ADR + Facet Join replacement

[Karger]

Hello,

I am now having issues with my facet join degeneration after an ADR about 8 years ago. I see in Germany they do facet join replacement and ADR.

Has anyone had this?

Thanks,

Andrew

[annapurna]

Neither Laura nor I have had it but you might also check into a trial that was going on in Austin and Grand Cayman, started out of Grand Cayman, for a device that incorporated both ADR and facet joint replacement. The trial was still running hot and heavy in 2020-2021 so it might still be going and accepting patients.

[phillyjoe]

research TOPS by Premia Spine. It is some sort of facet replacement system. I think it was originally being done by the German surgeons but is now also done in the US

[WentGin]

Hi - I have facet pain at 4-5 after ADR right side more than left. hard to get in and out of car or stand for very long, I am 41 and hard to fathom this pain for 50 more years.



I have tried Radial Nerve Block to cut off the nerve, no avail.



I am hesitant to put more hardware in my back.


Wondering about other generative options to exhaust first and preserve motion.



Has anyone done Plasma injections (PRP) at the facet joint? Has it help with the arthritis? Research looks really promising.



Also looking for recs for German spine surgeons and folks in germany that do the PRP (platelet-rich plasma) injections at the facet joints..


Thanks!

[annapurna]

I don't know of anyone performing fluoroscopic-guided regenerative injections into facets and the guidance is what it'd take to accurately inject inside the facet join capsule. That said, there's been some feeling that injection adjacent disc ligaments will flood the area and the PRP agents would benefit the facets, as the facet joint capsule isn't all that big and transport into it and across it is pretty likely.

One hesitation about regenerative injections: it's more than just getting the right agent, PRP in the case you're asking about. The injectionist's skill is important. How many or extensive the injections performed are; did you attempt to improve all related structures or did they focus on one spot and ignore anything related to it that led to it's pain? What kind of post-injection protocol are you following? I've heard some clinics even recommend NSAIDs for post procedure pain - a major red flag as the purpose of the injection was to cause some degree of inflammation and trigger healing. How much exercise is too much and how much is too little for the recovery time?

Sorry to dump all of that on you but, after working with one prolotherapist for 6 years, we finally had to accept that we weren't getting the treatment needed to advance and improve so now we're flying across the country a couple of times a year to get something better suited to improving our health. You not only get what you pay for but you also need to research to make sure you're asking for what you need.