I have gotten some (a few) positive feedback - but as I go back and read some of the past posts of folks who have had ADR - there appear to be many more negative outcomes to ADR surgeries than positives. I have to make up my mind soon - and this really scares me - some of what I have read have been horror stories.

There are other discussions about this topic but essentially, if ADR works and you have a life again, very few continue to post.

I have to agree with Anna. I am in bed recovering from major surgery. I would much rather be at work or on my boat with my kids enjoying the summer. I am curious where you read all the negative posts. The majority of post ops are positive that I have read here and on other spine websites. Even the not so positive have hope. If it were not for the hope and faith of a better life then I would be doing myself and my family a disservice. If out of fear we only see the negative then that is all we will read. I was scared to death of this surgery but went forward knowing that I will be better for it.

I also think it depends on what you consider a negative outcome. There are a lot of folks on these forums who have had some incredibly major surgeries and sometimes multiple surgeries in quick succession, but that doesn't always indicate a negative outcome. Each of us comes here with a different set of issues that add up to the entire problem, and sometimes one procedure isn't the full solution because of those various conditions.

I'd also have to agree with regards to positive outcome posts. I'm sure it's easy to forget to post when you're out enjoying the fact that your back pain is gone.

I'm also taking it easy after having a one level ADR surgery done back on June 23rd. Things have been progressing better than I could have ever dreamed of so far, but by the same token I have to be very careful to not over do it when I'm feeling great. Pushing too hard could cause my current state of feeling awesome to deteriorate or cause me issues later.

My best advice for making your decision would be to keep in mind your own condition's details and see if you can find post-op threads that include some of the things you're experiencing and some of the things your doctor(s) have said are an issue for you medically. If ADR truly is the solution for you, keep in mind that the recovery period will vary and the symptoms you feel post-op will likely vary too. Those who have posted and had similar pre-op issues to your own will be the better indications of what to expect. BUT, don't take those experiences as the end all be all of what could happen because each of us reacts slightly differently.

I can't personally advise on some of the details you've posted about your condition because I'm not knowledgeable about them. The folks who have posted, have given some really good advice. Any surgery is scary regardless of whether or not it fits, but the only other thing I can think of to say as advice would be to make sure you have confidence in the doctor doing the procedure. I don't have confidence in my primary care doctor but I can say that I had a ton of confidence in my surgeon for my own ADR surgery and that made my own decision to go through with it that much easier.

Hope this helps somehow and I hope everything turns out well in your quest to resolve your back pain issues.

~Sara

Good question, with some very thoughtful replies. Polli, please read this topic:

Reminder on this discussion board
http://adrsupport.org/eve/forums/a/t...1/m/8361017112

Hey PolliBibbs,

I agree for the most part what the others have said, those that have their lives back are out doing, and not here posting. It's human nature.

However even with the negative posts I think someone trying to make up their mind about ADR vs Fusion can reap some pearls of wisdom .... It was stated in another thread to do your homework and I think those negative posts you see might lead you to information regarding questions you should ask of not only yourself but your doctor. Things like, do you have facet disease? If so ADR may NOT be the best way to go for you..

So while there are some horrendous stories about back repair here on the site, I think they serve a real purpose.

Personally I was in a clinical trial and was randomized for a fusion instead of a 2 level ADR. In the log run it turned out the best possible solution for me. One that I am pleased with and so is my back surgeon. I have some arthritic changes in my back and I had a huge gap between C5-C6 when they got in to do the repair. An ADR would not have helped in that situation, but most likely done more damage. I've also got some funky odd junk going on that affects my back that no one seems to understand right now. That sort of complication might have been chocked up to an ADR had one been put in.

ADR's are wonderful if they are put in to a candidate that is truly matched for one. But an ADR in a patient that isn't a good candidate can cause a lot of pain and heartache.

Due diligence is difficult without all the information to base your choices on. The more active posts here are most likely those of us that have other stuff going on, and are not a clean concise ADR candidate. Those people are off leading their lives out in the real world...lol

So don't be scared.. be informed .... that's all I am trying to say http://adrsupport.org/groupee_common...on_biggrin.gif

PolliBibbs,

Most patients that do well post-op no longer post. That's why you see a greater number of posts of patients with negative outcomes, ongoing pain issues, facet issues, etc.

I have been doing great for the last 4.5 years, but I am experiencing a little blip on the radar. However, I consider myself a success as I was bed ridden prior to surgery.

I am one of the few successful ADR patients that continues to post on the forum. I do so because medicine is my choice of profession and I enjoy taking a few minutes throughout the day to pop in and offer encouragement to others.

I too experienced the spinal hell that most here have experienced. This is a very vivid experience that has not only changed my view on life, but has greatly shaped my career.

Be well,
Justin

PolliBibbs:

Justin is one of our angels that keep posting to instill strength, faith, and hope in those who are where we've been and are still suffering. I have been in the counseling profession for thirty years so that is why I continue to post as it is God's task for me to help others. I had 4 level ADR in November 2006 and am a 51 year old white male. I am very athletic and got right back on the bicycle within 5 months after this major surgery. I pedaled over 2,000 miles last Summer while healing from this surgery and have just about 1,000 miles so far this season. There is life after ADR for many of us. I am much happier than I would have been if I had a multi level fusion.

Hang in there and, continue to research so you go at this fully armed and informed as to the best choice for you.

Terry Newton

Here, here, to all of the above. The "wellbees" are off living their lives with gusto. It would be nice if some of them would poke their heads in from time to time, to update us on all their "activities." Thus far, we haven't had great success with that. But like Justin, Terry, et., explained, as we have healed (me, all over again...) we feel compelled to chime in and offer any support we can. I have been on the side of broken in pain, on my knees, like alot of these newbie folks are now. How can I turn my back? This forum was a life line for me, and the least I can do, is try to be there for some of these folks now. God bless you in your decision making process.

I am very familiar of how you feel right now. I have read all of your posts and this would be my advice. Have as many tests as possible and get at least two opinions, three would be better. I personally would have a hard time becoming the 19th ADR patient for your doctor with your age and complicated case.

I am happy with my surgery, two years post op and much better off than before surgery - no where near pain free or perfect though.

I would like to say that my life was in constant pain before I had my ADR surgery and then fusion surgery the following year. I have some pain now but is it is much less than before. I also have to say that I knew my L/3-L-4 disk had a bunch of tears in it but I elected not to have it removed and replaced with an ADR until I was sure that it was shot. I'm thinking the pain I am having now is generating from the L/3-L/4 disk. In my opinion, ADR is a God send and has helped thousands of people. I'm one of them.

Hi Polli:

Today I am 5 months out from my 1 level Prodisc at L4/L5. I have had a significant reduction in back pain since immediately after the surgery. I still have nerve distraction pain in my right leg although since I began physical therapy one month ago I am starting to see some improvement. I have been taking neurontin though I am now going to start on Lyrica as I have heard this may help me more with the nerve pain.
I am very happy I had this surgery. My only other option was fusion. I know some people that fusion is their only option and has turned out good but after doing much research I wanted ADR surgery as I felt this would give me the best chance at returning to a more active lifestyle with more range of motion than fusion.

I had initially wanted the Maverick disc as my Doctor was in the Maverick trial but because this disc for some reason still is not FDA approved I chose the Prodisc based on my Doctors advise as I needed to do the surgery in February or I may not have been an ADR candidate if I had continued to hold out for the Maverick in the future. All of my preop tests showed that I was an ideal candidate for ADR though I know that this alone does not give you a guarantee of success.
Any spine surgery is a risk with no guarantees.
I weighed all of my options and went with my gut feeling.

I wish you good luck in your research and decision making process in the future!

lumbar lami 1998
lami revision 2004
Podisc L4/L5 February 2008

I want to thank all of you for your responses and encouragement. This is exactly what I needed. Will keep you posted and again, thank you for all the positive notes and I hope each of you continue to do great.

Best of luck to you.I know it is a huge responsibility that you are being faced with. I recall you work in a law office - as I am also in the legal field - with this due diligence is key. I echo the above statements - see as many drs and have as many tests run- get several opinions on this. From what I have discerned - success depends on many things - being theright candidate, facet conditions, the right procedure, the right surgeon, your recovery, and a matter of how your body reacts to surgery.

I am still in the evaluation stage -the drs. are not ready to do surgery (and I have seen several) but I want to be prepared if and when that day comes.

Many best wishes.

Lisa

Until ADR becomes the norm I would plan to see a couple of the best ADR surgeons and perhaps one of the better local surgeons even if they only do fusion.

Don't be a test ADR patient. You want a surgeon to say he's done 100s of them not 10s.

I would go to some of the frequently mentioned names on this site. Dr. Yue (Yale), Dr. Bitan (NY), Texas Back Institute, Dr. Delamarter (LA), Dr. Bae (LA) Dr. Regan (LA), Dr. Garcia (Miami) or at least another one of the surgeons involved in one of the adr clinical trials.

Since I was having 2 levels of Prodisc done, I traveled from WI to southern CA for my surgery because I wanted one of the surgeons who participated in the 2 level ProDisc trials. I was told multi level implants is a much bigger deal. I also went to socal because I used to live there and still have friends there. I was comfortable with my surgeon and the area I was planning to stay for a couple weeks post op.

I met a total of 4 surgeons. My surgeon of choice who particpated in the prodisc clinical trial, and later with the Kineflex v Charite trials. I also met with 2 local (WI) surgeons, one with minimal ADR experience, and one with zero ADR experience. I also met with one of the surgeons who participated in the Charite clinical trials. This last guy was out of state but driving distance.

This is not an easy decision, and you might find that you will have to fork out some travel expenses even after your ins covers that actual surgery.

So far, I'm about 3.5 months out of 2 level surgery and I am doing better every week. I am still taking percocet but I'm down to 3-4 a day with 3 Gabapentins per day. I've been methodically decreasing my meds every few weeks and I'm meeting my surgeon's goals in this regard. I am doing well with PT and overall I feel like I am a success and will continue to be a success. Now, I only wear my back brace when I walk on the treadmill or do the ellipitical machine. I don't feel like I need the back brace anymore for normal days around the house or out for short errands.

My incision site is starting to hurt more as I begin to challenge it with stomach exercises and take less pain meds. But this is not unusual or anything alarming.

I am starting to think about getting back to work even though I'm not quite ready. I'm at least updating my resume and searching out potential opportunities.

On my last follow up surgeon visit I was told I no longer had any restrictions...same time I was first cleared to start PT.

On my next trip to socal for my next follow up surgeon visit I hope to do a little networking to get my old life back and have a little more fun with my friends.

I find myself looking at this site less and less but do post from time to time because I know how frustrating and overwhelming the process and information can be. My path is slightly different than most. Like most people, my ins denied adr coverage. I was forced to file and fight SS disability, before I could get Aetna Medicare insurance coverage.

If your ins will cover surgery than jump on it so long as you have the best surgeon and you've exhausted all other options and asked all the questions necessary to make sure you are a good candidate (have facet injections, Epidural Steroid injections, have a bone density scan, have one or two diskogram with the same results, exhaust PT and really be dilligent with your PT to see if you can heal yourself over time, etc.)

After reading many many posts over the last few years, I made my surgeon look at my facets on film and tell me I was a good candidate before moving forward. I also tried facet injections as well as had 2 separate independent diskograms. make sure they have a "control" disc that reads negative in your diskogram to determine how many levels of pain you have before going under the knife. You don't want to fix one when you really need two or more fixed.

Don't be hung up one one disc. Read up on them all and ask questions about them all to each surgeon you visit. If they refuse to answer your questions, move on to the next surgeon. Don't settle.

Hi Terry: I see you on this web site often. I notice that you had the Maverick. I am a candidate for a two level, L5-S1 and L4-L5 and am considering going to India for my operation. I am comfortable with the surgeon ther, Dr. Hegde, who is the President of the national Spine Arthroplasty Society and they tell me I am in good hands. Anyway, he uses both the Pro Disc L and the Maverick and he was leaning towards using the Maverick when I had my mind set on the Pro Disc L because it is FDA approved in this country and god forbid if I have some complications after I return home the insurance companies here may cover it because it is FDA approved.

But after reading a lot of blogs I am now confused. I read about this facet joint problem post ADR and I never heard of that potential problem. Here is what I sum up as the pros and cons on the two devices. Maverick pros are it is metal on metal design (although is all that metal good for my body?) and that the narrower keel may be less likely to cause facet joint problems, and it can be inserted anteriorly and through the side (for lack of a better way to describe it) which is less complicated regarding aorta and other vital organs. The cons I hear is because it is a two piece design rather than three (ProDisc) it is more difficult to remove should a revision be necessary. ProDisc L pros are it is FDA approved and it being a three piece design it is easier to remove should a complication occur. If you could guide me on this with your experience in all that you have seen and heard that would be great. I am planning on having this done September 09. Thank you.
Lori

Welcome, Lori
 

Hi Lori, glad we worked through the access issues, thx for posting! I just wanted to let you know that the topic you posted to was from last year...so I invite everyone else to comment as well.

:)

I may chime back in later....

Hi Lori,

If I recall correctly from some of the discussions I saw prior to my own ADR surgery last year, the potential facet issues should be recognized pre-operatively. I could be wrong, but that was the impression I got. Of course, there are always exceptions to everything since everyone's body is different. It would certainly be worthwhile to ask your surgeon what, if anything, he sees in the status of your facets. My surgeon, Dr. Balderston, didn't bring them up with me in pre-op discussion, but I asked anyway due to some advice given by folks on these forums. He said that he hadn't brought it up because my facets were fine so there was no need for concern. I had my 1-level procedure done a little over a year ago and have been doing very well.

I think the best advice I could give you is that if you have any concerns based off of new information you've gathered from reading various blogs and forums, ask your doctor those same questions. You'll get a lot of fantastic advice and many diverse opinions/experiences from the folks here, but any doubts you have or major concerns with the procedure should probably go through your doctor because he will know your specific situation more closely than us.

Hopefully this helps a little. Welcome to the forum and I hope all goes well with your surgery!

~Sara

Few comments...
 

Lori,

Just a few other quick notes:

- Dr. Hegde is not the president of SAS, but is of the SAS India Chapter. I am not sure it really matters but wanted to clarify this point. Dr. Chun-Kun Park from Korea is the current president.

- Some folks here have had surgery in Germany, France and Malaysia. I don’t know if anyone has yet had ADR in India. But OMG…the flight would kill a patient! The trip to Germany for most spine patients is enough hell to last a lifetime.

- Regarding complications, you raise a very good point about post-op follow-up. If you are tenacious, you may be able to find a state-side surgeon who could do follow up. Perhaps Dr. Hegde has colleagues here that would volunteer for that important service.

- You also raise some very good points about differences in ADR device designs, surgeries and possible revisions. We’ve talked about these a lot in the past five years. Please be creative in looking for these past topics (using search), and I’ll try to dig up some of these later this weekend if you don’t find anything substantive.

Hope this helps…

I'm not sure I follow the argument that a smaller keel leads to less facet problems. Lori, could you explain the connection?

Facet problems should be checked pre-op but they're somewhat hard to spot and we have built a history of not checking for them. When all that was available for spinal problems was fusion, facet problems weren't checked because they weren't important. The solution, once the disk was bad enough, was to fuse. It's different now with ADR but you need to make sure that your surgeon and radiologist have made the connection are have checked.

Hi Laura:
The facet joints, from what I see, are on the very edge of where the implant would be, therefore if the keel is narrow, as in the Maverick, then the force of it into the bone during insertion would be less pressure on the facet joints and less incidence of fracturing them during insertion, or other future problems. The Pro Disc L has a wider keel, and and so it could fracture the facet joints during insertion and/or cause other problems related to the facet joints because the ends of it are so close to it, from what I read.
Lori

I understand your reasoning now but experience has shown that much of the post-ADR facet problems people complain about are due to the increased loading placed on a compromised joint surface after the ADR is in place, not from the loads used to place the ADR. You probably have a point, but I suspect that it is a minor effect compared with joint loading after the ADR is in place.