ADR and Fusion combined??

[Pain-In-FL]

I have searched the archived threads for a question I have, but was unable to find it. I am 39 years old. I have 3 cervical herniated discs at the 3-4, 4-5and 5-6 level, and have had this condition for the past 9 years. I had intermittent pain for the first 8 years, but then it turned into constant pain in my neck that radiates to my shoulders and between my shoulder blades. The first Neurosurgeon I saw said there was nothing he could do for me because the pain I was having did not match up to the disc that was the most protruding, and I didn't have any numbness in my limbs so he could only recommend PT and pain meds to help me manage my life with this. I decided to go for a second opinion with an Orthopedic surgeon, he told me what the other Dr said did not make sense to him, but he didn't recommend I have a 3 level fusion because of the chance of messing up the good discs above and below the fused ones, so he sent me to 12 weeks of PT with no success, and then he had me try a Methylprednisolone dospak which I had a few months of relief from, but does not work anymore, he then sent me for facet joint injections, and that didn't work, so now he is saying there is nothing more he can do for me. I am not having the best of luck with Doctors, that's for sure. I am now searching for a new Dr., that can give me some kind of help, or advise.

Has anyone heard of a surgeon doing a cervical artificial disc replacement and then fusing the discs above and below it, so there would not be an issue with the wear on the good discs?

Please help me with your opinions, ideas or suggestions.

Sandy

[jessmith07]

I have heard of ADR and fusions being done in conjunction with each other, but I don't think that fusing on either side of the ADR would help. One of the purposes of doing ADR surgery is to help protect the adjacent levels, and so putting the ADR in the middle of two fusions on either side would defeat this point (IMHO).

Have you considered leaving the country and having all three bad discs replaced with ADR's? In the US, there are only a handful of doctors who will do more than one level, because the FDA has only approved a single level at both the cervical and lumbar areas. However, in Europe, hey have been successfully performing multi-level ADR's for quite some time.

My doctor, Dr. Bertagnoli in Straubing, Germany, did my two-level lumbar ADR three months ago, and I am 99% pain-free and have been since about 5 weeks post-op. I was off all pain meds within 3 weeks of my surgery. When choosing a surgeon, be sure to find out his/her experience level, as I believe that makes all the difference.

If leaving the country is not an option, I'm sure there are many people here that can give you names of US doctors who can perform this surgery for you, however, you may still have to travel, as there are only a few really good ones.

Good luck!
Jess

[dshobbies]

Sandy,

Ditto to Jess. You want the ADR on the ends and fusion in the middle. Mark recently had 4 ADRs over 5 cervical levels. He's doing OK but could possibly be further along if he paid attention to his doctor's instructions.

Many people go to Germany because the cost of ADRs in the US is too expensive and insurance is slow to cover this. Before investing time and money in finding a US doctor, you might want to discover if this is covered by your insurance company first. If yes, then staying here may be an option. If no, the cost in Germany, including airfare and hotel stays is much less. For me, 4 years ago, the cost was half but the dollar was a bit stronger.

I don't think you can do better than Dr. B in Straubing or Bogan and the care you receive is far superior to American hospitals. He insists his staff take English lessons so the only problem is TV. Food also doesn't translate????

You should know that ADRs may or may not prevent further degeneration and/or may or may not be successful. Spine surgeries come with no guarantees. Your best bet is the best surgeon. So find out what your insurance will and won't pay for - then proceed from there.

Good luck to you, Dale

[jessmith07]

...come to think of it, Kathy (iSpine user name search will find her) saw a doctor for her ADR in Miami, Florida. Maybe send her a PM and find out who she used...

[Bill1961]

In my opinion you should really try and pin point the problem. Have you tried nerve root blocks at each level? If a PM Dr. gave you the facet injections, they probably do Nerve Root blocks as well. I would start there.

If you do not have spinal cord compression and it's more of a tight foramin with disc or spurs compressing the nerve I would consider a foraminotmy. This is a very safe outpatient procedure that will leave you with your discs, just more room where the nerves come out. It's a very successful procedure with none of the draw backs of fusion or ADR.

[Pain-In-FL]

I see I was confused about the exact problem that fusion causes, and got it backwards oops (I'm not good at these mechanical type things lol).

I don't have the funds to go overseas for surgery, my husband was laid off from his 27 year job 2 years ago, and I'm not working right now. I do have BCBS insurance, but I understand they do not cover ADR multi levels.

I will check with Kathy about the surgeon here in Florida that she used.

I will also check on what you mentioned Bill1961, no Dr has even mentioned that to me.

I'm so glad I found this website, it's been a blessing to me, and I'm sure to others as well.

Thanks again!

[Bill1961]

If you want to read up about the Foraminotomy procedure you can go to LaserSpineInstitute.com. They have all kinds of info.. on their WEB site. Their right there in Tampa, Florida and do these all day long. Actually I believe you can send them your MRI for a free evaluation.

If that is an option for you most neurosurgeons can do the same procedure. Laser get's you in and out very quick but they typically charge 15K to you, then bill your insurance company for the balance.

I had the procedure done by a neuro., it was a piece of cake. My neighbor went to Laser Spine and his was as easy.