I Have Scheduled ADR Surgery

I am scheduled for ADR surgery at L4/5 on the 27th April. I have to await the results from my final test - Dexascan. It has taken me 6 months to evaluate all the data, gather all the professional opinions, and personal experiences from prior recipients (5 very happy people). I have had DDD at that level for over 20 years. I have maintained the constant pain and flare ups with diet, exercise, and medication. The past two years it has become unmanagable without the use of narcotics. The MRI, X-RAY, CT Scan, Bone Scan, and Discogram all point to the pain being generated solely by the DDD at L 4/5. I take oxycodone in mid-afternoon to get through the rest of the day. I feel this surgery is the ultimate step and I have fear and reservations. I feared ADR and was ready to do fusion - until I did my research on all that fusion entails. I spoke with a couple dozen people who had fusion and only one was happy with the results with the rest warning me to avoid it - if at all possible. It has kept me up nights worrying about the possible side effects or a poor outcome. I have faith in my surgeon and his staff. I am educating myself on all I can do on my part to make my care the best it can be pre and post surgery. So, I guess the rest will be in god's hands. I do worry about secondary infection and I will do all I can to avoid one. I am asking my patient advocate to be proactive as well. I will keep everyone informed on my progress as I do appreciate those that have shared theirs. Any thoughts on what I have said? Cheers

I've seen good, I've seen bad. I've done good, I've done bad. Good is better.

[sahuaro]

Sounds like you've taken control over everything you can have control over. I believe we can all relate to your fears and reservations--they are expressed in many posts here.
Wishing you all the best.

If you don't mind me asking, who is doing your surgery and what type of disc?

Craig

[Harrison]

It sounds like you've done a lot of your homework, but I am wondering what your real concerns are here? Or are the "usual" fears that every patient has when going into ADR surgery?

It sounds like you are waiting for more results to ensure your bone density is appropriate for disc placement. Keep us posted!

Good luck. I will remember you in my prayers. I have to wait till may 24 for my surgery. But I am exzcited.

[Fortitudine]

Hi SBP,

You have certainly been thorough in researching your options.

Perhpas it will help to alleiviate some of your reservations if I tell you what the spine surgeons said at a couple of spine conferences I attended last year.

They talked about the continuum of treatment, from tylenol and exercise all the way to surgery, and they said, "refuse to fuse!"

They suggested that when possible (i.e. when the indications were appropriate), motion-sparing technology should be considered first.

And remember, after all, you can still have a fusion if it doesn't work.

Good luck on the 27th.

For those who have enquired the ADR device will either be the FDA approved Charite or the as yet unapproved Kineflex. The ground rules of the study I am entered into are that I will not be told which disc in to be inserted until right before surgery. I'm kind of hoping for the kineflex due to the metal center. Cheers

[bobb0]

Seattle Spine, I truly hope your surgery will be successful for pain relief. We investigated the Seattle scene two years ago but there was no option at that time.

Fortitudine, not to be disrepectful, but I hope you have practical first hand information and experience to back up your statement:
"And remember, after all, you can still have a fusion if it doesn't work"

I sure hope you know what you are talking about when you suggest this course of action, it almost sounds like a walk in the park. How many patients have had this procedure performed on them after arthroplasty? What are the success rates?
I have posted on this forum in the past for anyone who had this procedure (or anyone who knows someone) to relate their experience.
Other than talking to two surgeons who participated in a total of four revisions like this, I'm very much in the dark.

If you can share, it would be greatly appreciated.

[Justin]

How many patients have had this procedure performed on them after arthroplasty?

Not many, as this is usually performed by an experienced spinal arthroplasty surgeon. I wish I had solid numbers on this. I know Dr. Bertagnoli has revised ADRs to fusions--I think he has had only had a handful of cases (I can look into numbers on this).

What are the success rates?

With an experienced surgeon, the success rates are better. --> I am guessing that success rates with Dr. Bertagnoli / Dr. Zeegers are pretty high, as they see some of the most difficult cases in the world. However, revision of ADR to fusion is a very challenging surgery.

Justin

[bobb0]

Thanks Justin, but let's be careful 'guessing' about success rates.

This may be a huge issue for the growing number of unsuccessful arthroplasty patients. I remember taking into consideration that fusion is still an option afterward, when considering surgery.
I wish we never would have used that reasoning in our decision equation.