Facing Possible 2 level ADR...HELP!

[2 Young 2 Hurt Like This]

Last year I found out I might be needing a double disc replacement at L3-4, L4-5 using the Prodisc-L. I've read a ton of post about it and I am wondering if anyone had PT leading up to the surgery and do you think it helped?

From Dec of 08 till now I have been doing light cardio using the elliptical machine at the gym and lost 75lbs. I am at surgery weight but still have 30 more to go. I've been doing PT at home 3-4 times a week for the past 5-6 months. I can tell I am getting stronger but overall it only aggravates my back.

I also got a 2nd opinion a couple weeks weeks ago. The doctor told me I have 3 options. A microdiscectomy (hollow out the jelly donut aka disc.), XLif (fusion) or ADR. He suggested trying to MicroD. Everything I have read about the MicroD mentions relief of leg pain not back pain. My problem is I have both.

I'm leaning towards getting the double ADR. To me fusion is out of the question. The MicrosD is to much of a gray area and I haven't been fully convinced it will solve both of my problems.

Getting back to the ADR recovery. Seeing I have lost so much weight I now have extra skin in my tummy area and it folds over where my belly button is when I sit. The surgeon said that it shouldn't be a problem and he can either make a vertical or horizontal incision depending on my bodies anatomy. I've read that the incision is one of the most uncomfortable parts and this has me worried.

I've scheduled an appointment for another opinion on March 8 2010. All this has me stressed out and I want to make sure I have all my bases covered before committing to anything.

I'm open to any suggestions and please don't sugar coat anything. This is my reality and I need to face it no matter how painful it maybe.

Thanks,

Liz

[jamie5136]

Would you be doing this state-side? If not, IM me and I will tell you my failed case over-seas in Germany, but there are success stories, mine was not one of them and the dozen or so friends who have had a two to three level ADR are also failures. If you go overseas, there are follow-up issues. My x-rays were ignored and a massive subsidence has now occurred and i am facing a removal and/or fusion on top of, which I hear does not work. They also did not do a bone density on me and two of the three sunk and a cement injection had to occur in Germany. In hind sight, I would have done a fusion at L5S1 and a one level ADR at TBI. I would have been fine, but I was told that the ADR had an over 90% success rate and this is not the case. I now can't sit, lay down and have pain in my legs.

So, DO YOUR RESEARCH. Stay on this board, visit other boards and make the decision at that time. I am a young, healthy woman and now destroyed because of this.... oh, and now broke. My family is besides themselves. I would never do an ADR again until it is more refined. Now I know why it is not approved by the FDA for more than one level. Oh, and if you need it removed, that is very risky and you can die or become severely injured/disabled. I know several bed-ridden women. So, there is the down and dirty. Some have had success, some not. Some have facet issues, some do not....yet. It was the biggest mistake I have ever made. If you do decide to do it, don't go overseas, if you can avoid it for follow-up reasons. It is good to have someone you can see. If you want any more info, IM me. Thanks!!!

[Rob Wilson]

Usually best to go with least invasive. That would be the mciro surgery. If the discs are bone on bone it might not help but worth a try. You can always have the ADR later. My 2 level ADR went great EXCEPT I almost died on the surgery table since they mistakenly cut the iliac vein. I ended up iwth many blood clots. The ADRs ended up working well though. OH I almost forgot. I also needed multiple micor surgery AFTER ADR surgery to decompress nerves. It is very difficult to decompress your nerves during an anterior ADR surgery. Many websites even state that ADR is for back pain not leg pain.

[longroadahead]

I have went to 3 different surgeons and 2 out of 3 say 2-Level ADR is not good due to the placement of the disc is never totally perfect and when you place 2 of them then the non-perfect placements puts more pressure everywhere else which leads to more problems especially if you back is not perfectly straight vertically.

One of the surgeons I have seen says right now the way to go if you need a two level is the ADR on one level and fusion on the other.

I myself would go with the least invasive options that leave options open for future technologies.

[2 Young 2 Hurt Like This]

Thanks for your replies. I do agree with trying the other procedures and not jumping into getting the ADR. I currently have a lawsuit against the person who did this to me. The trial date is in June. I feel like I need to hurry up and decide on something. My worry is later on when I am still hurting and the trial is over then what? I don't have health insurance, haven't been able to work or go to school and most certainlly can't afford more care for my back. Not to mention why the heck should I be the one to pay when I

Personally I like the idea of ADR but I dont think I ready to jump into something so serious if it can be avoided. I think if I got the ADR and something went wrong it would only be in that area (Maybe?) and they could fix it. I do know that is a very risky surgery. (Im struggling with explaining my thoughts.) With the fusion I feel that will cause to much stress on the rest of my spine and more problems in other areas.

I have noticed that a lot of people on here have gotten the fusion/ADR combo. The 1st surgeon I met with has never had a problem with any that he has done (Single and double). He did tell me he has had to replace/fix/fuse other doctors work.

With the MicroD I've only found info saying it relieves the leg pain/ numbness. If there was something more convincing that will help with both my problems I would most likely try it. Other than that I feel like its a half *** solution. Sorry I say that in lack of a better word. When I was looking into it I noticed if and when the MicroD fails a lot of people end up getting a fusion, is ADR even an option? When I tried looking it up I didnt find much.

I know there is no straight answer and being only 23 this really sucks! I want to be able to live life and be active again. I know nothing last forever and that there are pros and cons with everything. Some are just more serious than others. I've come so far and its been so long I don't want to do anything that will set me back. I'm tied of my life being on hold and I don't take this lightly.

I almost didn't get a 2nd opinion but now I am happy I did which lead me to set up a 3rd. I'm not going to stop until I find something I feel will work for me and last a while.

[Cirobi]

Hi Liz,

I can definitely see where your concern is with the MicroD. I think I'd have the same questions about whether or not it would help both problems. The tricky part is that some leg pain/numbness is caused by the same issues that cause the back pain (i.e. ruptured discs)

The advice I always give to folks still considering surgical options is to find examples of both the worst cases and best cases but keep in mind that you will most likely fall somewhere in between. Some of those who've replied gave a good spectrum of possible bad as well as a mixed bag of bad during surgery but good following.

Regarding your PT question, doing PT toward the start of my attempts to find relief actually helped me realize my initial diagnosis had to be wrong. The PT I did had zero impact on my back. I think it eased only slightly, likely due to the stretches, but plateaued quickly. On the flip side, the PT exercises could help you keep your core strong enough to help make the surgery easier if you do go with the ADR.

My thoughts on it are that I'd lean toward ADR. Any surgery is risky, not just ADR. While some of the less invasive measures may ease or lessen pain in the short term, I personally would have to ask myself and my physicians what the liklihood would be that I'd be back where I started (in pain) in a short period of time (i.e. a couple years). Bandaids are good for cuts, but if there's a way to fix something for a longer period of time, I'm personally drawn to the long term solution.

Also with ADR, my feeling is that, while it's not ideal, if you run into an ADR issue post-op, fusion is still an option whereas if you go fusion, ADR is no longer an option. Definitely do more research and as more questions about the less invasive options. There might be some folks here who can comment on the procedures. Unfortunately I'm not one of them since my disk herniation was such that it wasn't even worth trying less invasive surgical measures. However, there is a wealth of information here that will hopefully help.

Oh, and with the incision part, I think that no matter what your body type/shape is, the incision will always be uncomfortable because of what it is to begin with. There are ways to lessen the discomfort depending on which side (posterior/anterior). I found that for my anterior incision, these really wide band, lightweight sweatpant material shorts were the greatest things ever invented as far as clothes. My surgery was in the summer and I lived in those shorts for the better part of 3 months. The band laid over the incision site but was soft enough and wide enough to not be jabbing into it. When I went back to work, I had to pay special attention to where the waistband of my pants landed because when I didn't there was definitely a weird and unpleasant feeling at the incision site. That took upwards of 6 months go to away completely. Now I just have my incision dent since my tummy is nowhere near washboard flat.

Hope I was at least somewhat helpful and that no matter what you choose, you'll find relief from your pain.

~Sara

[2 Young 2 Hurt Like This]

Hi Sara,

I was told by the 1st surgeon I went to the herniation at L3-4 is causing my Leg pain/numbness because it is pressing on the nerves. The L4-5 is DDD with small herniation which is causing the lateral back pain. In order to solve BOTH problems he recommended the ADR at both levels. To me at this point in time sounds wonderful although the recovery process is scary. At the same time I want to see what else is out there.

I feel the same as you when it comes to finding a more permanent solution. This is why I'm not convinced the MicroD would do any good and would only be a band-aid to the problem.

I did PT a whole yr after the accident before I found a doctor that actually listened. PT didn't help then and still hasn't. I'm getting stronger and right after doing it I don't feel as stiff but the pain is still there. It's usually worse from getting aggravated.


My life revolves around my back and learning as much as I possibly can. I wish I would have known and thought about joining a forum a long time ago. My trial date is coming up and I need to figure all this out asap. At the same time I don't want to rush into anything.

Last night while I was trying to fall asleep I was thinking about how much pain I am in 24/7. I told my bf that I'm afraid to have anything done because I am scared it will only get worse ( like I don't hurt enough now). I'm really tired of living off Vicodin and I'm sure my liver is too. Sometimes Vicodin doesn't help but I refuse to get caught up on a stronger medication.

Thanks

[2 Young 2 Hurt Like This]

Hi LongRoadAhead,

I've been reading all the replies to my post a few time a day along with other members post. Sounds lame but I'm waiting for something to click.

While I was reading yours regarding the positioning of the 2 ADR I totally agree and understand why that would be a problem. You also mentioned the single level ADR with a single level Fusion. I will be asking my doctors about that and see what they have to say about it. I personally didn't think about it or even knew they could do both.

My main worry with a fusion is it can not be undone once you have it. I've read horrible stories about fusions, more bad than good. It seems like it puts way to much strain on the rest of your spine which then leads to new problems at different levels (domino effect).

[Cirobi]

I can completely understand where you're coming from. I think the only difference aside from number of levels is in how long I waited to seek any kind of treatment. I can't help but wonder if I had gone to the doctor for my back when I first hurt it back in high school if I might have prevented needing surgery at all. Too late now, of course, but the thought is always there.

I've seen, at least in cases on these forums, that the most common hybrid surgery is fusion at L5/S1 with the ADR L4/L5. I'd be interested to see if they'd do it shifted up a level. My main concern in that is the stiffness that fusion causes and how it'd affect your L5/S1 (if you have it, some don't) in the long run.

I think if you've got a reputable surgeon confident in a 2 level ADR, you're probably better off than most. I would trust my spine in a multi-level to my surgeon. You should ask, if you haven't already, approximately how many ADR's your surgeon has done. I think my surgeon was a little surprised I asked, but he had no problem giving an approximation of how frequently he did them. Heck, during my initial follow ups, there was a nun who was always in the waiting room the same day as me and she apparently had a 2 level ADR done by my surgeon. She looked like she was doing fantastic. Her recovery was visibly slower than mine, but I'd imagine it's not out of the ordinary for the recovery length to increase significantly with the more levels being done at the same time.

Oh, my other thought going into my surgery, and the same line of thought I presented to my mom who's about to have ACL surgery, was that the younger I went for it, the more likely my body would heal smoothly and potentially the longer time through the future that I'd be able to enjoy a pain free or significantly lessened pained existence.

~Sara

[2 Young 2 Hurt Like This]

Sara,

I 1st met with my surgeon Dec 08. He is a very confident doctor. He made both me and my boyfriend feel comfortable as soon as he walked in the room.

I told him I wanted to lose weight before having the surgery and he sent me to another doc for that. Once I got to surgery weight I met with him again in Dec 09. A whole year had passed and it felt like it had only been a few days. I told him I'm ready for the surgery and started picking brain with all the questions we gathered while researching.

I was sitting in a chair and the doc hopped up on the exam table and answered every question we had no matter how silly it might have seemed. He never once tried to rush us off. He told me he isn't going to lie, it's gonna hurt like hell.

I asked him how many ADR he has done. He told me he's done a lot of both single/double and that he has never had an issue with any of them. I then asked if he ever had to take one out and he said yes he has had to fix other surgeons work.

He told me recover is 6 months to a yr. From reading what people have said on here I suspect it will take longer.