New here, looking for fusion sucess rates

yvette · #1 (**permalink**) 12-16-2006, 03:58 PM

I want to first say I am glad to find this site. I am trying to find fusion sucess rates at L5-S1 as I have heard so many negative storys. I have been told by two surgeons that I need the ADR, so I have it in my mind that, that's what I need and want.

I have DDD at this level, and bulge, bonespurs and narrowing foramen. Probably other stuff forgetting to mention.

I have tried epidurals, physical therapy etc been off work for almost a year. Living on pain pills.

Finally got approved for state medicaid (missouri) finally got into see another neurosurgeon, now that I have mediciad can't find anyone to take it. Now being seen at the teaching hospital in Kansas City. The surgeon had me go take flexion/extension xrays and a catscan. Although I already had MRI's he said he's checking for instability. Now I have to wait some more to see him.

When I look at my xray (I can only understand side one) the vertebrae has moved but not alot. I have called around everywhere trying to find a surgeon who will accept medicaid, that knows how to do the ADR. Found out yesterday that medicaid will not pay for ADR.

So i feel like once again they are gonna try to push me into fusion. I need to be able to work again. If I try to work even pt, I will loose medicaid. My family is going into financial ruins, I have got to do something to be able to work again.

All these years I have been told, never to do the fusion, as it causes other disc's to herniate.

Any suggestions, I am running out of hope hear, endlessly searching the internet for some sort of miracle cure. I don't have 50,000 grand to fly to germany, but wish I did.

Help.

mmglobal · #2 (**permalink**) 12-16-2006, 04:47 PM

Yvette,

Welcome, I'm glad you found us. You are living the problems that so many spine patients have suffered through over the last few years. Insurance companies are still dragging their feet and denying access to FDA approved technologies, saying that they are still too new.

I know many successful fusion patients and of all fusions, I would fear L5-S1 the least. Some people are not good candidates for ADR and must accept fusion as their best option. Also, there are many new fusion techniques that should increase the odds and reduce the invasiveness of the surgery, but sometimes it's difficult to gain access to them because of the relative costs and insurance issues similar to ADR issues.

Take your time... learn about your options. Make informed decisions. Good luck... please keep us posted.

Mark

PS... single level ADR can be done for about 25k

yvette · #3 (**permalink**) 12-18-2006, 03:32 PM

Thanks for replying. It is very frustrating. Some say L5-S1 is worst outcome in fusion, others say best outcome. Why such different information? I am waiting to see what the results of my tests for instability show to see if I am even able to get adr if I can find a way. I have tried to find places on internet to see what the xrays should look like, as I sit here and research and try to find solutions myself.

Very frustrating. And like you said might not have an option. Just ready to move forward. Idle time, sitting and waiting is driving me crazy. Being isolated is driving me crazy, maybe even more than the pain. Rambling here. Sorry and Thanks

djscal · #4 (**permalink**) 12-19-2006, 07:50 AM

Hi Yvette,

I had a single level Charite at L5-S1 that I'm considering converting to a fusion. My facet joints were painful before the disc replacement and have gotten much worse after disc replacement. I should never have been considered as a candidate for disc replacement as a cyst was on one of my facet joints BEFORE the disc replacement. It was unfortunately missed by the doctors I saw. Those of us with painful facet joints or other contraindications to disc replacement don't have much of a choice other than fusion. I feel that one should never go ahead with a disc replacement when their are contraindications. Otherwise, you could go through the surgery, the painful recovery and not be any better. (like me)

Dan

yvette · #5 (**permalink**) 12-19-2006, 03:22 PM

How do you know the facets are the problem? My mri says something about arthiritis in those I think, or the word meant arthirits?

I sure want whatever is going to fix the problem and not end up with extras. It sometimes seems like a big guessing game. Isn't it weird, we can send space shuttles up to moon but we can't seem to figure out spine stuff?

Michelle · #6 (**permalink**) 12-19-2006, 04:33 PM

Yvette,
I have facet arthritis as well, and I wanted to say that I wouldn't let that stop you from having an ADR. ProDisc is easier on the facets because the design doesn't allow hyperextension. I am going to have a facet block soon, but despite that residual pain, I am much better than I was. Totally worth it. On the other hand, I've never heard of a fusion patient having facet problems. Problems with surrounding discs, yes, but not facets. Everything in life is a trade-off. But I'm happy with my decision. Hopefully you find the right one for you!

yvette · #7 (**permalink**) 12-20-2006, 02:28 PM

Well I think I maybe shut out of adr as an option now. I believe by looking at my xrays that my vertebrae have moved more than three mm. I am waiting for surgeon to look at my new ct and flex/ext xrays. However its probably moved 20 percent or 1/5 which probably knocks me out of being candidate. Someone called me from Charite yesterday and confirmed that it has to be les than 3 mm. Not the answer I want. I am fighting fusion in my mind here.

I know for along time it was basically that I needed adr chronic back pain. My doctor had told me to try to walk alot, and I did, I was walking miles a day, it didn't help my back pain at all. Now I have nerves impinged and bone spurs etc and my legs and feet kills me more than my back. frustrating. Oh and heres a good one, I was talking to my husband about fusion etc and he told me I should just quit thinking about it all.

Oh yeah a surgery that will affect the rest of my life for the good or the bad and I should just put it out of my mind, while I sit here in pain and can't do anything.

Michelle · #8 (**permalink**) 12-20-2006, 11:54 PM

What a huge decision-affecting your entire life! I know this is all-consuming to you right now-been there!- but all I can say is try to relax. Find out what the surgeons say. And I say surgeonS because I really think you need at least 2 to make an informed decision. You will find a patient who is thrilled with every different type of surgery out there. You will also find those who regret their decision with every breath. All you can do is look at your options, listen to your doctors, and do a lot of research. You're on the right track! Just because ADR worked for me, doesn't mean it's right for everyone. But be open minded, and see what the surgeons say. You may be surprised! Hang in there, and hope you keep coming to the forums!

dshobbies · #9 (**permalink**) 12-21-2006, 12:02 AM

Just one quick word of warning, which you may already know. When choosing any doctor for a second or... opinion, make sure they are well versed and capable of performing all your options. It seems that some doctors who can't or won't do adr's, put them down and claim you are not a good candidate when that may not be necessarily true.

Still, others who are new to adr's my be looking to put another notch in their belt. So forewarned is forearmed.

Happy holidays, Dale

yvette · #10 (**permalink**) 12-21-2006, 02:14 AM

I've actually had the opposite problem in the past, all the doctors kept telling me I am the perfect candidate for the surgery, but they don't do it. And told me not to be the guinea pig either, to wait until they have lots of practice.

Now waiting on neurosurgeons apt and do have another second opinion scheduled in jan. - Trying to relax. Thanks

mmglobal · #11 (**permalink**) 12-22-2006, 04:58 PM

Yvette,

These are tough choices. You might want to get a second opinion from a surgeon with extensive ADR experience, AND experience with marginal cases.

For those with marginal indications, doing ADR surgery with a surgeon without the extensive experience is more risky. They have not discovered the limits yet.

Also, hearing that "you are not a candidate" from a surgeon without this experience is also less valuable than an opinion from the surgeon who's been there... done that. "You are not a candidate" IS NOT THE SAME AS; "you are not a candidate for me at my experience level." I've heard of surgeons who have said this and have sent their patients to more experienced surgeons... but they are the exceptions, not the rule. For the most part, I see either ill-advised surgeries by inexperienced surgeons, or patients sold on fusions while being told things like, "2-level ADR surgeries are not possible."

Do your homework... make informed decisions. Contact me off the forum if you want my help in seeking opinions from the most experienced surgeons in the US or around the world.

Mark

yvette · #12 (**permalink**) 12-23-2006, 06:10 PM

I am first going to wait until friday to see the results of the amount of the vetebrae's movement. And then go from there. I am actually feeling better the last few days...knock on wood...except my feet are still killing me. However I haven't been doing ANYTHING either lol. Thanks for the advise.