New Member: Carla

[CarlaSB]

Hello to all,

I had a 3 level fusion (c 5/6/7) about 10 years ago with good outcome. Even so, I have to rank the pain post-op from this surgery as being a 10+. Not a good memory.

5 years ago, I injured my L5-S1 disc and so utilized all conservative treatments, combined with pain management, since then. I finally went back to my reputable spine surgeon, (who has a fellowship in spine surgery.) His professional opinion is that I am a perfect candidate for an artificial disc replacement (ADR).

However, my current insurance will not cover this surgery as they believe it is "experimental." They will pay for another fusion, though.

I am not interested in another fusion... given the stats for the "domino effect" in fused spines, I do not wish to end up with a completely fused back and lose function. I love to sail, swim, hike, garden and travel, so I want to preserve function as I age.

My husband's employer offers multiple insurance plans, and allows employees to change plans every October and become effective in January. One of the plans offered will cover the ADR surgery, so the game plan is to switch plans and then have the surgery in January, 2011.

Pre-existing conditions does not apply since it is the same employer. Silly that patients have to consider creative problem solving to get their spine needs met.

For the rest of the year, I will take it easy and hope my symptoms do not get worse while I wait. I found this website forum while doing some ADR research.

Regards,

[Toebin]

Carla,

Welcome !!

Glad you found us and we'll be happy to travel down your path of discovery as you move forward towards you goal.

When you say your spine surgeon said you are a perfect candidate for an ADR at L5/S1 can you be more specific? I am assuming (big assumption) that you don't have any facet disease and no pathology above or below the affected disk?

A couple of things you may want to have looked into for an optimal outcome would be bone density DEXA scanning and Vitamin D levels prior to committing to surgery. Making sure your bones can perform well with the new disk replacement is a little but important step.

I look forward to hearing more from you !

Toebin

[CarlaSB]

My Dexa scan was normal and I have been taking supplemental D and sun therapy to raise my D. My D levels are being re-checked next month.

Yes, only one level is involved, and other than a flat disc, the disc spaces above look great. No sign of facet disease. I want to remain active, and not sure if this will impact one way or another, but I recently lost 30 lbs and now have a healthy BMI.

The spine surgeon's comment was as he was explaining my MRI and films to me and my husband. The alternate option, where they fuse with instrumentation, with incisions front and back, is something I do not care to have.

May I ask what symptoms I may possibly expect post surgery? I am sure that gaining an inch is bound to cause some muscle pain and other issues.

Thanks, Carla

[CarlaSB]

I notice you list that you have a really low vitamin D levels. May I ask what you are doing to raise your levels?

Btw, I also have DDD and osteoarthritis. My rheumatologist also supports the ADR over the fusion from his perspective. I just want to go into this really informed and educated.

Like most on this Forum, I live with daily pain. No whines, just reality.

[Toebin]

Originally Posted by CarlaSB

I live with daily pain. No whines, just reality.

Sad but true for so many of us Carla ....

It sounds like you've covered all the bases and have a really good attitude going into an ADR surgery. Keeping active and loosing those extra pounds can do nothing but help your post op recovery. Having a good team of docs supporting you is important as well and it looks like you've got that as well..

I personally have not had an ADR placed so I will leave the "what to expect" question for those more versed in the who, what, why of it all ... except to say that you will need to be kind to yourself and take it easy , build back to normal activity slowly and let things heal before you go climbing mountains again..lol

I am probably the most perfect case of what NOT to do with spinal surgery.. so I am not a good example for anyone to follow..

I am currently taking 3000 IU of Vit D daily and my levels have gone from 12 (yes 12, I didn't typo ) to 43, and that has taken almost 2 yrs to climb up that high. But then I also had some very rare nasties causing that low of a Vit D that no one caught until after my neck refused to fuse... The tumor that caused my Vit D and calcium issues has been removed and current expectations are that my bones will fully re-mineralize within 5 yrs of maintaining "normal" Vit D levels.

I Had a normal DEXA x2 but they were taken on my hip and did not show the severe osteoporosis I had in either my spine or my rib cage.. so it's important to get your scans on the area where the surgery will be performed.

Current research out of the UC Riverside Vit D group says that older adults can safely take 3000 - 4000 IU of Vit D without any side effects if your levels are low. But please follow your Physicians advice on the issue as this is a new and ever expanding area of research right now..