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  #1  
Old 01-16-2017, 08:43 AM
robertodnr robertodnr is offline
Junior Member
 
Join Date: Dec 2016
Posts: 5
Smile Hello Everyone

Hello everyone,

First of all I would like to thank each and everyone of you that post on this forum, sharing your good or bad results.
This is a unique knowledge source of information, since there is not much spine related or trustable information online (too much marketing in my opinion).

I am 28 years old and I live in Santiago, Chile. I was diagnosed with DDD (L4-L5, L5-S1)when I was 18 years old, and pain triggered by a volleyball fall. Since then I haven't stopped visiting the doctor on a regular basis. I have all kinds of treatments done

PT
Celebra, tramadol
Swimming
Homeopathy
Chiropractor
Facet joint injections
Radiofrecuency ablation
Discectomy at L4-L5 and L5-S1 (very succesufull) 4 years ago.

But this year my symphtoms got worse (not as bad as they were before the discectomy), but still among a 4-7 just by standing on the metro or just walking.

My orthopedic surgeon has recommended me doing pilates, which has improved my symptoms but not enough to have a full sports rehab (my goal is to do sports again, like soccer).
In case this didn't helped me enough, he is recommending me a spinal fusion.

In Chile surgeons don't do ADR since they are mostly based on the US experience, and in my knowledge, prodisc L or the Charite has been very controversial against fusion with very different resulta. Also my doctor told me about economic interests among doctos and the clinical trials.

Right now based on my research and this forum experience I am considering Dr. Clavel, Dr. Bierstedt or Dr. Pimenta (Brazil, close to my country) for surgery. Also I am considering only M6 or ActivL devices.

Again I would like to thank you all for your kind words and sharing your experiences. I will try to keep you updated and share any decision I make from now on.

Cheers.
Roberto.
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  #2  
Old 01-16-2017, 03:25 PM
Blizzaga Blizzaga is offline
Senior Member
 
Join Date: Nov 2016
Posts: 130
Smile

Hello Roberto,

You really seem to have tried everything! I think it sounds like you may well be a good candidate for two-level ADR. I hope you will find a good surgeon and get better! Based on my research, ActivL sounds like a good choice. There are also other promising discs like Freedom, which you may consider. M6 is a bit controversial, but most likely better than fusion still. With your history, I don't think conservative treatment will help enough.

Wish you luck with decision making and keep us updated!
__________________
2015 Lost ability to sit
2016 Gradually worsening despite conservative treatment
2016 L4-L5, L5-S1 activ L success!
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  #3  
Old 01-23-2017, 07:42 PM
robertodnr robertodnr is offline
Junior Member
 
Join Date: Dec 2016
Posts: 5
Smile

Hi Blizzaga!

Thanks for your wishes!

Right now and after a lot of research, I am having my doubts about having an ADR... there isn't justt enough info to say if it works... only time will say.

On the other hand, Stott Pilates + Dolo Neurobion has worked great for me. I have reduced tramadol from a daily basis to 2-3 pills per week. I would strongly encourage everyone to try Stott Pilates with a personal trainer.


R.
__________________
28 years old, from Santiago, Chile.
2007 - Did fall backwards playing volleyball. Small pain began
2007 - Multiple PT sessions and facet joint injections
2010 - Herniated discs L4-L5 and L5-S1 after usual firefighter training
2011 - More PT sessions and then discectomy at both levels
2012/2016 - Multiple chiropractor and facet joint injections
2016 - RF ablation and PT sessions
2017 - Stott Pilates. By far the best treatment I've had so far

Trying to decide among a fusion or ADR...
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  #4  
Old 01-24-2017, 03:14 PM
Blizzaga Blizzaga is offline
Senior Member
 
Join Date: Nov 2016
Posts: 130
Thumbs up

I am happy to hear you found a conservative treatment that works for you! You should not go for surgery until you simply have lost all hope. The research I have seen, which uses the Oswestry disability index, shows that the surgery will most likely significantly lower your disability index. However, it does not most probably set it to zero (it can if you are lucky). This means that there may still be some issues remaining. But if your condition gets worse and you end up lying in bed, eating painkillers all day, with no hope left, then ADR will be your saving angel.
__________________
2015 Lost ability to sit
2016 Gradually worsening despite conservative treatment
2016 L4-L5, L5-S1 activ L success!
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  #5  
Old 03-03-2017, 07:56 AM
donmas2000 donmas2000 is offline
Member
 
Join Date: Dec 2016
Posts: 58
Default

Quote:
Originally Posted by robertodnr View Post
Hi Blizzaga!

Thanks for your wishes!

Right now and after a lot of research, I am having my doubts about having an ADR... there isn't justt enough info to say if it works... only time will say.

On the other hand, Stott Pilates + Dolo Neurobion has worked great for me. I have reduced tramadol from a daily basis to 2-3 pills per week. I would strongly encourage everyone to try Stott Pilates with a personal trainer.


R.
Hi, have to decide ADR or fusion. I am also think both at the moment and decide which is better? I only have one level at L5S1 so need to think if ADR will be good or will have more problem as more movement cause problem on that area.
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  #6  
Old 03-03-2017, 03:17 PM
Blizzaga Blizzaga is offline
Senior Member
 
Join Date: Nov 2016
Posts: 130
Default

Hi donmas,

The role of the intervertebral discs is not only to provide movement, but also to absorb stress in compression. When you walk, run, sit and lift heavy objects, your discs are compressed. The strain is distributed among the discs. If you fuse one level, the strain of that level is moved to the adjacent level. Therefore, fusing L5-S1 will make your L4-L5 take on the stress of both levels. This will make your L4-L5 more prone to degenerative changes. It is the adjacent disc syndrome.

So yes, fusing L5-S1 may be easier than fusing other levels (or so I have been told), but you are taking the risk of having to do surgery again as your L4-L5 breaks next. If you choose ADR, the risk of L4-L5 breaking is proved smaller, since the artificial disc will still absorb strain as a natural disc.

Some ADR have special designs for the L5-S1 level.
__________________
2015 Lost ability to sit
2016 Gradually worsening despite conservative treatment
2016 L4-L5, L5-S1 activ L success!
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  #7  
Old 03-03-2017, 04:39 PM
annapurna annapurna is offline
Senior Member
 
Join Date: Dec 2004
Posts: 1,668
Default

Also, fusion of L5S1 can drive more stress into your SI joints, something that the medical community doesn't really have a good solution for if they were to go bad.

On the other hand, putting an ADR in when what you really needed, because of extensive damage or other problems, was a fusion is a really good way to guarantee a miserable life post-op. I saw your other post; you've picked good surgeons to investigate. All of them have, in the past, recommended against ADR for those patients who couldn't use it for whatever reason. I'd suggest that you contact them and discuss your situation. Likely, you'll get different opinions between those three and between all of them and your local surgeons. Sorting out who to trust is often difficult and confusing but you may get lucky and have the recommendations end up being similar.
__________________
Laura - L5S1 Charitee
C5/6 and 6/7 Prodisc C
Facet problems L4-S1
General joint hypermobility

Jim - C4/5, C5/6, L4/5 disk bulges and facet damage, L4/5 disk tears, currently using regenerative medicine to address

"There are many Annapurnas in the lives of men" Maurice Herzog
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  #8  
Old 03-04-2017, 07:30 AM
donmas2000 donmas2000 is offline
Member
 
Join Date: Dec 2016
Posts: 58
Default

Quote:
Originally Posted by Blizzaga View Post
Hi donmas,

The role of the intervertebral discs is not only to provide movement, but also to absorb stress in compression. When you walk, run, sit and lift heavy objects, your discs are compressed. The strain is distributed among the discs. If you fuse one level, the strain of that level is moved to the adjacent level. Therefore, fusing L5-S1 will make your L4-L5 take on the stress of both levels. This will make your L4-L5 more prone to degenerative changes. It is the adjacent disc syndrome.

So yes, fusing L5-S1 may be easier than fusing other levels (or so I have been told), but you are taking the risk of having to do surgery again as your L4-L5 breaks next. If you choose ADR, the risk of L4-L5 breaking is proved smaller, since the artificial disc will still absorb strain as a natural disc.

Some ADR have special designs for the L5-S1 level.
I was informed that ADR only suit someone has no facet problem and not bone on bone. I also found out that some people on this site has experiencing facet problem after getting ADR. So it is really hard to determine which has more disadvantage and i am pretty sure if fail ADR will put someone into more problem as not many surgeon is capable to remove ADR without much risk.
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  #9  
Old 03-04-2017, 07:42 AM
donmas2000 donmas2000 is offline
Member
 
Join Date: Dec 2016
Posts: 58
Default

Quote:
Originally Posted by Blizzaga View Post
I am happy to hear you found a conservative treatment that works for you! You should not go for surgery until you simply have lost all hope. The research I have seen, which uses the Oswestry disability index, shows that the surgery will most likely significantly lower your disability index. However, it does not most probably set it to zero (it can if you are lucky). This means that there may still be some issues remaining. But if your condition gets worse and you end up lying in bed, eating painkillers all day, with no hope left, then ADR will be your saving angel.
Hi Blizzaga, i do not think it will be good to do surgery if one has been suffering on the bed and eating lot and lot of pain killer. For me, i will try to do it soon before that happen. That seem to be really suck as i have been there for 2 months and since i have depression. I am slight better after a spine rehab program but i still looking for surgery as i am nowhere near like a normal person can do...and miss my old days in the gym 2 years ago.
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  #10  
Old 03-06-2017, 03:34 PM
Blizzaga Blizzaga is offline
Senior Member
 
Join Date: Nov 2016
Posts: 130
Default

Quote:
Originally Posted by donmas2000 View Post
Hi Blizzaga, i do not think it will be good to do surgery if one has been suffering on the bed and eating lot and lot of pain killer. For me, i will try to do it soon before that happen. That seem to be really suck as i have been there for 2 months and since i have depression. I am slight better after a spine rehab program but i still looking for surgery as i am nowhere near like a normal person can do...and miss my old days in the gym 2 years ago.
Yes, I know exactly this feeling. I agree that waiting too long will also statistically somewhat reduce your surgical success. On the other hand, one must wait long enough to ensure that the symptoms are not only caused by the common "bulging disc", which can heal in a year or two. We must ensure that, for example, a degenerative change is playing a role and inhibiting the disc from healing. Maybe a good time is around half a year: if things are not improving at all, but rather going worse, in half a year, despite conservative treatments, then, surgery can seriously be considered.

You will probably miss those old days in the gym for the rest of your life (I will), but with a successful surgery, you will at least have some type of "happy days in the gym" to look forward to in the future
__________________
2015 Lost ability to sit
2016 Gradually worsening despite conservative treatment
2016 L4-L5, L5-S1 activ L success!
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