My story L4L5 disc problems....
 

Hello everybody, I appreciate this forum since I have been able to gather quite a bit of information to help me make a good decision.

I am a happily married faithful man with two children ages 5 and 3. It is for my family above all that I look to improve my back pain situation. So again, thank all of you for your stories and information. I am looking to document my story for anybody who may be helped by it.

I am 36 years old and have had back pain for about 18 years now. I am not exactly sure where all of my pain started but I believe that it could have started from a high school football game during my senior year. My “pain” did not really start off as pain but more like a certain type of discomfort in my back. As a very young man at the time, I didn’t think anything of it and figured it would just go away. It never really did go away.

Although the discomfort never went away, it still never kept me from living a very active lifestyle. In fact, shortly after I graduated from high school, I enlisted into the U.S. Army. I have no regrets for serving my country and feel very proud to have done so but while I served, I put my body through a lot physically. I served in the Middle East, went to airborne school, air assault school, IOBC, etc.

I have had several “episodes” through the years where I have been put out of commission because of my back. Back in 2011, I had enough and decided that I need to pursue some sort of procedure to relieve my pain. I had to take a whole lot of time off of work and ended up getting a discectomy in February of 2012 by Dr. Anthony Yeung in Phoenix, AZ. I do not recommend anybody see this doctor. His bedside manner is terrible and I’m not so sure that he is a good surgeon since I didn’t do as much research at the time as I should have. Of course, at the time, I was desperate. My sciatica did subside after the procedure but another pain on my right side (hip/butt area) surfaced after the procedure.

I was able to manage this pain for the last 5 years until this last January. For some reason, my pain mounted to the point where I was having trouble getting out of bed. Walking has also been a problem although when the “wheels feel greased” I can get around a little better. Mornings, evenings, and nights are most difficult.

I will attach my MRI report from the Veterans Affairs. I am suspicious that maybe the report does not report all of the symptoms of my back since I question the competency of the VA. Also, the VA gave me a cd with my MRI images on them but I do not know how to download the images to my computer.

With all of that said, I have begun to look for what could be a possible solution for me. At this point, I do not know if I’m even a candidate for ADR but would prefer this vs fusion. I will be seeing a Veterans Affairs surgeon on May 31st for information purposes only since there is no way I would let him operate on my back. I expect that he will want to give me shots in my back or prescribe me pain medications. I will report back on this.
I have also reached out to Dr. Rischke in Switzerland via email and will be seeing him at some point in the near future since I will be moving to Europe for at least a year to be with my wife’s family in France.

The two discs that seem to be the best based on testimonies are the LP-ESP and the Axiom Freedom disc. M6 scares me because of some testimonies and ball-and-socket discs make no sense to me since our back doesn’t work this way. Does anybody on this forum know who does the Freedom Lumbar disc? I know the Jamaican Doctor, Kingsley Chin, does it but does anybody know of doctors in Europe that do it? I believe Dr. Rischke used to do it but I think he now uses the LP-ESP.

Attached is my MRI report.

Why not m6? Actualy alot of people goes more with m6 disc then any another...

Attached is an M6
 

Look at the attached. This is an M6.

I haven't had as long duration of pain as you have but understand your situation and disc questioning. I had the same selective endoscopic discectomy as you but by another surgeon. It was a bandaid and still glad l did it. It's been a year and I haven't returned to activity that l like - mountain biking, skiing, backpacking, running, and weight lifting.

I've rresearched all the discs. Each manufacturer makes different sizes. Some make several sizes like ActivL and M6. Others only make one size that may be too small for your supporting L5 vertebrae. That's the case with me. I'd love to get the LP-ESP but it's too small. My choice for x-large is choosing between ActivL or M6. I understand your reservation for either. M6 inner disc is only 25 mm which causes problems like the image you showed. It's 25 mm regardless the size of end plates.

Launch your CD and measure the width and length of your L5 vertebrae. Let us know in cm or mm. The size may eliminate some choices. Dr. Rische prefers LP ESP over Freedom. Though he was an investigator of the Freedom disk. The end plates don't bond well to the bone. He's had to remove several Freedom discs after several months with zero bone bonding. That's unacceptable.


Another choice for LP-ESP is Dr. BIREN DESAI in Germany. Total package cost including everything but travel is US $15,800. I would not hesitate going with him. Too bad my vertebra is too large fir this disc.Send a CD to him with your email contact, description of your current pain, and activities and he'll email you after he's reviews your mailed info.

RJ,

The MRI report notes reactive changes in the endplate, possibly suggesting a more acute inflammatory process. IMHO, you need to work very hard to rule out infection, which is surprisingly common in back pain patients. Pls see this article and read a few times:

http://www.ajnr.org/content/29/5/838

Also see this relevant topic:

https://www.adrsupport.org/forums/sh...ower+back+pain

PS: I emailed you yesterday too.

That disc was incorrectly installed not a failure because of the actual disc (I will most likely gow tih the LP ESP by the way not m6, I just wanted to point out the problem in that mri is the surgeon not the disc)

M6
 

I was shown over 100 failed m6 disc X-rays and actual photos of the failed disc as seen on approach. I believe the more I learn about the ball n socket design the more I like it.

Hello everybody, I apologize for taking so long to get back on the forum. I have been working on moving me and my family to Montpellier, France and arrived just a week ago.

I am going to start seeing Doctors here in France to see if the doctors can come to a consensus about what my problem is and what approach is best.

Just before I left the U.S., I saw a VA Doctor in Albuquerque who was a pretty nice guy but didn't really know anything about ADR. The visit was somewhat of a waste of time. I was hoping to get some information from him before I left.

Side note: Veterans are medically covered overseas for any service-connected disabilities. The program is called the VA Foreign Medical Program. If you are overseas for whatever reason and need to be covered, call this number: 303-331-7590

The first Dr that I will be seeing is Dr Gregory Dran. I will see him this Thursday. I am curious to see if he offers LP-ESP and what he thinks about ADR. I'll keep everybody posted.

Dr Thierry Marnay is another doctor that I would like to see here in Montpellier. He performs the Pro-Disc, which I'm not interested in, although I would like to hear him out.

The next Dr on my list to see is a Dr in Paris although this is going to take a little more planning because Jean-Yves Lazennec is in Paris. I am certain that he does the LP-ESP. It may be a little while before I can visit him.

Also, I have been in contact with Dr Rischke in Switzerland and just sent him my MRI. He is currently on vacation so it will be a little while before he gets back to me.

I also sent an email to France Rachis to get information on all of the Doctors here in France that use the LP-ESP........

I'm in the process of scheduling an L4-5 LP-ESP from Dr. Desai in Germany.

Hi RabidJ,

LP-ESP is less aggressive than the freedom. I am sure you can find Michael Walls youtube very helpful. I am waiting for surgery at my L5S1 using LP-ESP. There is a Facebook where people like us gather together and share information. It is very helpful as i met another guy from Canada and he will travel to Germany for M6 surgery. Look out for 'ADR Artificial Disc Replacement Group not affiliated with a specific Dr' Facebook.

Donmas, may I ask who is doing your surgery?

Hi Matthewdds,

I am from Australia, my surgeon call Dr Neil Cleaver and he is located at Gold Coast Queensland. I will be going there for my surgery on 10 Aug, so i will try my best to do any update here otherwise will be at ADR Facebook. You or me and we are not alone, so open out to each other for care and we will pass this stage and move on our life with a better back. Hope, you take your time looking at this ADR option, it may or may not be your option but look deep to find your own solution. That will be the optima goal for most of us. Cheers buddy.

Great. Thanks. I will keep in touch.

Hey donmas, thanks for the response. Why do you believe LP-ESP is less aggressive than the Freedom? Where did you get this information?

Quick update: I recently saw Dr. Dran here in Montpellier. He seems very competent but only does Fusion. If I end up deciding on fusion, he is the guy I would go with. He was offering to do a fusion at L4-L5 with dynamic rods at the next level above.

I asked him about ADR and other Doctors and he didn't seem to have any strong opinions one way or another. He did mention Dr. Marnay who is here in Montpellier whom I will be seeing at some point. Although Dr. Marnay only does the Pro-disc, which he invented.

When I mentioned the name Jean-Yves Lazennec, he had heard of him but did not have an opinion. The fact that he heard of him was a good sign to me since Doctors here in France do not really advertise for business.

So I ended up calling Dr. Lazennec who is in Paris but the first appointment that I could get with him is on December 14th, so I took it. This guy is very well known and booked out for quite a while. He is supposed to be one of the best. He does the LP-ESP and fusion so hopefully I can get an honest opinion from him about what is best for me. The sucky part is having to wait cause I am dealing with pain on a daily basis.

Before I see Dr. Lazennec I will be seeing a Dr in Marseille named Patrick Tropiano. Tropiano also does the LP-ESP so I am interested in what he has to say. I am scheduled to see him on August 25th. I will keep ya'll updated.

Also, I am waiting for Dr. Rischke to get back to me since I sent him my MRI. I think he was on vacation.

I thought you said your vertebrae was to large and the LP-ESP was too small?

Another update:
 

I took a drive to Zurich the other day and spoke with Dr. Rischke face to face for the first time.

His recommendation for me was to have discs replaced at l4-l5 and l5-s1 with dynamic rods at the L3-L4 level. He said that my schmorl's nodes would not be an issue whatsoever.

My disc at the L4-L5 level is trashed, he said that the dis at L5-S1 is protruding and causing pain, and the disc at l3-l4 is at the beginning stages of degeneration.

Overall I'd have to say that I felt pretty confident with him and may decide to move forward but will be talking to a few other doctors first.

He said that he has done over 3,000 disc replacements and was in charge of a spine department in Germany at one point in his career. He seems to have a lot of experience.

I had the opportunity to see and hold the LP-ESP and it seems to be a pretty good disc although I am no expert. I did try to squeeze the disc as hard as I could to see if I could see the shock absorption but it was not evident. I was not strong enough to squeeze it (probably a good thing). The disc is very stable and seems to be very tough and rigid.

He also let me see and hold the Freedom Lumbar disc even though he does not use this disc right now. He said the core of this disc is great but the plates are very aggressive. When I held the freedom disc, I was able to confirm how sharp and aggressive the endplates were.

He is very expensive although I believe that the VA will pay for the operation as long as I front the money.

His recommendation was to stay in Zurich for two weeks after the operation so that he can follow up to make sure everything looks good.

Again, I will be seeing another Doctor in Marseille, France in two weeks to see what he thinks.

Were the dynamic rods being placed from the posterior in a second surgical procedure? My issue is that I would need a second surgery if I did the lp-esp, prob a fusion, due to instability issues. I am scheduled on Sept. 14 in the Cayman Islands to get the BalancedBack disc. This restores stability w/o a fusion. I am hopeful this works for me.

Good luck in your quest. Whether you choose France or Switzerland you are likely to be better off soon.

Hi RabidJ, you are strong but the LP-ESP only able to compress and move on body temperature. I have discharge, and i am pretty good so far. I do have a slight old pain on my back but i am positive as it will be gone later. I did a couple of update on FaceBook ADR (Artificial Disc Replacement). Jump in there and join us, as you will also gather extra information there. Hang in there buddy, you will be fine.

The entire procedure would be done at once. He would simply flip me over after having placed the discs.

About your concern with de-stabilization. My understanding is that when you get a disc replacement, this should stabilize the spine as well.

Thanks for the reply Donmas. I will go check out the facebook page to see how you are doing. I wish you the best. :jump:

In my case, I am too unstable for just disc replacement. Need something extra. BalancedBack has extra tail on it for stability.

Update:
 

Once again, I apologize for taking for ever to get back with everyone.
I have seen two Doctors since my last post and contacted another via email.

The first Doctor that I saw was one of Dr. Marnay’s protégé’s here in Montpellier. This dude seemed way too young for me and only performed about 300 procedures. I took the appointment just to get an opinion. This clinic only works with the Pro-Disc which obviously was a non-starter for me. The young Doc said that he thinks I should only work on my L4L5 disc and leave all other discs alone.

I have confirmed so far from three different top notch doctors that pain is being generated from my L4L5 and my L5S1 so I know this clinic/doc was mediocre.

The next Dr. I spoke with I was really impressed with. His name is Dr. Patrick Tropiano and works at a public hospital in Marseille, France called Hopital de La Timone. I had to drive two hours east of Montpellier to see him. The reason I wanted to see him is because I learned that he uses the LP-ESP disc that I am interested in. It turned out that he is a professor as well and teaches other surgeons in Europe and the U.S. how to perform surgeries. He has performed over 1500 operations and uses all of the latest technologies. He went above and beyond to help me get more images CT Scan, EOS imaging, and scanner. I have never seen scanner or EOS imaging in the U.S.. The only bummer for me is that he believes, like Dr. Rischke from Zurich, that my L5S1 disc is problematic as well and causing me pain. Tropiano believes that it would be better for me to have a hybrid operation placing a new disc at L4L5 and fusion at L5S1. I told him that I really wanted to avoid fusion but he said that my vertebrae is not flat at L5S1 and disc placement there may not be a good idea.

I immediately contacted Rischke to get his thoughts and below is exactly what he said:
“I don't share this view, because I never had a problem preparing the end plates of the vertebrae with a burr or diamond cutter to fit the implant save and stabile
I never observed a displacement of the LP -ESP.”

I have to admit, Rischke feels very ballsy and aggressive to me, yet confident. I even alluded to this at our meeting and he basically said that his solution is to try to fix the problem so that I won’t ever have to mess with surgery again. But at the same time, it seems like you shouldn’t do anything that may not be necessary, like placing dynamic rods at L3L4. Although my L3L4 is showing the beginning signs of disc problems, it doesn’t mean for certain it will be a problem. Man, tough decisions!! I wish he wasn’t so expensive too.

Lastly, I contact Dr. Biren Desai. He has written me back and said that we should do a double disc replacement. He didn’t say at what level but I am assuming at L4-S1. This is all the information that I have from him so far as he will be re-contacting me this week to talk about details.

Dr. Lazennec from Paris is another Dr that I would like to speak to but I am becoming very impatient. My appointment with him is set for Dec 13th. I am going to send him an email to see if there is any way I can get a consultation from him sooner but I am doubtful. Lazennec is the Doctor that was lead on many of the trial studies for the LP-ESP.

Bon courage a tout le monde!! :D

Could you share few pics of axial mri findigs of those levels of l3l4 and l4s1 ?

MRI Image...
 

Thanks for taking a look and letting me know your thoughts. :beer:

I think that a good neurosurgeon with wide experience and knowledge will not have problem to realign endplate to put artificial disc in safe position. Me too like yourself hesitate on what disk to go for M6 or LP ESP...

I chose a Dr....prayers appreciated.
 

Once again, I have taken forever to update.* I have made a decision on which Doctor I will be using.* I have decided to go with Dr.* Biren Desai in Cologne, Germany.*

I am going to leave out some detail on why I chose him over Dr. Tropiano because I am tired and a little stressed out about my upcoming procedure.*

So I ended up driving up to Cologne, Germany about a month ago to meet Dr. Desai and was unbelievably impressed with his patience, detail in explaining my situation, his honesty, and his kindness.* The procedure that he will be performing will be a hybrid procedure with a disc replacement and L3-L4, L4-L5, and a fusion at L5-S1.

Reasons I chose him:

Highly competent. Many years of experience with adr (I’ll try to update on exactly how many later)

Uses LP-ESP disc

His ability to do multi-level operations. I was debating whether to leave L3L4 alone because it may not be causing pain but more than likely will be in 5-10 years since it is damaged. Since I’m hoping that this will be my last experience with back surgery, I decided to get it done (extremely tough decision). In France, Doctors are hesitant to perform more than one disc level using adr.

Lastly, price. I believe that I am getting the same world class quality health care as any other person in Europe at a price that is doable. I’d like to point out that I will be requesting that the Veterans Affairs pay for this operation via their Foreign Medical program but am still uncertain that this will actually come to pass.

Note: I tried to avoid the fusion but had a couple of Dr.’s confirm that I have an unstable vertebrae at L5-S1 and did not want to risk any issues by forcing an adr operation at this level. I’m sad about this but I will try and make the most of it.

Prayers are appreciated since I will be operated on in 4 days. I will no longer post here but on the ADR outcome section of this forum.

good luck. What degree of spondy do you have at 5-s1 that makes you not an adr candidate? try not to be stressed out about the surgery. the decision was the hardest part, and it is behind you now

Good luck RabidJ!

Best of luck with the upcoming procedure. I'll be curious if see if the VA actually winds up covering the operation, as I've been fighting with them regarding my back issues for several years. Ironically, I just returned from the US following a year of activated reserve duty in Germany, and would have serious considered a couple of the German ADR surgeons had I known this was even an option.

Surgical outcome forum and video blog.....
 

https://www.adrsupport.org/forums/sh...ad.php?t=13836

https://youtu.be/omGp9JDdPbg

https://youtu.be/sN_4Z-K4CiA

https://youtu.be/CTGuPNs6zUw

https://youtu.be/d0RQIrLVAlQ

https://youtu.be/BVtMpWUC7QE

https://youtu.be/ZVnoCvsKZdo

https://youtu.be/hXszUrSBplU

Please whatever you do...DO NOT get a ball & socket design (Pro Disc) installed into your Lumbar spine. They may be fine for a cervical application, but in the Lumbar zone they have no shock absorption, & they have no lateral stability which puts all the stresses onto the Facet joints, wearing them out.
I'm pretty much in the same boat you are, and I'm waiting until the third quarter of 2018 when the Axiomed Freedom Lumbar disc will get full F.D.A. approval.

Disregard in my last post there where I warned you against getting a Pro Disc.
I just cannot emphasize enough what a catastrophic failure they can cause.
I'm glad to know you were able to get your surgery RabidJ.
And in my opinion, that you didn't get fused is awesome.

Gen Patton, pls see this post to see how to add a signature:

http://adrsupport.org/forums/showthread.php?t=11053

Your post implies that all ProDiscs will fail. This is not accurate. The majority have done well.

Unfortunately, we have seen catastrophic failures -- with many different disc designs. It's mostly a function of the surgeon's skill, training and placement of the discs.

The other BIG part is ensuring the patient is healthy enough to receive the disc; and rule out all other risks, like localized local infection. Ironically, the latter is the least understood and diagnosed; and I would argue the biggest contributor to localized vertebral disease and degeneration which can lead to subsidence.

Case in point:

https://www.wellbeingjournal.com/the...f-coconut-oil/

Cool journal, by the way.

I have had x2 lumbar all and socket ADR's (Maverick design) for 12 years. No major issues.

2 Level ADR 5/21/2017
 

RabidJ Hello I was reading about your surgical experience / outcome etc. and noticed the X-ray dated 5/21/2017 with the 2 ADR. Elsewhere it states you had your surgery 11/2017 correct? Am I missing something?
Looking at the X-ray there is in layman's terms some serious looking curvature going on. Was there ever any question as to whether there was too much curve to utilize ADR vs Fusion?
I have been advised an ADR can only be utilized with a specific / limited amount of curvature (been avoiding a 3 level fusion for years).
Thanks for the videos / info.

Xray adr
 

RabidJ is this your x-ray???

Layne,
I've heard several accounts that Dr Desai prefers not to implant the LP-ESP in patients over 6'5", which might include me. You make a really good point about the M-6L using the same 25mm inner disc regardless of endplate size, and that is certainly food for thought. I do not know if there is a definite size limit for the vertebral body, and I also don't know if I have measured my own MRI correctly. The LP-ESP sounds like a great disc, but if my size absolutely eliminates me, I may be wasting energy researching that path.

Thoughts appreciated and congrats on your recovery success.
Cheers,
Paul

Lazennec contact?
 

hello how are you ? do you have the LAZENNEC contact?