newbie need help l5 s1 fusion or ADR

[postman4125]

Hello im 37 and work as an operator in a plant. Job requires me to lift atleast 50 lbs. with that said ive been out of work for six months. I did all the things like pt, injections so forth and then came down to a microdiscectomy in jan this year. things was going great then it blew out again in feb.I saw the dr he wants to do another one but im thinking about a fusion or adr. ive been doing some research online and it appears alot of people wait as long as they can to do surgery but i cant. DDD runs im my family so to do another discectomy seems useless. it looks like it would be great to go to germany and get something like the m6 but i dont have the funds. I have aetna but i believe it only covers in US. what other ADR options are there in the US. Or should I just get a fusion. thanks

[Lillyth]

Welcome!

The good news is that you only have one level, so just about any insurance company will pay for an ADR. I would remain as much mobility as I could. Personally speaking, I would never fuse anything unless I had NO other choice because it puts too much strain on the adjacent levels. I know other people on here feel differently, but that's my take on it. ESPECIALLY if DDD runs in your family. The likelihood of another level blowing with a fusion is just too great.

Where in the country are you?

Also, given that you lift a lot, I would find a surgeon who can put in the Bryan, rather than the ProDisc, as that has no up-down cushioning.

This is a great group of people and you will find much needed support here!

[postman4125]

I live in Texas and i haven't heard of the Bryan i will have to look that one up. I'm just kinda scared with both procedures because I've seen negative both ways but i do like the fact of being mobile will help me out.how long has the Bryan been out.

[NJ Gene]

Originally Posted by postman4125

I live in Texas and i haven't heard of the Bryan i will have to look that one up. I'm just kinda scared with both procedures because I've seen negative both ways but i do like the fact of being mobile will help me out.how long has the Bryan been out.

If you live in Texas, check out Dr. Jack Zigler at the Texas Back Institute in Plano. He is one of the people spoken about on this board.

[Lillyth]

Originally Posted by NJ Gene

If you live in Texas, check out Dr. Jack Zigler at the Texas Back Institute in Plano. He is one of the people spoken about on this board.

I was just going to say that. Lucky you!

[kimmers]

Newbie, Hi Welcome.

I would check about being able to lift a lot of weight after having surgery. It may be okay, but really heavy weights are not encouraged after ADR.

If your vertebral disc is your pain generator, nothing short of replacing that part is going to make you feel better, IMHO. Getting an ADR is major surgery and it is not a walk in the park and different people heal at different rates.

I have several friends who think that fusion at L5/S1 is not as bad as say at a higher lumbar level as the area is less mobile and just the SI joints are below and not another disc.

However, I had SI joint problems and I figured that fusion might really throw that area off. So I was in favor of ADR at L5/S1.
But I know people with fusions and they are doing fine. You are right, there are people with good and bad stories with both fusion and ADR.

I would suggest getting multiple surgical opinions so you can form an informed opinion.

K

[Lillyth]

Originally Posted by kimmers

Newbie, Hi Welcome.

I would check about being able to lift a lot of weight after having surgery. It may be okay, but really heavy weights are not encouraged after ADR.

If your vertebral disc is your pain generator, nothing short of replacing that part is going to make you feel better, IMHO. Getting an ADR is major surgery and it is not a walk in the park and different people heal at different rates.

I have several friends who think that fusion at L5/S1 is not as bad as say at a higher lumbar level as the area is less mobile and just the SI joints are below and not another disc.

However, I had SI joint problems and I figured that fusion might really throw that area off. So I was in favor of ADR at L5/S1.
But I know people with fusions and they are doing fine. You are right, there are people with good and bad stories with both fusion and ADR.

I would suggest getting multiple surgical opinions so you can form an informed opinion.

K

What Kimmers said.

[Slackwater]

Originally Posted by postman4125

I live in Texas and i haven't heard of the Bryan i will have to look that one up. I'm just kinda scared with both procedures because I've seen negative both ways but i do like the fact of being mobile will help me out.how long has the Bryan been out.

The Bryan artificial disc replacement is for the cervical spine / neck. The testing started many years ago in the U.S. (more in Europe?) with an FDA approval in 2009.

FDA - Link

Product Name: BRYAN® Cervical Disc
PMA Applicant: Medtronic Sofamor Danek
Address: 1800 Pyramid Place, Memphis, TN 38132
Approval Date: May 12, 2009
Approval Letter: http://www.accessdata.fda.gov/cdrh_docs/pdf6/P060023a.pdf



You have a lumbar L5/S1 issue, so ... it is good to ask questions. You might search for ProDisc on adrsupport.org to get the metrics comparing fusion and adr/tdr. Individual results vary. Clinical results with a larger sample size show a cautious trend.

Lumbar ADR/TDR is OK+. The ProdiscL clinical testing (FDA trial) advantages appear to be fewer reoperations, less narcotics use and faster rehabilitation leading to employment v. disability. It looks good from the top, but ... every surgery has risks. Time plays a role in both Fusion and ADR/TDR.

All orthopaedic and neurology surgeons have more school, training, internship, residency, fellowship, ... than one can easily imagine. Surgeon choice can be limited by local or geographic medical practice patterns. Surgical choice may be limited by insurance coverage. Some patients go to Europe for lumbar ADR/TDR surgery and sometimes cervical cases. We all want to be confident in our choice(s) be it the type of surgery, the adr/tdr device and the surgeon.



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Slackwater_SF

[postman4125]

Thanks everyone for the responses I've got a couple dr appts set up in the next coming weeks.

[Lillyth]

Do keep us updated. We are thinking about you!