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  #1  
Old 06-14-2016, 08:35 AM
Lasso Lasso is offline
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Join Date: Jun 2016
Posts: 3
Lightbulb New Member with some questions regarding ADR and recovery

Hi folks,

my name is Lasse, 38 years old, coming from Hamburg, Germany. I had an ADR surgery at L4/5 (Spinal Kinetics M6-L, 10mm/6°) one week ago and left hospital yesterday.
Compared to my condition before the surgery, I feel very good so far. All the horrible leg pain and dumbness has gone immediately after surgery and all the abdominal and lumbar post surgery pain is getting better every day and can be held in control with some good meds as far as possible.

If someone had told me I could stand and sit almost pain free just one week after surgery, I would have said he was crazy
Nevertheless, all the movement like walking, standing up, turning around or changing my sleeping position in bed is done very cautious at the moment and is (in some situations or during specific movements) accompanied by some pain hitting in the lower back. Apart from that, I felt some constant lumbar pain, slightly radiating in the buttocks after the first day of increased movement.
I was told that this is normal and that it´s mostly coming from the facet joints that firstly did not like the hard stretching during surgery and secondly have to get used to the new biomechanics and statics, since the implant causes a different angulation and alignment, especially of my vertebrae L4 and L5.

Since this is my first (and hopefully my last) ADR, I´m curious what I can expect regarding recovery and convalescence. It seems that my surgeon did a good job (the control x-ray showed a perfect fitted implant), but unfortunately he was not the kind of surgeon with lots of empathy or with much time to talk. The hospital´s physiotherapist was a real disappointment. After some first mobilisation 2 days after surgery I haven´t seen him again. So I don´t know anything about the upcoming period of time and how I should ideally feel, let´s say, after 1, 3 or 6 weeks post surgery when everything is going fine and normal.

Even though this is truly not my first bigger issue with the lower back / lumbar spine, I am feeling a bit lost at the moment and it´s a really strange feeling with this foreign object in my spine. It feels like going on cotton wool... or ... to be more precise.. I am moving like C3PO or Robocop – on the one hand because I totally lost confidence in my body or the feeling for it, on the other hand it´s the fear of any new pain, I guess
Is it normal that it feels like immediately breaking into two halfs when trying to bend?

So, how should I proceed? All I know is that all sport activities are forbidden for at least 6 weeks. So when to have the first slight physiotherapy, for example? What can I do and what should I avoid? Do you have any special tips for what to do to help my facet joints and the lumbar muscles getting familiar with my pimped high-tech spine? From what techniques, activities or things do or did YOU benefit the most?

And the most important question to all of you fellow sufferers (especially those, who had the exact same surgery): How long did it take till you had the feeling that you are fully back to life?


Your answers are highly appreciated

Best regards,
Lasse

P.S.: my english is a bit rusty, I am sorry for that!
__________________
- Spine / lower back problems since the age of 23
- Microdiscectomy on L5/S1 in 2000
- Open Discectomy after recurrent sequestered disc prolapse at L5/S1 in 2003
- Black disc / disc bulge at L4/5 for many years with strong, recurring pain episodes due to pinched nerve root
- ADR at L4/5 on 6/6/2016 with Spinal Kinetics M6 L
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  #2  
Old 06-14-2016, 11:23 AM
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Romakis Romakis is offline
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Posts: 197
Default How long

Hi Lasse,

It has been one year when I finally can say I do feel better. If you are like the 95% of the rest of us, you will get better and worse many times in the following 12-18 months. I, like you, first thought it was a matter of weeks; I was bitterly disappointed.

The feeling you are describing was the same for me: my body felt like it did not know what was done to it, and reacted in many strange and sometimes painful ways.

I would NOT do any PT or exercises for the first 3 months at all. 6 maybe even better. The worst thing that can happen to you in my opinion during this time is the movement / displacement / sinking of the implant. Just walk, as much as your body will tell you.

This is my opinion only; others may disagree and this is fine. Everyone is different.

Regards,
Roman
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46yo, DDD of L4-S1. Microdiscectomy L5-L4 in 2014. L4-L5-S1 M6 ADR with Dr. Clavel - June 2015.
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  #3  
Old 06-14-2016, 11:26 AM
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Romakis Romakis is offline
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Posts: 197
Default L5-s1

Can I ask why you did not do the L5-S1 level?
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46yo, DDD of L4-S1. Microdiscectomy L5-L4 in 2014. L4-L5-S1 M6 ADR with Dr. Clavel - June 2015.
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  #4  
Old 06-14-2016, 03:00 PM
drewrad drewrad is offline
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Walk. Moderately. Slow gait. Lose some weight, if that's an issue. Should help for facets as well as inflammation. Eat lots of organic vegetables. Walk some more. Get some sunshine. Vit D will be central to avoid subsidence of implant into vertebrae. Get control of your core. Fire your pelvic muscles, but be moderate in everything. This is not a race. It is a walk. Backs like a good bourdeaux by the way IMO. Do that moderately too.

What doctor did you choose to entrust yourself with?
__________________
Weightlifter since 12 years old, now mid-40's and figuring out this wasn't such a good idea.

Chronic back pain started in 2010 while shrugging weights that a 40 yr. old shouldn't even try.

MRI in 2012 showing L4/L5, L5/S1 herniations and L2/L3 bulge.

L5/S1 taking on new shape, chronic sciatica, etc.

DEXA bone scan performed 5/7/14 showing mild osteopenia.

Surgery performed July 9th, 2014, Dr Clavel, hybrid three level lumbar.
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  #5  
Old 06-15-2016, 01:34 AM
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Fathub Fathub is offline
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Posts: 156
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Good advice from Romaksis and Drewrad....NO EXERCISES for 6 weeks. There's a good exercise regime from Dr. Bertagnoli's PT. I've followed it for 6 months and it's stupid looking and wussy to start with .... but GD it works and doesn't overdo it and put you back a month.
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Dec 1/15 - 3 level ADR from S1/L3 c/w 360 mobility preservation at L3/L4 for Spondylolisthesis done by Dr. Bertagnoli in Bogen GmbH.
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  #6  
Old 06-15-2016, 02:01 AM
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Fathub Fathub is offline
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Default

Exercise regime I used here:
http://www.bitanmd.com/Physical_Therapy.pdf
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Dec 1/15 - 3 level ADR from S1/L3 c/w 360 mobility preservation at L3/L4 for Spondylolisthesis done by Dr. Bertagnoli in Bogen GmbH.
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  #7  
Old 06-15-2016, 05:29 AM
Lasso Lasso is offline
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Join Date: Jun 2016
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Hey guys,

thank you for your replies and your suggestions.
It helps a bit to know that everything seems to feel as it should right now

However, what unsettles me are the diverse opinions about the do´s and dont´s and when to start with PT or some moderate load in general.
The statements vary between 6 weeks and 6 months which is quite a difference
For example, how about riding a bike? I am not thinking of riding a fully in rough forest terrain but an ordinary bike on an even surface and in quiet surroundings. Or what about driving a car? This means: when am I allowed or able to do the things that belong to "everyday life"?

Having lost all confidence and feeling for my body, I am the type of guy who is inclined to avoid everything other than lying, sitting, standing or moderate walking. And this most likely for much longer than I probably should.
I can´t imagine this to be helpful for the facets, muscles and tissue if I move stiff like a robot, let´s say for the next 3 months.
Weight is not an issue (6"1, 176 lbs / 1,85 m, 79 Kg) but I lost a lot of muscle tissue (especially at my legs and at the core) since I haven´t had any activity for weeks and laid in bed for almost 2 weeks prior to the surgery because I was not able to move any more. I always thought that it´s important to restore these muscles as soon as possible.

How about massage? Did you have some and did it help you?

@Roman
I did not do the L5/S1 level because my doctor/surgeon says, that there is no need to do it and his explanation seemed plausible to me.
As you can see in my signature, I had a surgery in 2003 at the L5/S1 level. I have several MRIs that were made nearly once a year over the last decade. Since this second surgery, nothing has really changed at this level. There was no further decrease of height monitored over the last 10 years and the rest of the disc is ossified, so it´s unobtrusive. My doctor says that there is barely any movement in this segment and that restoring movement at this level would not be of any help for me – on the contrary, in my case it could cause a lot of problems, he says. Even a fusion at this level seemed not to be necessary... and I am glad of it.

@drewrad
If you ask me if I have chosen one of those worshiped doctors in germany that everybody in the world seems to talk about, my answer is no and probably nobody here knows my doc. His name is Dr. Ropers and he´s chief physician of the clinic I have been to. Of course his focus is spine surgery and fusion and ADR in particular.
At the end I had not much choice.. the prolapse was so severe that I had no time and no power to travel my country first, getting more opinions or chosing any well known distinguished expert.
It was just lucky that the hospital next to my home has established a competent spine center some years ago with a small team of experienced surgeons like Dr. Ropers.
As far as I can evaluate it, he did the job as good as Dr. Ritter-Lang, Bertagnoli or all the other saints


@Fathub
Thanks for the exercise regime. This will be of some help..

Regards,
Lasse
__________________
- Spine / lower back problems since the age of 23
- Microdiscectomy on L5/S1 in 2000
- Open Discectomy after recurrent sequestered disc prolapse at L5/S1 in 2003
- Black disc / disc bulge at L4/5 for many years with strong, recurring pain episodes due to pinched nerve root
- ADR at L4/5 on 6/6/2016 with Spinal Kinetics M6 L
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  #8  
Old 06-15-2016, 03:43 PM
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Harrison Harrison is offline
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Join Date: Oct 2004
Posts: 6,909
Default

Nice posts in reply to your question, Lasso!

Here's the motherlode:

http://www.adrsupport.org/forums/showthread.php?t=9283

I saw this as a problem in 2004, when I was recovering. My physical therapist was a...physical terrorist! He had me stretching so much, I injured my hamstrings!

So, take it easy. Slow and steady wins the race.
__________________
"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
Donate www.arthropatient.org/about/donate
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  #9  
Old 06-16-2016, 06:08 AM
Lasso Lasso is offline
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Join Date: Jun 2016
Posts: 3
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Dear Harrison,

thank you for the provided link – this should be definetely enough stuff to read. Maybe this will answer some my questions.

Kind regards
__________________
- Spine / lower back problems since the age of 23
- Microdiscectomy on L5/S1 in 2000
- Open Discectomy after recurrent sequestered disc prolapse at L5/S1 in 2003
- Black disc / disc bulge at L4/5 for many years with strong, recurring pain episodes due to pinched nerve root
- ADR at L4/5 on 6/6/2016 with Spinal Kinetics M6 L
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  #10  
Old 06-27-2016, 08:34 AM
Chris4377 Chris4377 is offline
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Join Date: May 2016
Posts: 50
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Hello fellow German,

I had ADR on L5/S1 on 10-06. I think I was lying in bed too much in the first two weeks post op. Now that I started little walks of 10 - 15 min. a few times a day this particular pain is gone. But I still feel a very similar pain to the one pre op.
I only learned here that it will take a lot longer than I thought it would. This is hard to realise and accept.

I would think that I had one of the top surgeons in Germany and he told me no physio in the first three months. Let the bone and the disc properly grow together first. I will stick to it and start some physio therapy after 3 months only. I was allowed to sleep on the side and the golden rule is don't bend forward and don't lift heavy.

I'm having trouble sleeping at night and as long as there is pain I can't see myself being able to sleep for more than 3 - 4 hours. It's absolute tough stuff if you can't sleep properly. But as long as I will be able to live a painfree life in a few months it's all worth it.

I hope I could help a little bit and if you have any more questions, fire away.
__________________
Chronic back pain since 2009.
Tried all sorts of things.
Had ADR on 10th june 2016 with the LP-ESP disc at L5/S1.
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