New to DDD
 

Hey guys

I finally got the guts to sign up online after a few months of trolling! :)

I'm 33 years old and live up in the Great White North (Canada). Shovelling all the snow sure is getting to be a chore!

I'm not sure where I'm going or how I'm going to try and treat my condition, but there have been a number of you that have helped me to come up with a general course of action.

My Diagnosis:

L5-S1. No Malalignment or destructive marrow leasion. Developmentally narrow lumbar central canal, particularly at L3 and L4 due to short pedicles. Conus terminates normally at the L1 level.
Discs and facet joints at L1-2 and L2-3 are well maintained with no evidence of spinal or foraminal stenosis.
At L3-4 the disc is well preserved. There are mild-to-moderate hypertrophic degenerative facet joint changes bilaterally with mild thickening of the ligamenta flava, without significant aquired central spinal stenosis. Foramina remain patent.
L4-5: There is mild disc space narrowing, desiccation and a combination of fatty and edematous endplate signal changes. No paraspinal soft tissue swelling. There may be very minimal enhancement of the disc and adjacent vertebral bodies but this is quite subtle. There is a mild disc bulge identified, eccentric to the left along with a central annular fissure. Mild to moderate degenerative facet joint changes are seen bilaterally with mild thickening of the ligamentum flavum resulting in mild acquired central spinal stenosis and left lateral recess stenosis. There is moderate left and severe right foraminal stenosis predominantly related to encroaching facet degenerative change.
At L5-S1, the disc appears well-maintained. Mild-to-moderate degenerative facet joint changes. Spinal canal and foramina are widely patent. No impingement of the descending roots.

The long-short is that it hurts like heck to bend/twist and absolutely aches when I'm sitting and in bed. The NSAID's help a little, but I've read that they can interfere with cartilage healing in the long run and they kill my stomach. Damned if I take them and Damned if I don't.

I've been exchanging emails with Mike86 and have read all about Tyler's experiences with the M6 and Mr. Boeree in the UK. I've exchanged a number of emails and phone calls with surgeons and have settled on Mr. Boeree IF I decide to go the surgery route. However:

1) I'm trying to exhaust any and all non-surgical treatments first
2) The surgery isn't covered by our government healthcare

My symptoms have lasted just over 6 months and are getting worse as I become more and more inactive. Pre-injury(DDD), I was up to 3 nights a week of hockey and a couple of nights of yoga per week, while I sat in a desk all day.

I'm living with the pain, but the tingles and numbness in my toes/hamstrings are concerning me greatly... they come and go, but I've read that is a troubling sign.

I've had a history of back problems at L4-5 and the first bulge/protrusion happened about 10 years ago. Losing 40 pounds and picking up yoga along the way kept in check until last September when this current bout of pain began. I'm currently at 6' tall, though I've lost 1cm in this ordeal somehow, 165 pounds and until September, was in the best shape of my life. My core strength is still pretty good, so making it stronger has been of no help.

I'm not sure where this leaves me, but any pointers will be greatly appreciated... Why can't cartilage just repair itself! http://www.spinepatientsociety.org/f...ilies/wink.png

Until my appointment with my local specialsts here in Calgary (3 month waiting list - I'm in on April 8th), I'm popping glucosamin, chondroitin, MSM, omega fatty acids and collagen supplements in hopes that my lame disc can rehydrate itself - if even just a little. Gentle excercises hurt a bit, but I'm trying everything I can to get the transfer liquid and nutrients in and out of the disc. Physio has been a bust.

Cheers,

-Brett

Hi Brett, thanks for finding us. Hope we can help.

Quick questions: do you feel LESS pain in the morning? Are you doing any traction exer. like chin -ups, hanging, or water therapies? Also, do you find that you feel much less pain after taking any type of NSAID?

Don't forget what the TLA stands for -- DDD is a disease process. Most people want to forget about this as they are in such pain. If one looks it as a disease, it may help in the information gathering process before treatment decisions are made. More on that some other time...

Thanks for the welcome, Harrison.

Definately more in the morning and throughout the night as I try to sleep along with sitting at work. I guess it seems like the less I move, the more it hurts, as long as I'm not bending or twisting. Walking definately makes it feel better. More than the pain though, I'm worried about the tingles and numbness down my left hamstring and big toes. It comes and goes but seems to be happening more frequently. Should I be alarmed?

I'm also getting what one surgeon called "referred pain" accross my sacroiliac joint and left groin/hip - it seems my muscles are mad at the nerves who are in turn mad at the inflammation.

I've tried swimming and definately need to get out more with that. The NSAID's really do help with the pain, but these 550MG Naproxens feel like they're eating a hole in my stomach.

I bought one of those Spinal Stretch devices as well to try and decompress each night before bed, but I haven't seen any results yet - though it's only been a month with that thing mind you.

TLA... terms of the license agreement!? I didn't ever sign a DDD contract I hope! Sorry, I'm not sure what you mean.

I think I understand that it is a disease and I'm terrified of it progressing further at L4-5 and squeezing these nerve roots even more and/or causing adjacent level issues. That's probably why every ADR surgeon I've spoken with has indicated I'm a good candidate. Then the hole quagmire of surgery rears its head. There seem to be a real mixed bag of outcomes and I'm not sure I'm willing to risk coming out worse than I am now... BUT will not doing anything now leave me crippled in 5 years anyway?

How does anyone know they are ready for surgery? Serious nerve compression and pain make sense... but is surgery the real answer for someone just trying to ski and play with their 20 month old daughter again? Is it unrealistic for me to want to be as active as I was a year ago?

I don't know... sorry for the rant.

You're not approaching the injury correctly. If you decondition it will hurt you more. You have to learn how to unload the spine as much as possible and give it time. Most of the time it will settle to a point that is good enough.

Stuart McGill is a professor of biomechanics based in Canada, and has done a lot of work on core stabilisation. Find a physio who's up to date on his stuff and that will be a good starting point. From there head to pilates.

If you want a good cheap book on it, buy 'Spinal Stabilisation' by Jemmet off Amazon for $40.

These are all good options to explore before you subject yourself to invasive surgery.

Good luck

I'll look into it for sure... I've already been doing lumbro-sacral stabilization excercises and the rebuild your back program. Every minor flexion (forward or backward) seems to aggrevate the tingles and numbness.

Like I said earlier, I've dealt with approximately 4 injuries (bulges/protrusions) at the same level over the past 10 years. I was overweight for quite a while and didn't care for my lower back properly. Each injury required months of rest and physio to get bck up and running. Yoga really helped to stabilize my core over the past 5 years and I've been doing great until my dog tripped me down the stairs last August. It seems to have been the final straw that "broke" both the camel's and my back. This one doesn't seem to be getting better and the redicular symptoms are actually getting worse. Hence my concern about nerve damage. I guess that's why its called degenerative disc disease - it keeps getting worse?

I haven't really been able to sit still for very long unless I'm on NSAID's for about 6 months and have found the only time I'm comfortable is:

1) walking - Tough to do when it's been -20C almost all winter
2) laying on a couch or on the ground to play with my kid. Getting up to chase her is another story!

Swimming really wasn't as easy on my back as I had hoped it would be... so I might try deep water running for a while.

I'll look into the McGill stuff too.

At what point does someone decide enough is enough and go for ADR surgery?

I have reached the enough is enough and am ready for surgery and has taken me shorter than most. It has been almost 3 years of constant back pain and in the last few months of now leg pain symptoms.

For me, it's not being able to do all the things I use too but more importantly being able to do things with my 9 year old son.

If I read your post correctly it has just been around 6 months of pain but prior to that you had problems 10 years ago. It's a tough decision to commit to surgery and surgeons seem to be quick to recommend surgery (or at least from my experience).

There some new exciting stuff out there for sure but may not be available 5-10 years out...

I hear ya... Always something better 5 years out, eh? There never seems to be the perfect solution when you really need it!

Constant pain for 3 years must be terrible. Sorry to hear that.

Mine has only been constant for 6 months and off and on depending on the injury over the past 10 years. Probably about 4 specific times I found myself in bed and doing physio/accupuncture for months before I was able to be normal again. Sorry if I wasn't clear.

in my opinion, all these PT is completely useless. I would like to hear a case where PT has completely cured a person from his or hers back problems. Then I will consider it. Whats the point of spending more and more time and money doing PT if it doesn't guarantee success? Atleast surgery goes to the root of the problem and after doing a lot of research, i believe ADR is very benefitical for the right patients. Its even more helpful for younger ppl since they recover faster.

I'm not going to touch the argument about conservative care vs. surgery. Even if you're dead set on surgery, though, a good solid core strengthening and flexiblity regime buys you time, gives you the most you can get out of your life while you're working to get surgery, and makes your recovery time shorter after the surgery. A few years back, Bertagnoli replaced every disk in one gentleman's c-spine with a mix of ADRs and fusions. The man had worked hard to remain fit and it paid off with a recovery time in weeks. I don't recall the exact time but he was up and about within some number of weeks, definitely less than two months.

Even if u have the surgery thats only half way there. You still have a 'bad back' and need to work it optimally. So uve still gotta do all the PT.

I'm 3 months post op lumbar hybrid.. for me prehab and rehab isn't an optional extra.. helped keep me out of screaming pain and employed for a number of years before it all went to **** too

its just biomechanics.. all science based.. it works.

Hey guys,

I don't want to create a flame war between conservative treatment and ADR in my first post here!

I've done physio in the past and will continue to do it while my back hurts - nothing has helped me as much as time and yoga, I might add.

The only thing troubling me right now is that I haven't seen any improvement in 6 months this time around and the radicular symptoms are getting worse. That's why I began looking into ADR.

I have seen 3 physical thearpist since I started having backpain. 2 of the 3 said they didn't think they would be able to help me. One of them thought so but after a few months I was still the same.

Everyone is different but I don't want to go the PT route again before surgery but think everyone should at least try it first...

Laura corrected me. The person had every disk in his L-spine, not c-spine, even strengthening the argument for being in good shape at that start of your surgery.

Mind you, it's pretty unlikely that you'd even be here reading these posts if you're the kind of person who could be entirely repaired by PT. My advice: continue pursuing surgery and use PT to improve your quality of life until you have your ducks in a row for the surgery. If things go the way they typically go, you'll have at least a month or two of PT under your belt, so to speak, by the time you get to your surgery/no-surgery decision point. See if the PT is helping then and make an informed decision. The other important thing is to not look at PT as something you have to go to a therapist and get your PT appointment or else it doesn't count. Don't let those PT appointments crowd your life to the point where you don't have time to live. Get exercises, stretches, whatever from the therapist and do them faithfully at home and just use your appointments to add or subtract from those based on what's working and what isn't.

Hi Brett,

Just read your post and can sympathize with your condition. I've had back troubles for about 8 years now, but for the last 2 years it has been getting progressively worse (ie 1 day not bad followed by 2 days of pain). Like you, I'm currently chasing my 15 month old child around which aggravates it a lot and have been trolling this site for possible ADR surgery.

Also, I'm caught up in Ontario medical system and the Doctors seem to not know how to approach back problems. After getting an MRI was told to keep doing pilates and hang in there! Thanks, tell me something I don't know. One thing I was wondering was, do you have a positive straight leg raise test? Mine is negative so a surgeon won't even see me even thought my feet are numb.

One more thing I wanted to mention; in 2005 I had a really bad disk herniation that they wanted to operate on (I was living in the U.S.); but instead I tried two ESI done with a fluoroscope. My pain went from a 10 to a 1 and it lasted for 3 years until I injured another disk. They were about $650 each, but I don't think they do them in Canada, not sure though.

I would be very interested in learning what you decide do since I'm in the same boat.

Good Luck

John

Thanks for the reply, John!

I've got my appointment with our spine specialists from the UofC on Friday. I'll see what they have to say and keep you guys posted. My leg raise test was terrbile in November, but it has gotten better while taking gluco/chondroitin etc... I'm not sure how it's working, but my pain is a little less after ~2 months of taking it. I'm taking something called "animal flex" - some crazy body builder supplement that I read about. It's got the gluco/chondroitin/msm in it along with some natural anti-inflammatories. I'll ask the doc this friday about the ESI injections to see if they are applicable to me.

As a side note, I applied to be part of the Mesoblast Phase II clinical trial for invertebral disc repair (stem cells) - but was rejected today because my stenosis is slightly larger than 3mm. So close!

Too bad. For any of you out there wondering about Mesoblast, keep your eyes peeled for the Phase III trial next year. I'll be posting on here as soon as I hear anything. It will be their pivotal trial with a larger patient list and a little more lax on the requirements to get in.

I decided to blog my journey (as Mike did) through this back in Feb... Probably a boring read for most of you that are old hats at this, but I'm trying to document everything I come accross just in case it might help anyone else (especially us canucks).

"Backup"

Sorry, Annapurna... missed your post. I'm sticking with the daily PT excercises for sure, but it's been tough seeing no improvement since November. I need to look into the Mckenzie PT stuff too, as aluded to in an earlier post.

Thanks again guys for your insights.

Well, my meeting here in Calgary wasn't as helpful as I had hoped.

It was a combo physio/doc/excercise therapist assessment and got off to a great start. The physio assessment was very thorough and he was very nice and listened well. We re-established my issues with flexion and extension, twists, numbness, tingles and pain. My leg raise tests increased back pain exponentially as expected (more right than left) and he remarked about my limited range of motion. The physio then took a quick look at my MRI, noted the bulge and brought in the spinal triage doc to go over my history and scans. He also also noted the bulge, my symptoms and the hypertrophic changes of my joints, the disc degeneration and all the the nerve root compression as a result. Obviously a fan of conservative treatment, he told me to continue my limited exercise repertoire and that a fusion now would result in ~3 more surgeries over my lifetime to relieve the degeneration on adjacent levels. According to him, you only operate when the leg pain/numbness/tingles exceeds the back pain. He said I’m destined to live with my current (and worsening) level of pain for the next 20 years, when they will likely pursue a 3 level fusion. As such, I am not a candidate for any surgeries yet, but if the leg symptoms stay or progress, I will need something. He didn’t indicate what kind of a "something" that would be or if/when I should even follow up with him. When I asked him specifically about laminectomies and ADR, he replied:
1) Laminectomies will just create more tissue growth than before and make everything worse
2) ADR will not help any of the pain I’m feeling because he felt it is mostly related to the facets.

Needless to say, I left the consultation a good deal more confused.

I've spoken with Mr. Boeree and Dr. Clavel who indicated my facets are only slightly degenerated and are just on the larger side of normal. Both agree my pain/tingles/numbness are direcltly related to the disc degeneration/bulge. Both agree that I'm a candidate for ADR and my local spine doc tells me they are wrong and that I'm destined to just suck it up for 20 years until they fuse my entire lower back. Who am I supposed to trust? My heart wants to trust Mr. Boeree, but man... this fellow in Calgary really shook my confidence. Is the doc in Calgary really looking out for my best interest or is that the answer of an overburdened public system that only deals with the most serious cases? Are the docs in Europe just out to make a buck? Is it folly to be pursing ADR? I'm going to phone Mr. Boeree next week to go through the Calgary results.

John, I honestly thought our healthcare system might be able to help, but I was speechless when the doc told me that. They also told me there was no way they'd reimburse me for a foreign surgery of this nature... A long shot, I know - but I had to ask again for us canucks.

I'm worried that if I do pull the trigger on the surgery, my follow up coverage in Canada will be poor because the docs told me to just suck it up in the first place.

I posted some shots of my MRI as well online if anyone is inerested and I'm working on gathering some more shots of the facets (I didn't even know what they were until recently).
My Diagnosis « "Backup"

This is kind of a weird and dark question - but does pursuing an "elective" surgery like this generally negate any existing life insurance or critical illness insurance policies? I would hate to leave my family financially exposed in a worst case scenario should I move on the surgery.

My personal opinion on a few things:

1. We've all been there. It's a subject that every person on this website seems to lack: a quick, easy decision that stems from multiple opinions that agree. I had 5 different recommendations (fusion only to 3 level ADR only, and everywhere in between)
2. As a medical professional myself, it's hard to recommend something you really aren't experienced in doing. If you had the training, support staff and facilities, and reimbursement: you'd probably be providing it yourself. ADR is not a new, crazy surgery. Professionals recommend what they know and believe in at the time.
3. Read your insurance policies, but I can't imagine have elective surgery for any reason (cosmetic, sex change, whatever!) would be a reason to deny payment if things went south. There are usually clauses regarding suicide, drunk driving, war.... but not surgery.
4. Keep working toward an answer that is unique to you. It has taken me around 6 months to make and feel good about a decision. (Nick Boeree for me, by the way. If you go that route, I have some housing info cheaper and more comfortable than a hotel).

Best wishes.
United in hope for a mobile, pain-free future,

Brett (and John),

Condolences on your terrible dilemma.

I don't know if you should go with what the Canadian doctors are telling you, or if you should go with what Boeree and Clavel are telling you. I can tell you that in reading these forums that I have never seen a kind word written about the Canadian medical system where spine issues are concerned; and what I've seen posted about Boeree and Clavel has been almost universal praise.

My situation was so much easier; six opinions, five of them were identical; a two level ADR. Clavel did my cervical ADRs, and I've been able to resume all activities that are not contra-indicated by the fact that two of the strongest structures that hold my head to my body had to be removed for ADR. BTW: when I was in Barcelona for surgery, I was one of two foreign patients that Clavel had at the time. The other guy was a Canadian lumbar patient who could not get treatment within the Canadian system.

Would it be possible for you to visit a US ADR surgeon? Or better yet, multiple ADR surgeons? They would probably come down somewhere between the Canadian and European surgeons; probably closer to the Europeans. I would strongly ditto Joey Sue's words; accept trash talk about ADR only from a surgeon that has some experience with ADR. If I were to tell you that Chevrolet's were terrible cars, but I'd never actually even seen one ...

Good luck, Jeff

Hi Brett,

I was catching up on the posts and saw your update, sorry that it didn't go that well, but I'm not that surprised. My doctor here in Toronto told me a surgeon wouldn't even see me without a positive straight leg test and if he did get me get me in (about 6-8 month wait) he would only want to fuse the two or three levels; standard approach. No thanks! Thus my options are limited to pilates and/or massage which will never solve the underlying problem, but won't hurt and will most likely help even if I get and ADR so I keep doing them.

As for the ADR, although OHIP won't pay for it my accountant told me you can get 25% back from CCRA when you file your taxes, it's not a lot but at least it's something. As for your decision to have it done or not, I'm in the same boat although I suspect my pain level is far below yours at this point. I do believe that the Canadian doctors are only going to recommend/push surgery or care that they are familiar with. I do have concerns about follow up care when one returns from an ADR, but maybe some of the other Canadians who have come back from having ADR could comment.

Have you ever contacted the Texas Back Institute? They have been on my "radar", but I haven't talked to them yet. The main thing with them is that they do everything, not just ADR's and they are quite close to us. Not sure about cost, but if your self pay I think there rates are competitive to the Europeans. Just my $0.02! Hang in there hope some of my rambling helps.

John

texas back
 

i am getting a L3 L4 alif fusion from TBI any day , they told me tthe new m6 disc is 21.000 just for the disc

Hi John,

The tax thing is great to know... if I ever elect to get something done out of the country. It's working up to getting something done that is the tough part, eh? I just read some of Harrison's info on biofilms - now I'm even more iffy about getting something like an ADR done. LOL I knew infections were a risk, but those biofilms sound horrible!

As for pain, I don't know that mine is even a 1/4 compared to what most of the people on here are going through. I'm ok off pain killers as long as I don't bend and twist too much and take breaks every hour or so from sitting. It's just the tingles and numbness that are scaring me. Quite honestly, I feel selfish for even looking into ADR when I read about some of the problems some other unfortunate people are going through on these boards. I'm just trying to play with my kid(s) and do some sports again and I'm not entirely sure ADR will even do the trick for that. OR if the benefits outweigh the risks.

I pinged TBI to get an opinion as per your recco and JSS'. Like Jstuckey, I'm pretty set on Mr. Boeree if I go for surgery. Clavel was awesome too, but Boeree was a little cheaper and exceptionally responsive/compassionate. They are both eminently qualified as far as I'm concerned. I also love going to London! Can't beat the local brews. :beer:

As a side note, I requested a copy of my last bone scan, because I assume they show densities... am I correct? I want to make absolutely sure my bones are up to the task should I choose to ADR it up. For any of you on the other side, did you bother going through metal allergy tests beforehand? I'd like to have all my ducks in a row if I'm going to make a move.

Thanks again for all the insight, guys.

Tx back and Mr Boerre
 

I still need to post my experience with surgery and recovery. Doing pretty well so far after a week out. I am probably doing a little more than I should, but feeling pretty good overall. Just some muscle pain between my shoulder blades and in my shoulders, which is normal and should go away with time, and it is already getting better.

I had a hybrid fusion/ADR at c6/7 c5/6 performed by Dr Blumenthal at tx back.I am quite happy with my choice of surgeon, and the hospital staff was wonderful.

Also, I wanted to chime in that I spoke with Mr Boeree and he was very helpful (the only other opinion that confirmed my Dr.s opinion, so he really helped put my mind at ease).

He is a delightful person, and I am sure he is a wonderful surgeon. The factors that Led me to decide to go with tx back were the skill of my surgeon, that i would likely end up with a hybrid in England as well, and the issue of follow up care (and the fact that insurance would cover my tx procedure and timing was an issue as my quality of life was becoming quite low).

You should be in good hands if you decide to go the Boeree route though.

DAnn

I've been reading more about the severing of the Anterior Ligament during ADR. Is this something they attempt to re-attach, or is it severed permanently During the Op? I've read that this can contribute to a lot of spinal instability?

Good question for the surgeon. I'll ask myself. Here's an internet picture of what they are talking about. I'm guessing they don't/can't reattach
http://ts3.mm.bing.net/images/thumbn...y_11_pic01.jpg

No it can't be reattached, it's just one of the downsides of adr and is in all likelihood a contributor to facet problems.

The bottom line is the outcomes from a correctly indicated adr are generally better than a fusion.

I just spoke with Mr. Boeree about the ALL and this is what he said (from memory so I might be a little off):

The ALL is divided to implant the device and no effort is usually made to fix it, because it would just turn into scar tissue with no benefit to the rest of the spine. This was an issue in older generation devices as they were unconstrained, so they had to keep part of the original annulus in place to prevent pop-outs of the prodisc and charite in extreme extension. The artificial annulus of the M6 lessens the importance of the ALL and flexion/extension are not an issue.

My Take: He didn't think it would destabilize the spine at ALL (bad pun), though he did offer to stitch it up for me if I would prefer! Again, it just becomes a bunch of scar tissue with no elasticity.

Thanks for sharing! Makes much sense!

Banhorn, I really don't know what to make of your comment about the surgeon's politeness:

"...though he did offer to stitch it up for me if I would prefer!.."

It's interesting, perhaps odd, that we patients are literally getting into the bowels of surgical details with doctors.

I have noticed through the years and various conversations with patients and doctors that there are myriad differences in surgical techniques; some of these matter greatly in terms of mfr.s' compliance to "proper" implantation of devices. Other techniques may not be taught in school, or in product training, but surgeons develop many refinements over the years. We hear bits and pieces of these refinements here, from doctors, from sales reps or spine brokers.

Ultimately, we have to like and trust the doctor who will perform a very invasive procedure on our bodies. It helps if we also "believe' that the device is the best in terms of design and ease of implantation. I still don't like keeled designs, but it doesn't matter what I think...

What's the latest results on your DEXA scan T scores Banhorn? If your T scores are not optimal, it may be wise to steer away from a keeled design -- or even cleated.

Do tell!

That's very funny, I'm sure he was having a bit of a lend.

Yeah Hooch, he might have been taking the piss a little. ;)

Harrison, I'm not sure how my DEXA scores turned out... I got the "bone scan" back and have the CD sitting on my desk, but I can't make heads or tails of anything on the disc. It really just looks like a bunch of blurry low-res xray shots. They refused to give me the report and would only give me the originals. Silly Canada. I'm not even sure this was the right scan for densities.

As for keels, cleats, clamps or duct tape, we value everything we hear back on these boards... :) We are rookies looking to you vets for your experience! Does the freedom disc have "cleats"?

One more interesting thing I heard (2nd hand mind you) - One of the ADR surgeons in Calgary didn't want to see me because I have developmentally short pedicles. He indicated that patients with shorter pedicles in the lumbar area generally have a lower success rate with ADR. Has anyone heard of this before?

I did some more digging around but can't find much on this - can any of you experts chime in?

I've got short pedicles and a narrow-er than normal spinal canal. My disc degeneration is therefore putting more pressure than it normally would on a person's spinal canal/foramen. All of my local docs are telling me to stay away from surgery and all of the ADR surgeons aren't concerned about it. Should I be?

This is all speculation but it would seem like surgeries that restore initial disk height should be less of a problem for decreased pedicle size. That's not just ADR but fusion with cages or anything like that. Surgery that doesn't give you the most possible canal area after your surgery would be a pretty bad idea.

Big thing here is to be very careful to understand scarring as well as the ADR or cage being used. Scar the area and you'll lose the room you need.

All this may be moot if your DEXA scores are abnormal or contra-indicating surgeries like disc replacement...

:look:

Harrison:
I've scheduled the DEXA scan and am waiting patiently. I had a nuclear bone scan originally, which was used to rule out discitis while I waited for an MRI. No densities measured. :uhoh:

However, as a 33 year-old, otherwise healthy and active male, are my chances of having an abnormal bone density lower?

What happens if you receive and ADR and begin to lose density as you age? Do the risks of subsidence or dislodgement increase?

Annpurna:
Thanks for the info. My local docs must be referring to scarring. Other than that, I don't know why an ADR would affect canal space.

Bone density scans are smack dab in the middle of the road for a 33 year old male. I'm in the middle of the curve and have no issues according to my doc. They told me to keep taking vitmain d and calcium. I'm guessing this is ok for an ADR?

I've been doing more research on shorter pedicles and speak with my local ortho on thursday. There is a chance shorter pedicles put higher stresses on discs than normal ones. I'll let you guys know what I find out, but it could just be simple physics.

Some past topics worth reading
 

B, Here some past topics on this issue of osteoporosis, the first one is the most helpful and relevant to these last posts:

http://www.adrsupport.org/forums/f51...porosis-10179/

http://www.adrsupport.org/forums/f49...e-issues-5333/

http://www.adrsupport.org/forums/f45...d-topic-10200/

http://www.adrsupport.org/forums/f60...ter-life-9153/

In particular, see my 2010 posts from March -- tons-o-info on the topic of supplements and DEXA scan results.

I finally got my hands on the report and my t scores are:

1.6 - Left Femur
1.5 - L1-L4

T-Score Category: Normal

Well, I've decided to bite the bullet. My local doc finally referred me to our ADR surgeon, but it's a 2+ year wait in Calgary. :(

He said he'd be going to Europe if he were in my boat and I will not see any improvement at this point. He also indicated that they've got my back for follow-up care.

So, I've booked July 13th with Mr. Boeree. I inquired at TBI as well, but they were $15k more and I'm paying out of pocket. :(

LA Spine is still accepting patients for the Axiomed Freedom Disc trial, if anyone is interested. (I opted out of this one due to the travel back and forth to LA)

Good luck to the rest of you and I'll be posting again soon post-op.

Cheers,

-Brett

Thx for the update Brett. Hey, did you ask if your travel to LA would be paid for? Just curious...some times the trials will allow for that...but not usually.

No worries, Harrison.

For an insurance-less guy like me, the freedom disc trial was ~$10k out of pocket without complications or unscheduled followups. I was responsible for all travel and accommodation too. The price would sky rocket if anything went wrong and the scheduled trips to LA last for quite some time. I'd probably be close to or over the European surgery cost by the end of the trial.

I'm sure it would be far cheaper for someone in the US with insurance. It's definitely worth looking into... they are looking for more enrollment.

-Brett