Some advice regarding lumbar ADR between 2 fused levels

ANDREH · #1 01-14-2012, 02:52 PM

Hi, does anyone have experience on 1 level lumbar ADR between 2 fused lumbar disc. In my case I have L4-L5 discogenic pain 11years after L2-L3 and L5-S1 fusion. I am not so sure regarding positive outcomes in those cases. I have been doing some research and I think this is a great place to have unbiased real outcomes answers. Would also search for some advise regarding xlif vs regular ADR. Thanks

Slackwater · #2 01-14-2012, 03:17 PM

I have not read about any results in the literature, from my limited recall.

laid up doc · #3 01-14-2012, 04:07 PM

i haven't heard of anyone, but in theory it makes more sense than having 3 consecutive fused levels.... of course, depending on a myriad of variables.

most people with situations like you mention have them in their cervical spine....

ANDREH · #4 02-23-2012, 08:43 AM

Hi all, thank you for the answers regarding ADR possibilities and literature between 2 fused levels. This ADR community has been very helpful providing a lot of INFO. Since I suffer from DDD since I was 21 (use to do a lot of sports) and do my own research since then (I am almost 39 now).
When I started and had most of my surgeries in 1999-2001, ADR was still at early days. my last fusion last year was at thoracic T1-T2 and ADR was not on the table due to the low amount of motion of that level and no device for thoracic (at leats that was the explanation from my doctor in Minneapolis at the time, he does only fusion but I guess he is a very experienced spine doc and honest). Regardind Xlif and Nuvasive device does any one have some experience or any view regarding this procedure vs the other M6 or pro disc outcomes? seems a smaller incision but haven't seen a lot about the outcomes and since it is a smaller procedure and people are not going for it I guess ther must be some problems?
Thanks

laid up doc · #5 02-23-2012, 05:19 PM

What approach was used for your prior lumbar surgeries??? Anterior, posterior, or transforaminal??

ANDREH · #6 02-23-2012, 09:41 PM

Hi Doc, thanks, my l5-S1 was 360 so posterior and anterior. The l2-l3 fusion was anterior lateral (i guess they call this alif) and later posterior (yes 2procedures at this level, the fisrt wasn't enough. So basically I have scars all over, but still leave no left side alif scars, I guess that's how 1 of the doctors mentioned he would proceed in case I chose what he call X Liffey procedure.

laid up doc · #7 02-23-2012, 10:04 PM

yeah, i would think a 2nd anterior procedure would be less than ideal - unless you can't have an XLIF for another reason.

did they do the 360 b/c you were unstable at L5/S1?

good luck w/ your decision!!

ANDREH · #8 02-24-2012, 07:49 PM

Hi, thank you. The doctor that performed the 360 fusion in my opinion had a bad decision making process I guess, and at that time I only new that it increased the chances of fusion by some small percentage, the posterior approach with enough bone between the vertebrae would suffice, I guess. No, only degeneric disc, nothing was unstable at that level. Thanks again, I have still to start visiting the doctors in Europe to make a decision, since the pain is something I can still handle I am in no hurry, want to try to make the best decision and wait maybe for some technological advances or at least more info on the outcome of the currently available discs....any suggestions are always welcome!

srajan0929 · #9 02-24-2012, 08:25 PM

hey andre...first off..after you had your two lumbar fusions...how successful were they? did they relieve your pain completely? there is a poster here who goes by jss who had a i believe a one or two ADRs inbetween two fusions. but his is in the cervical area and he is doing just fine. infact he comes here often and advises a lot of people. he is back into running and seems to be painfree...you can ask him perhaps? send him a pm..

ANDREH · #10 02-28-2012, 02:32 PM

Hi, thank you. The short answer is yes, the fusions where successfully and I am pain free from those levels (I had to do the L-2-L3 twice but it did work after almos 1 year), they where performed 10 years ago. Unfortunatelly the remaiming discs are doing the extra load, therefore my L4-L5 in bad shape (I had a disectomy done at that level last year but it worket only for 4 months...). I will try to contact jss. I aim going to have an appointmet with Dr B in Germany (first trough phone) to see if he had some performed. My fusion Dr is very well regarded (I wish he did ADR's but due to insurance reembursment in the us he doesn't) and his advice where the following: If I where you I would listen to Dr B, but I am not sure it would ADR would work well between 2 fusions, either I would fuse another level or most likely wait until we het technological improvments in ADr in the next 5 years. So will start by talking to Dr B Thanks!