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  #1  
Old 10-10-2005, 10:24 AM
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Harrison Harrison is offline
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Posted by Gillian (Member # 555) on October 08, 2005 05:50 PMOctober 08, 2005 05:50 PM:

Hi all. I'm a new member and would really appreciate the benefit of your experience. Apologies for the v long post by the way!

After 11 years of a more or less constant cycle of dull pain, toothachey pain and sciatic pain I've finally got a diagnosis after a discogram (the MRI was inconclusive and the CT scan didn't show anything). The L5/S1 is "flat, degenerate and distended." My consultant said that I'm a good candidate for fusion or disc replacement from a purely surgical perspective but that he was a bit concerned about the shelf life of the artificial disc given my age.

I'm leaning towards fusion but I would appreciate any advice you might have. In particular, Alastair, do you know anything about my surgeon's record? He is Mr P Dyson and he's at Bupa Harpenden, NHS St Albans and NHS Hemel Hempstead. He's the first consultant I've seen to give me any sense that he knows what he is talking about - and I've seen a few!

Thanks in advance - this seems to be a really helpful site.


Posted by Alastair (Member # 4) on October 09, 2005 05:57 AMOctober 09, 2005 05:57 AM:

Hi Gillian,
I don't know anything about your specialist who is Mr Peter Henry Philip Dyson with regard to ADR he did qualify in 1975 which sounds as if he's been around for a while. I don't know every single spine surgeon in the UK, just the ones that are doing a lot of ADRs . Did you ask him how many ADRs he had done? That's always a good question and it's always good to have someone who's done at least more than 50.

I notice you mention your age so I'm guessing that your postmenopausal? So has he done bone density tests to justify being able to offer you surgery of this sort?

I hope you've got your body mass index between 20 and 25 because this operation is done anteriorly i.e. from the front beneath your navel about 3 inch cut. Also it's good if you've got yourself as fit as you possibly can so you recover quickly from the surgery.

If you look at my story you will see that I was actually aged 65 when I had my ADR surgery across in Munich, ADR was almost unheard of in the year 2002 in the UK.

If you wish to e-mail me please click on my name for my e-mail address.
Best wishes,
Alastair


Posted by Gillian (Member # 555) on October 09, 2005 06:57 AMOctober 09, 2005 06:57 AM:

Hi Alastair

I thought it might be worth asking if you knew of him but I'll see what I can find out.

No I'm only 28. He said that from a pure surgical perspective I'm a perfect candidate. His worry is that the artificial disc might not last long enough to avoid me having to have further surgery later in life. He said that at the moment they just aren't sure how long the artificial discs will last but that if the experience of hip replacements is anything to go by they might not last long enough for me. He said that with that in mind he thought that fusion was probably the better option.

I'm not too worried about my BMI. It's borderline at 24.9 but I've been doing cardio since March (at that point I'd been told there was nothing seriously wrong with any of my discs and that I could heal any problems with conservative treatment - not by Mr Dyson I should add!). I've also been doing one on one body control pilates because my entire body's frazzled from the pain and is constantly tensed - the nurses picked up on that after the discogram so I really need to concentrate on releasing the tension. Even if my weight doesn't drop much between now and surgery I know I'll be building muscle mass because I'm not going to give up on the exercise in the meantime!

I haven't had a chance to read your story yet but I will. Many thanks


Posted by Alastair (Member # 4) on October 09, 2005 09:24 AMOctober 09, 2005 09:24 AM:

Well a jolly good idea is to ask him how many ADRs he has done? I'd be pleased to know, I build up my whole portfolio of UK doctors from patient feedback.

There's always a bit of latitude between 20 and 25 for your body mass index, it's happy if it is between the two figures but doesn't need to be perfect.

Do let us know how you get on, take care.
Best,
Alastair

[ October 09, 2005, 09:25 AM: Message edited by: Alastair ]


Posted by Alastair (Member # 4) on October 09, 2005 03:20 PMOctober 09, 2005 03:20 PM:

Do remember a fusion stops movement in a joint. That means in the spine that the rest of the joints, especially the adjacent ones will take the majority of wear trying to make up for the fused joint. This usually ends up causing those adjacent joints to cause problems and also more fusions. If this were repeated you spine would be a single unbending rod of bone.

This is the beauty of ADR in that it retains your movement and restores height where your worn out disc has flattened
Best
Alastair


Posted by Carmont (Member # 97) on October 09, 2005 03:27 PMOctober 09, 2005 03:27 PM:

Alastair,
Maybe this should be a new topic, but I'm wondering if weight loss is common after ADR, due to a person's new found ability to function and exercise? That certainly was the case for me. That and adding Topamax to my drug regime. Carmont


Posted by Gillian (Member # 555) on October 09, 2005 05:09 PMOctober 09, 2005 05:09 PM:

I'll let you know when I find out more about him Alastair - and of course whichever surgery I decide on you can be sure I'll tell you if he was any good. He's certainly inspired confidence so far. The more decent surgeons you know about the better for all of us patients I suspect!

I'm a little sceptical about BMI because it fails to take account of the old rule that muscle weighs more than fat - the BBC recently reported that Brad Pitt and Tom Cruise are both technically overweight based solely on their BMI. I fully take the point about not being overweight before surgery (not to mention the boost to my ego that losing weight would give - gaining weight's just another thing to bring you down when you're already feeling bad)but in itself BMI's not always the best indicator.

Re. loss of movement in fusion. If it was the L4/5 or above it'd be an easier decision to take. My current range of movement is about 4/5ths and my consultant didn't disagree when I suggested that fusion would leave me with the same sort of range of movement but (hopefully) without the debilitating pain. Maybe I should start a new topic to see what other people have been told about how long the new disc could be expected to last. I'm not sure if it'd get picked up in here!


Posted by Alastair (Member # 4) on October 10, 2005 05:18 AMOctober 10, 2005 05:18 AM:

I think if you look in the FAQs you will find some information on the subject.

The Alphaklinik have been doing this procedure since 1989 with quiet confidence
best,
Alastair


Posted by Alastair (Member # 4) on October 10, 2005 06:26 AMOctober 10, 2005 06:26 AM:

http://www.charitedisc.com/charitede...nts/faq.asp#Q2

Many implants have been functioning properly for over 17 years in vivo. Laboratory testing has also demonstrated remarkable durability over time, assuming an average of 125,000 significant bends each year or approximately 340 per day. As with any implant however, patient activity levels and life style can have an impact on the actual results.

And:
http://www.spine-health.com/research...ificial05.html

The Charit� Artificial Disc was designed to restore disc space height, to restore motion segment flexibility, to prevent disc degeneration at adjacent segments, to reduce or eliminate pain from motion or from nerve compression, and to improve the patient's functional activities. It was designed to be biocompatible and durable. It has a life span of 40 years (85 million cycles).

The Charit� Artificial Disc has kinematics that mirror the segmental motion of a normal spine. It is designed to allow anatomic alignment in lordosis, and to allow normal facet joint loading and unloading.

Wear debris, a concern with polyethylene implants in the peripheral joints, has been studied in the Charit�, given the implant's proximity to the spinal canal and nerve roots. In a long-term laboratory test of cyclical motion simulating >11 years of use, no wear debris particles were identified. There is minimal deformation of the core, with less than 8% height loss expected in 10 years of use.

(Moved from another topic)
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  #2  
Old 10-10-2005, 12:40 PM
luvmysibe luvmysibe is offline
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Welcome Gillian,
My age - 35 - was a factor in my selection of ADR rather than fusion. Prior to my injury, I lived a very active life. My desire was to keep as much flexibility and motion as possible post-surgery; therefor, I chose ADR over fusion. The materials used in the devices is similar to artificial knees and hips which have been implanted for several decades. My view towards a possible future surgery was that I wanted the highest quality of life for as long as possible. If it meant that in 30 years I might need a fusion, so be it. However, at the rate of medical technology, by the time another surgery could possibly be needed the procedure could be quite advanced and fusion not required.

Best wishes with your journey
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Old 10-11-2005, 05:30 AM
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Thanks Crystal. I am coming round more and more to the idea of fusion. At the end of the day, even 20 years pain free seems like a fantasy after 11 years of pain.
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Old 10-11-2005, 05:54 AM
Alastair Alastair is offline
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I'm patiently waiting to see what your surgeon has said to you today.
Best,
Alastair
__________________
ADR Munich 26th July 2002 L5/S1. Aged 82 now
Your best asset is your health
My story is here
http://www.adrsupport.org/alastair.html
Thank goodness for Dr Zeegers I am painfree
I am here to help,I live in the UK


I now run the UK spine site and can be contacted at

www.adrsupportuk.com/
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Old 10-11-2005, 07:28 AM
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Sorry just realised I said I was coming round to the idea of fusion - I meant ADR! Maybe I should show that to the insurance company who don't think that pain affects my capacity to do my job - no I don't need a working brain to function!

I'm only seeing the GP today but I'm definitely going to get more info from the surgeon. Unfortunately there's a lot of red tape to get through before I can get an NHS appointment with him though.
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Old 10-11-2005, 08:35 AM
Alastair Alastair is offline
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Hey Gillian, try and plant the idea of ADR into your GP`s mind when you see them?? Mighty oaks and things -- - -
The Charit� Artificial Disc was designed to restore disc space height, to restore motion segment flexibility, to prevent disc degeneration at adjacent segments, to reduce or eliminate pain from motion or from nerve compression, and to improve the patient's functional activities. It was designed to be biocompatible and durable. It has a life span of 40 years (85 million cycles).


Best
Alastair
__________________
ADR Munich 26th July 2002 L5/S1. Aged 82 now
Your best asset is your health
My story is here
http://www.adrsupport.org/alastair.html
Thank goodness for Dr Zeegers I am painfree
I am here to help,I live in the UK


I now run the UK spine site and can be contacted at

www.adrsupportuk.com/
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  #7  
Old 10-11-2005, 09:02 AM
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I will do Alastair. Unfortunately we've got to waste a lot of time going over my insurance problems but I'm about 90% converted to ADR - it seems a more pro-active solution than fusion. She's generally really helpful so I'm sure we'll have a reasonable chat about it. She's pretty opened minded too - when I told her I was trying the Bowen Technique she asked me to let her know if it helped my neck problems because she would give it ago herself if it did.
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