at the time of initial surgery. My adr has been very successful and I do not regret having it but want to know what to expect now. I have had symptoms for the past 18 months.

Thanks

[CharlesinCharge]

Alison,

I just had an XLIF fusion in September (so 5 months ago) after having a 2 level ADR done in 8/06 and I am doing great! An XLIF (Extreme Lateral Interbody Fusion) is a minimally invasive fusion, you can google it and learn more if you are interested.

When I had my two level ADR surgery over 2 1/2 years ago (L4-L5 and L5-S1) the level above (L3-L4) also showed signs of degeneration. But, it did not test positive for concordant pain on my discogram, and so I could not convice the surgeon to replace that level as well (I was afraid of further degeneration, and felt since I was already cut open and on the surgery table, why not replace all three levels?). Unfortunately, I was in a car accident about a year later, and that level got much worse and my pain came back.

Having another ADR surgery was not really a good option at that point, since they would have to go back in through the stomach and there is a lot of scar tissue there and also on the blood vessels of the spine. So, after much investigation and consulting with several doctors, I decided to have the XLIF fusion on L3-L4, as it was the most cutting edge and minimally invasive fusion available (I went home the same day, did not even spend a night in the hospital).

So, I now have a fusion on the level above my two artificial discs, and I feel the best I have felt in over 3 years! I do wish they would have replaced my L3-L4 disc back when I had my ADR surgery as it would have saved me having a second procedure, but they decided to be conservative and I guess that is usually the way spine surgeons handle things. I am going on a ski trip this week, so you can see I am healing pretty well.

[AJ]

its really reassuring to know that you are doing good after your previous adr and recent fusion. I am anxious as I'm not physically able to talk to anyone who has had a fusion after adr. Having a comparative experience is really useful.

I've not been offered a minimal procedure, presumably because fusion is on a prior adr level. I'm facing further surgery on a new level as well as further revisions so its worth gathering as much information as possible.

I have skiied on numerous occasions prior and post adr so heres hoping I get back post fusion. It seems a long way off at the moment so please let me know how you go on.

[AJ]

Having my fusion done on 23rd April. I'll post how it went hopefully quite soon after. I've been told approximately 5 days in hospital but I've had problems managing my pain post op previously so think it will be a couple of weeks before I start to feel human again.

[Harrison]

Alison, do you feel relieved yet? A sense of peace, feeling that you did all your homework? It's quite an arduous process, isn't it! Good luck with your procedure in two weeks. When you can, share more details about the "gutter fusion" procedure too.

[AJ]

I am happy that the procedure will definitely improve that level and it will be interesting to see which symptoms are left once the fusion has healed up.

My goal is to ski again once the fusion is shown to be solid!

[Kris]

Hi Charles, I was reading your post and was wondering if you could please tell me who did your XLIF fusion? I need a 2 level fusion below a 2 level Prodisc ADR surgery, and above bilateral SI joint screws. Sitting on top of the 2 ADRS is another disc with small herniation. I need a REALLY good surgeon who is good with complicated cases. COULD YOU PLEASE HELP ME IN ANY WAY? Currently not walking or doing much of anything due to another car accident 3 weeks ago. Thanks so much!!!

Originally Posted by CharlesinCharge

Alison,

I just had an XLIF fusion in September (so 5 months ago) after having a 2 level ADR done in 8/06 and I am doing great! An XLIF (Extreme Lateral Interbody Fusion) is a minimally invasive fusion, you can google it and learn more if you are interested.

When I had my two level ADR surgery over 2 1/2 years ago (L4-L5 and L5-S1) the level above (L3-L4) also showed signs of degeneration. But, it did not test positive for concordant pain on my discogram, and so I could not convice the surgeon to replace that level as well (I was afraid of further degeneration, and felt since I was already cut open and on the surgery table, why not replace all three levels?). Unfortunately, I was in a car accident about a year later, and that level got much worse and my pain came back.

Having another ADR surgery was not really a good option at that point, since they would have to go back in through the stomach and there is a lot of scar tissue there and also on the blood vessels of the spine. So, after much investigation and consulting with several doctors, I decided to have the XLIF fusion on L3-L4, as it was the most cutting edge and minimally invasive fusion available (I went home the same day, did not even spend a night in the hospital).

So, I now have a fusion on the level above my two artificial discs, and I feel the best I have felt in over 3 years! I do wish they would have replaced my L3-L4 disc back when I had my ADR surgery as it would have saved me having a second procedure, but they decided to be conservative and I guess that is usually the way spine surgeons handle things. I am going on a ski trip this week, so you can see I am healing pretty well.

[CharlesinCharge]

My XLIF fusion was performed by a Dr. Jeffrey Coe, who works out of Campbell, CA (near San Jose, about 40 minutes south of San Francisco). He is one of the pioneers of the procedure, and has done more of them than any surgeon in the western U.S. I found him through the Society of Lateral Access Surgery (SOLAS) and here is a link to their website:

The Society of Lateral Access Surgery

You can go to the website and put in your zip code, and find a surgeon near you that performs the XLIF procedure.

Good luck,

Charles