ADR/fusion hybrid

Has anyone had this procedure done in 2 operations - ADR and fusion done separately?

[DougMcLager]

I've never heard of this being done, but I suppose it's possible. I had my fusion and disc replacement done at the same time. This seemed to be the way to go.It would be pretty rough having the abd. incision opened twice or if the fusion was a posterior approach, they would have to open you up there anyway.

[cathydownunder]

Is there any particular reason you'd
consider having the procedures separately?
I had my hybrid L3/4 L4/5 done last July via an abdominal incision and it wasn't pleasant.
Any surgery is very stressful and has the risk of complications so unless you need to have them done individually I'd suggest not to.
B.T.W. my surgeon said if I need another spine surgery (most likely) he wouldn't be opening up the old incision site but going in from the other side.

[Terry]

I had 4 discs installed at one surgery. Two in my cervical and two in my lumbar. I could not imagine having to go through another surgery now. The scar in my lower abdomen is 4 1/2 - 5 inches long and still hurts near 4 months later. I could not concieve of having to go through the same area as I imagine what the scar tissue looks like internally. I would find the best surgeon to agree to do all at once. Peace.

Terry Newton

[tmont]

Hi,

I'll be a hybrid case with 2 different surgeries (three, if you consider the percutaneous nucleotomy): fusion C6-C7 in 2003 and ADR C5-C6 'sometime' in the future.

Why hybrid, and why two different surgeries in my case?

Surgery was an absolute necessity on C6-C7 due to incapacitating pain and neurological symptoms, and the prosthesis that was available at the time (Bryan) was not one my NS felt was viable, so he opted for a fusion despite a slight discopathy in C5-C6.

While I was instantly free of all pain and symptoms immediately after surgery, and got right back into intense sport with no noticeable ROM restrictions, the fact remains that 4 years later the discopathy has evolved and disc replacement will be necessary. But I'm thankful that I'm in nowhere near as disabled or as in as much pain as prior to my 2003 surgery.

I consider my case both a statement for fusion and a caution regarding it, as paradoxical as it seems. For: waking up after surgery and being out of pain and able to function normally and highly athletically was incredible, and if there was loss of motion I certainly still do not feel it. Caution: the weakness in C5-C6 developped subsequent to fusion and my active lifestyle, and I'm now looking at more surgery.

I wonder what really caused this degeneration, and whether had there been no weakness to exploit in C5-C6, I'd still be fine today. The mechanics and of adjacent-segment disease and the role of my fusion are unclear and likely to remain so unless a definitive verdict is reached by the medical community regarding the merits and risks of ADR vs fusion, which is why I'm impatient for long-term study results.

Going back to surgery doesn't thrill me either, but at least the same incision can be used....

[Terry]

Maybe a misunderstanding on my part as I also had a previous surgery in 1995 @ Mayo Clinic in my cervical area and now ADR in 2006. I got the impression that the question was to have them closely in line with each other. I could be wrong though. CMS: How soon are the surgeries apart from each other and why are you looking at two seperate surgeries?

Terry Newton

[Alastair]

I think if you were to ask for two separate surgeries that the surgeon would decline to do that.

An anterior approach as ADR requires, is a huge surgery, and larger than most other surgeries ever done, even heart surgeries now. Don't forget about the scar tissue as well which can be extremely troublesome for the rest of your life
best,
Alastair