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  #1  
Old 01-18-2012, 12:24 AM
jwb903 jwb903 is offline
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Join Date: Jan 2012
Posts: 3
Default New Guy

Hello all, I just found out about this site a couple of days ago and am glad I did!

My Dr. has perscibed an ADR and a fusion. Naturally I am concerned about surgery but have reached a point where I am ready to try anything to get back to normal. My work and personal life have been severely affected by my condition. Both of my parents have had lumbar surgeries so I guess its my turn.

I am optimistic about the ADR (prodisc) but apprehensive about the fusion. I was told by my Dr. that a multiple level ADR has not been approved by FDA but evidently it has been done after reading some of the posts on this forum. Can you guys expand on this?

I am receptive to the fact that I will have to change my ways, which has already happened by default in some cases. I currently do not nor do I plan on picking up anything heavy ever again. I would like to be able to run for exercise, perform like a normal human at work and continue wakeboarding, which has never had a negative affect on my back so far but maybe I haven't had the right wreck yet. On a day to day basis, standing up from a sitting position, getting out of my truck 20 plus times a day and standing cause the most pain.

I am looking forward to learning more from y'all. Thanks!
__________________
32 years old, have experience back pain most of my adult life. The pain has been progressively getting worse. I enjoy watersports (wakeboarding)
MRI 9/11, Discogram 12/11
Surgery scheduled 2/10/12
Ruptured disc @ 4/5 ADR
Herniated @ 3/4 Fusion
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  #2  
Old 01-18-2012, 07:45 AM
annapurna annapurna is offline
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Join Date: Dec 2004
Posts: 1,668
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Multi-level ADR surgeries were generally either done as part of a trial, overseas where the FDA didn't control what could be done, or sequentially - one ADR followed by a second ADR surgery when a second level went bad some time later.

One suggestion is to make sure your doctor suggested the hybrid fusion/ADR only based on what the FDA is allowing. If he/she also thinks that you might have facet problems or other concerns that drive a need for a fusion at one level, you might truly need the hybrid and arguing for a double ADR would get you in worse trouble.
__________________
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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  #3  
Old 01-18-2012, 09:04 AM
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jss jss is offline
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Join Date: Nov 2009
Posts: 1,411
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JW,

Condolences on your condition, but welcome. You'll find a lot of lumbar ADR experience here and a lot of useful information. I'm one of those with two ADRs. My ADRs are both cervical; which is a walk in the park compared to lumbar ADR.

Multilevel ADR is commonly performed, even in the US. However, insurance companies almost NEVER cover the second level, causing most patients to choose the hybrid, one ADR and one fusion, which the insurance companies do commonly cover. If you do opt for a multilevel ADR over the hybrid, as Jim alluded, be 100% sure that you are a good candidate for such a procedure or you may end of in worse condition that you are presently. Also, if you opt for multilevel ADR, be prepared to pay for it out of pocket.

Who is your surgeon? Has he/she performed many ADRs? Hybrids? Multilevel ADRs? Is there aversion to multilevel ADR based on a lack of FDA support? Or is it from their personal experience?

Good luck, Jeff
__________________
C4/5 - ACDF in 2000
C5/6 - ACDF in 2002
C3/4 & C6/7 - M6 ADR, Nov 2009, Barcelona
Conceded defeat to a manifestly disingenuous BCBS-TX in my quest for reimbursement, Jan 2011
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  #4  
Old 01-18-2012, 12:58 PM
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Cirobi Cirobi is offline
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Posts: 415
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Sorry you had to come looking for us but also glad you found us. This site is full of really helpful people with a wide variety of issues and outcomes. Hopefully you'll find some good useful info for your particular situation.

Unfortunately, the US doesn't make it easy on multi-level patients. Heck, single level are still having issues with insurance companies, which I personally think is very sad for as "advanced" as this nation is supposed to be. But that's a different rant.

When I had my single level lumbar ADR almost 4 years ago, the one surgeon I spoke to before getting to my actual ADR surgeon within the practice, said that thankfully my particular insurance was very likely to approve a 2-level ADR if I had needed it. But, even though he said that, I'm sure it would not have been a guarantee as insurance companies seem finicky about approvals. 2-level ADRs are definitely done in the US and there are numerous surgeons that are well practiced in it, but the insurance/payment end of it would be the trick. My own surgeon seemed pretty proud of the positive outcome of several 2-level patients he had. In fact, there was a nun in the waiting room the same time as me on several occasions who had just gotten a 2-level ADR from him. She looked to be doing extremely well so early in her own recovery. I'm not sure now since my follow ups are now very far apart. I'm due for a 4-yr follow up this summer.

I think, and someone more knowledgeable is welcome to correct me, that 2-level ADR is approved but only in very limited circumstances and very limited disc models. I think Prodisc is allowed at 2 levels in the lumbar but I'm not sure about cervical. I think trials were still in progress when I got my single lumbar Prodisc. I could be wrong or have that backwards though.

Definitely ask tons of questions of your surgeon or even other surgeons in your region to get as much info as possible pertaining to your specific physical condition. As Jeff mentioned, there's a lot of factors in play to ensure one is a truly good candidate so it never hurts to double check with a doc if they haven't mentioned already during a consultation.

Hopefully you'll find a good clear path to resolving your spine issues!

~Sara
__________________
*************************
31 yrs old
Lumbar herniation L5/S1

- Did mild PT, some chiropractics and self regulated pain management since initial sports injury in Spring 1997.
- XRay and Bone Scan Jan/Feb 2007
- PT March to May 2007
- MRI Jan 2008
- Disco positive at L5/S1 Feb 2008
- ADR surgery at L5/S1 on June 23rd 2008 - Prodisc
- Recovery - so far so good!

*************************
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  #5  
Old 01-18-2012, 04:52 PM
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Jstuckey Jstuckey is offline
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Join Date: Nov 2010
Posts: 305
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Welcome to the like-minded people that have been there, done that! I was originally recommended the same surgery as you - just one level lower - by my local ortho in Indiana, but couldn't get insurance coverage. Went to England and had the "same" surgery as originally recommended of a one level lumbar ADR and fusion, but much different devices (M6-L, STALIF TT) and totally different technique than I would have gotten here in the states (neither of my devices are FDA approved). Very happy with my results, and you are welcome to peruse my blog / ask questions! Best wishes on your research. If you can physically manage - research thoroughly before you do anything! Almost a year of daily research had passed before I scheduled overseas - and was very confident I'd made the right decision by the time I did. Whether you have it done here or elsewhere, make sure you are fully informed!
__________________
Joey Sue - 50 years old
9/28/2011: Hybrid STALIF TT interbody fusion at L5-S1 and M6-L ADR L4-5 with Nick Boeree, UK - forever grateful to you Nick! Still doing great.
Prior to the fix: Severe DDD L4-5 and L5-S1 with moderate facet degen at L5-S1, but only mild facet degeneration at L4-5.
http://healthyback2011.blogspot.com/
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  #6  
Old 01-18-2012, 08:43 PM
jwb903 jwb903 is offline
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Join Date: Jan 2012
Posts: 3
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Thanks for the feedback! Dr. Raabe at Azalea Ortho in Tyler Tx is my specialist. He has a great reputation but i'm not sure how many procedures he has done. His demeanor suggested it's going to be a walk in the park. He seems confident in his decision. I asked him about a multilevel ADR and he mentioned FDA. He didn't say anything about facet problems, at the time I would not have know what he was talking about had he mentioned facets.

If one were to look it this like it were a financial investment, I would be getting some diversification with a hybrid procedure. Its going to be interesting to see how long the Prodisc will last, as well as the rest of my back. I am concerned about loosing flexibility with a fusion and putting stress on surrounding discs.

Things are moving awful fast now after having surgery scheduled in February!
__________________
32 years old, have experience back pain most of my adult life. The pain has been progressively getting worse. I enjoy watersports (wakeboarding)
MRI 9/11, Discogram 12/11
Surgery scheduled 2/10/12
Ruptured disc @ 4/5 ADR
Herniated @ 3/4 Fusion
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  #7  
Old 01-18-2012, 09:00 PM
ANDREH ANDREH is offline
Junior Member
 
Join Date: Sep 2011
Posts: 27
Default Worry a little but not too much..

Hi, Iwould not worry too much regarding loosing flexibity, I have 4fusion on my spine and still enougth movement. Regarding others discs getting more load and therefore potential for degenerating, that is somewhat true for my case, but ADR is more efficient then fusion in dealing with this. Regarding this I would avoid exercises that put too much load on the spine like weightlifting, running too much etc... But this is for the long run. Anyway good luck.
__________________
Diagnose with DDD at 21, L5-S1, Fusion in 1999 at L5-S1, L 2-L3, C5-C6 and in 2011 at T1-T2 Cervical 1 level ADR (C6-C7) March 2017 Dr Clavel
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  #8  
Old 01-20-2012, 04:07 PM
nanfromsactown nanfromsactown is offline
Senior Member
 
Join Date: May 2005
Posts: 145
Default Welcome

Hi JW,
Welcome to our little community here.

I had a 2 level surgery on Nov 30 in Germany with Dr. Willem Zeegers. My surgery is a hybrid with ADR at L45 and STALIF fusion at L5S1.

One thing that jumps out which I would research a bit more if I were in your shoes is that your doctor is recommending ADR at the lower level and fusion at the level above (unless I read it wrong, wouldn't be the first time!) and I would wonder about the level above the fusion degenerating as time goes by. I think they usually do the fusion at the lower level and ADR above, so that motion is maintained and wear and tear on the adjacent disc is minimized.

There is tons of information on this site! Feel free to read my blog about my experiences, the address is in my signature.
__________________
3/96 injury, bending over to pick up book and felt a snap.
MRI's show DDD at L45 and L5S1, disc bulge at both levels.
Discogram and CT 1999: posterior annular tears at both levels.
TREATMENT: IDET, ESI's, Radiofrequency, Chiropractic, Pain Management, PT.
No work since 1999.
ADR Surgery at BetaKlinik, Bonn, Germany 11/30/11-Activ-L at L45,STALIF at L5S1--recovery good so far!
http://backtalk2011.blogspot.com/?v=0
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  #9  
Old 01-21-2012, 01:39 AM
jwb903 jwb903 is offline
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Join Date: Jan 2012
Posts: 3
Default

Nan, You read it right. It does seem backwards to me as well. Like always, I develop questions well after I have had time to process things in my head. I don't know how Doctors work. Is it appropriate to call If I have a question or do they prefer to schedule an appointment?
__________________
32 years old, have experience back pain most of my adult life. The pain has been progressively getting worse. I enjoy watersports (wakeboarding)
MRI 9/11, Discogram 12/11
Surgery scheduled 2/10/12
Ruptured disc @ 4/5 ADR
Herniated @ 3/4 Fusion
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  #10  
Old 01-21-2012, 09:41 AM
Cirobi's Avatar
Cirobi Cirobi is offline
Senior Member
 
Join Date: Feb 2008
Posts: 415
Default

You should be able to call and at least get a physician assistant to call back with an answer. My surgeon's office has always been like that at least. And depending on the time of day I call, sometimes I get a call back the same day, but if not it's almost always the next day unless there's a holiday or a weekend in there.

Some docs are more responsive than others, but hopefully yours is pretty good about responding quickly.

~Sara
__________________
*************************
31 yrs old
Lumbar herniation L5/S1

- Did mild PT, some chiropractics and self regulated pain management since initial sports injury in Spring 1997.
- XRay and Bone Scan Jan/Feb 2007
- PT March to May 2007
- MRI Jan 2008
- Disco positive at L5/S1 Feb 2008
- ADR surgery at L5/S1 on June 23rd 2008 - Prodisc
- Recovery - so far so good!

*************************
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