Success rates of ADR?

[KBear]

Hey everyone,
Lately, I have been reading about a lot of you who have had unsuccessful ADR. That scares the crap out of me and now I am second guessing myself as to if I want it done. So, I thought I would do an informal survey, asking anyone who has had ADR about it good/bad/indifferent outcomes/opinions.
Here are my questions:
0) How long were you in pain prior to surgery? (question added, 10/20)
1) What level(s) did you have done?
2) How long ago was your surgery?
3) Who was your surgeon?
4) What disc(s) did you get?
5) Was it successful?
6) Did you get instant relief?
7) Did you get relief after a certain time period? If so, how long before
you got relief?
8) Did you never get relief?
9) If you did get relief, did it last? If not, how long did it last?
10) What was your pre-surgery pain level and what is your current pain
level?
11) What other surgeries/procedures have you had done on the operated
level, if any? EDIT: What surgeries procedures have you had done on the operated level, after having ADR, if any? (question clarified 10/20)
12) What other spine problems has this caused at the operated level or
any other level, if any?
13) What do you wish you would have done different, if anything?
14) What do you wish you would have known before surgery, if anything?
15) If you could go back, and knowing what you know now, would you
still choose ADR?

[phylly]

Well here goes, this will be long post.
1. I had levels L4-S1 done
2. My surgery was one year ago
3. My surgeon was Dr. Delamarter
4. I got the Pro-discs
5. It was a very up and down recovery for the first few months with no relief of buttock and leg pain. Back pain gradually decreased.
6. I am not sure the relief was instant. It was slow and steady with some rough patches when I over did activities. I was able to walk a lot and that felt good. I was starting PT
7. At about 6 months I had almost full back relief . I was able to start exercising and reducing meds.
8. hence the second foraminotomy at 7 months to decompress the nerves in my buttock. something occurred after the decompression in my back and sacral pain increased over the months following surgery with pain at high levels. PT increased the pain in my facets. I needed many epidurals which did not work and then facet injections which helped a little. I still have bilateral calf pain and weakness upon walking. All activities are on hold with constant back pain.
9. I guess I never really fully felt relief but felt that I had two different things going on. The leg and buttock pain was not properly diagnosed.
10. Pre-surgery pain and pain now are very similar but in different places. Pain before was about 8/10. Pain was in buttock, left leg and low back. Pain was fairly incapacitating. Pain now can be 8-9/10. The pain now is just as incapacitating because I can't exercise at all. and pain and weakness go down into both my calves causes me to need to lie down. Scalding pain in low back and sacrum The Rhizotomy may help some of these symptoms.
11. I had left sided decompression surgery to reduce leg pain. Pain in buttocks is a little better
12. I feel since the second surgery I have had facet problems from too much movement in my back.
13. I wish that I had talked to lots other patients, Spent time online. Asked more questions that I did.
14. I wish I had known all the positives and negatives of what ADR's could do. I wanted to know all the risks and complications.. I would liked to have know about the failures as well as the cures. I wish my Dr. had not glossed over the facet joints since I had asked about them and my age.
15. Honestly, I am really not sure if I would have done the ADR, I might have tried a hybrid or gone ahead with a fusion. I would probably have tried a hybrid if offered.
Phylly

[berry]

Hi Kathy
Here are my answers to your questions, I think the length of time from begining of problem to surgery should also be considered:

0) How long were you in pain prior to surgery?
First hurt back back in 1978 when lifting a patient as a student nurse. Intermittent pain over next 20 years, just put up with it and worked through it. Biggie came in Jan 2002 when sneezed in flexion (as I was locking the medicine trolly) and prolapsed discs ...& ending my career. So 2yrs 1 month of agony prior to surgery.

1) What level(s) did you have done?
L4/5 & L5/S1 then four years later C5/6 &6/7 -Having lumbar issues puts great strain on the neck I've been told.

2) How long ago was your surgery?
Feb 2004, 58 months lumbar: Feb 2008 Cervical, 10 months

3) Who was your surgeon?
Ian Shackleford - UK

4) What disc(s) did you get?
Lumbar Prodiscs, Cervical Activ C

5) Was it successful?
Yes both times

6) Did you get instant relief?
Instantly felt relief from leg pain after lumbar and arm pain after cervical- a wonderful feeling and I was ecstatic. Back pain was different post surgery. I was deighted that I could stand up straight (and still can) rather than like twisted like an 'S' hook. That red hot burning spade stuck in back lumbar pain was gone.

7) Did you get relief after a certain time period? If so, how long before
you got relief?
Lumbar recover took around 6 months. Returned to clinical nursing at 8 months and managed busy clinical shifts withour problem. Neck was much easier and recovery was quicker and really feels as good as new now.I know it never wil be as good as new but it feels as if there was never a problem with my neck.

8) Did you never get relief?
Thankfully I did.


9) If you did get relief, did it last? If not, how long did it last?
Gradual return of lower back, sacral and leg pain after about 3+ years, initally mild but over the last seven months I have had four episodes of severe (8-9/10) pain that have taken a couple of weeks to resolve and sitting toleraance has reduced.

10) What was your pre-surgery pain level and what is your current pain
level?
Pre-lumbar surgery 5-9/10: Current lumbar 2-9/10
Pre-cervical 3-9/10: Current cervical 0-3/10

11) What other surgeries/procedures have you had done on the operated
level, if any?
Lumbar: facet injections x3, sacroiliac injections x2 , epidurals x2, physio, core strengthening & pilates, accupuncture, hydrotherapy, reiki, massages, electro-accupuncture, interferrential and anything else you can think of

Cervical: Epidurals x2 and physiotherapy

11b) What surgeries procedures have you had done on the operated level, after having ADR, if any?
Facet joint injections at operated levels in May 2008, 4yrs 3months post op. These did provide relief for 3-4 months.

12) What other spine problems has this caused at the operated level or
any other level, if any?
Further degeneration was notice on lumbar x-rays at two years post-op but was asymptomatic then. By three years I had had some pain return, put down to facet arthrosis at index levels also overriding facets and instability above prostheses An mri in Sept 08 confirmed further disc degeneration at the three levels above the artificial discs.

Cervical none yet! Have mild degeneration at C3/4 but hope that holds out.

13) What do you wish you would have done different, if anything?
Post-operatively I would not have done so much rotational exercises on the gym ball as I personally feel this has contributed to the decline of the facets by increasing the stress put on them. I was doing exercises 6 times a week rotating to the extreme thinking I was doing good when really I believe I have done harm. My surgeon disagrees with my theory though, although he recently told me that they are finding that they are not providing the stability hoped for in some people. He now uses Activ discs which are promoted to be kinder on the facets.

14) What do you wish you would have known before surgery, if anything?
I wish I had considered and generally cared for my spine though my life...being an 'old school' nurse who was trained in the 70's to lift patients my spine has had much wear over the years. Obviously I wish there had been results of mid-long term studies which showed these shortcoming which are coming to light. I tried my best to learn what I could and thought I was making the best decison for me. I do still think that as I am still currently better than I was without the surgery. I wish I had though more about the possibilites of revison further down the line but at the time my main concern was relief from pain. I asked about the longevity of the device and it may well last 40 years but the rest of my spine continues to degenerate I've read some research which showed that 20% of women with two-level TDR go on to have progression of facet arthrosis and adjacent segment degeneration.

15) If you could go back, and knowing what you know now, would you
still choose ADR?
Yes, as my alternative was pain management clinics, fusion wasn't offered as an option to me so I would, but, like Phylly, I would look into the possibilties of a hybrid surgery as I also think the ProDiscs have permitted too much movement and subsquently stressed the facet joints which are now causing pain.
I would look into the possibilities of receiving the newer total segment replacement devices which replaces the facets as well as the discs but that isn't currently widely available.

Got to go

Lynda
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[Terry]

1) What level(s) did you have done?
L4/5 & L5/S1, C5/6 &6/7 because both areas were a mess and, lumbar issues affect the cervical area

2) How long ago was your surgery?
November 4, 2006

3) Who was your surgeon?
Stenum Hospital in Germany

4) What disc(s) did you get?
Lumbar: Maverick discs, Cervical: Prestige discs

5) Was it successful?
Yes

6) Did you get instant relief?
Yes I got instant relief though the recovery time was a roller coaster. I had Sacroiliac and facet injections every three months for the first year. I was also on Lyrica for quite awhile and discontinued that in June of 07.

7) Did you get relief after a certain time period? If so, how long before
you got relief?
The cervical relief was instant and have had little issues since. The only time I notice the cervical area is if the Lumbar area is inflamed. I would say that, for the lumbar area, it took all of twenty months to feel top shelf.

8) Did you never get relief?
Thankfully I did.

9) If you did get relief, did it last? If not, how long did it last?
Knock on wood it has lasted. I just had a bump in the road with pain for the last month and a half in the lumbar area. I just got sacroiliac joint injections the other day that seem to be doing the job.

10) What was your pre-surgery pain level and what is your current pain
level?
Pre-lumbar surgery 5-9/10: Current lumbar 2-5
Pre-cervical 3-9/10: Current cervical 0-2

11) What other surgeries/procedures have you had done on the operated
level, if any?
Lumbar: facet injections x4, sacroiliac injections x2

Cervical: Nothing

12) What other spine problems has this caused at the operated level or
any other level, if any?
None

Cervical none yet!

13) What do you wish you would have done different, if anything?
Nothing. I have no regrets as I have my life back. I went in to the surgery in fabulous condition. I have worked hard to stay in shape since to keep the weight down.

14) What do you wish you would have known before surgery, if anything?
Nothing

15) If you could go back, and knowing what you know now, would you
still choose ADR?
Yes I would. I hate the thought of adjacent segment disease. ADR gave me an option of returning to an athletic life and not being crippled up. I can walk, bicycle, gardening, kayaking, snowshoeing, etc. I truly feel like I have my life back. i can operate professionally as well. My job and career have been on the hi rise since surgery. The board likes having the old me back.

Terry Newton

[Cirobi]

1) What level(s) did you have done?
L5/S1

2) How long ago was your surgery?
6 Months as of Dec 23rd 2008

3) Who was your surgeon?
Dr Richard Balderston with 3B Orthopaedics in Philadelphia, PA

4) What disc(s) did you get?
Prodisc

5) Was it successful?
Very

6) Did you get instant relief?
Yes - Aside from post-op pain I expected, from the time I woke up from anesthesia I could tell that the familiar, annoying and painful pressure I'd dealt with for about 10 years was gone gone gone! Had I not been so worried about retrieving my cell phone and credit cards from the lockbox at reception, I probably would have been grinning from ear to ear from feeling none of the old discomfort.

7) Did you get relief after a certain time period? If so, how long before
you got relief?
Any pain from the surgery was pretty much gone by the time my 6 weeks of disability leave from work ended. The incision site was tender for the better part of 3 months and I still get some occasional discomfort from the incision, especially if I'm wearing blue jeans and forget to pull the waist band above the incision area before sitting.

8) Did you never get relief?
N/A

9) If you did get relief, did it last? If not, how long did it last?
I still have relief. I will say that I still have some ups and downs were some days I will feel sore and others I won't. Much of the soreness is muscular and I can easily tell now that I have the comparison of the pre-op discomfort. Prior to really finding the true diagnosis of my back pain, most docs thought it was still a muscle strain issue when it never felt purely muscular in nature. Now, after learning more about back pain and problems that can trigger it, it's easier to distinguish between them. I also have plenty of recovery left to go. I feel great and am back in action at work to nearly 100% capacity, but know that if I don't continue strengthening my core muscles, my total recovery could have more than a couple minor ups and downs.

10) What was your pre-surgery pain level and what is your current pain
level?
Pre-op - anywhere from 7-10. there were some days I felt like it would be impossible to function and other days I'd feel relatively ok. I say relatively ok because I learned how to just deal with it and push through any discomfort... not a very good thing to be learning.

Post-op - 0-3. usually when I feel a larger amount of discomfort it's after doing too much at the gym or if I haven't gotten enough sleep for too many days in a row. Also, my monthly womanly torture cycle tends to still make me extra sore in my low back. Generally i'm at about a 1 on average.


11) What other surgeries/procedures have you had done on the operated
level, if any?
Just a discogram a few months prior to my surgery.

12) What other spine problems has this caused at the operated level or
any other level, if any?
None so far if I understand the question. I'm not sure if you're referring to prior procedures at the level I was operated on or if you mean the ADR surgery caused some other issue. In either case, no further problems have come up yet.

13) What do you wish you would have done different, if anything?
I probably would have fired my primary care physician sooner and gotten the ball rolling sooner no matter what the hassle may have been. I waited until the start of 2008 to really push forward to find a real diagnosis after my former primary care physician failed me. The only reason I waited was to avoid insurance hassle since I was previously on an HMO, suspected my physician of discriminating on my care due to the type of insurance and had to wait until Jan 1st for my new open access policy through work to kick in.

14) What do you wish you would have known before surgery, if anything?
The only wish I had is a faily absurd one because there's no true way to know, but I wish I had known the exact time frame I could expect to feel up to most activities. I had general timeframes as that's all a doctor can really do is generalize the time it may take to recover. It's just so hard to plan appropriately around generalized things. What can I say, I'm a control freak like that. Haha.

15) If you could go back, and knowing what you know now, would you
still choose ADR?
Yes, very yes. In fact, if I run into any further back issues, I will still choose ADR as long as I remain a proper candidate. Of course, if there's another newer technology that has emerged and proven itself to be worth the risk, then I'd likely highly consider trying the newer technology. For example, the Dascor Nucleus replacement thing fascinates me. Well, new technology of most kinds fascinates me. I'm not sure I'd want to participate in a trial for a product, but I don't think I'd mind being a relatively early adapter. As long as I can try to keep my spinal mobility and flexibility to some degree, I'll be happy. Fusion will only ever be a last resort for me and that would even include suffering another decade of back discomfort if I had to. I'm a very stubborn person and I want to do what I feel is right for my body while taking a very heavy consideration to what the doctors advise. They're the experts in their fields, but I consider myself the expert on my body and how my body feels.

[berry]

This link may be of interest:
The Potential Biomechanical Etiology for Lumbar Disc Replacement Failures:
Review of 24 Patients and the Rationale for Revision

http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijmist/vol1n2/failures.xml

[rhatzy]

Here are my answers
1) What level(s) did you have done?
I had L3-4, L4-5
2) How long ago was your surgery?
January 25, 2008
3) Who was your surgeon?
Dr. Ritter-Lang Stenum Hospital Germany
4) What disc(s) did you get?
Maverick
5) Was it successful?
Yes
6) Did you get instant relief?
No
7) Did you get relief after a certain time period? If so, how long before you got relief?
Total relief after 6 months
8) Did you never get relief?
9) If you did get relief, did it last? If not, how long did it last?
So far so good. No meds at all
10) What was your pre-surgery pain level and what is your current pain
level?
5-7/10 hard to tell because I was on percocet. Current pain is 0
11) What other surgeries/procedures have you had done on the operated
level, if any?
Discectomy L4-5, 1996 Discectomy L3-4 2007. Epidurals, facet blocks no help. Had a endoscopic laser procedure to clean out some scar tissue at L4-5 which freed up a nerve july 2008.
12) What other spine problems has this caused at the operated level or
any other level, if any?
None
13) What do you wish you would have done different, if anything?
Not had the last discectomy and went stright for the ADR
14) What do you wish you would have known before surgery, if anything?
I asked all the right questions. It took a while tho
15) If you could go back, and knowing what you know now, would you
still choose ADR?
YES

Mark

Hey Berry
Wow that was scary,X-ray # 14
I was hoping ADR was the answer, just keep moving forward
Thank You

Gil Denis

[Sandra L]

1) What level(s)? C3-4, C4-5, C5-6, C6-7.
2) How long ago? April 8, 2008
3) Who was your surgeon? Dr. Bertagnoli, Germany
4) What disc(s) did you get? ProDisc-C
5) Was it successful? Yes
6) instant relief? No. Felt good several days after surgery which I contribute to oxicodon. Very ill month after got home, improved after emergency gall bladder surgery.
7) after a certain time period? Yes, but feel lost weight and gb surgery slowed me. how long before relief? Improved slowly until November.
8) Did you never get relief? Not total.
9) did it last? Have days to a week that are good. Days to a week that are bad, trap pain, burning, electric shock returned.
10) pre-surgery pain Low level pain for years (1-2) caused by boat accident in 70's, car in 80's and riding jet ski pounding the waves, and heaving landscaping, building houses. Relieved with ibuphrofen. In 2004, pain (3-6) increased, developed numbness in left arm, thumb and pointer with electric shock in neck. Tramadol taken several times weekly to around the clock in Dec 2007, when MRI showed spinal cord impingement. current pain? Higher post-op (2-9). I am one of the lucky ones who didn't have high pain pre-op.
11) procedures on the operated level Massage, chiropractor (high velocity, above and below replaced discs, which I have stopped, caused horseness and swelling). Just got prescription for muscle relaxer, which I'd stopped taking. Will look into injections.
12) other spine problems None.
13) done different Rode jet ski like an adult instead of a teenager!
14) known before surgery More about everything. Should have read more posts/threads. But I went into this with no fear and expected no pain within 2-3 mos. after surgery. So better I didn't read more??
15) still choose ADR? Yes, I'm mobile and look forward to again. I have faith that I will be pain free or close. I feel I could not have chosen a better more experienced doctor for mulitple cervical ADRs.

[KBear]

Thank you for all your replies. For everyone who responded, or read responses, I did a question number 0. How long were you in pain prior to surgery? Thank you Lynda for giving me that question, that is an important bit of information. I also clarified question number eleven to read: 11. What surgeries procedures have you had done on the operated level, after having ADR, if any? Meaning, post-ADR, have you had any procedures or surgeries, such as injections, revision, etc.
Thank you all for taking your time to answer this.

Anyone who hasn't posted, please do, I have gotten several pm's today regarding this post and lots of people looking forward to reading your responses.