ISpine Newby

[frfletch]

I am an active 67 male living in Whistler BC, with a degenerative spine particularly affecting the lumbar sections. Latest MRI 2014 reveals L1/2 severe los of disc height making contact with L2 nerve root, L2/3 same with thecal sac compressed to 8.5mm and compression of L3 nerve roots, L3/4 moderate loss of disc height with marked right and left facet arthropathy, and stenosis in canal down to 8mm with compression of L4 nerve roots, L4/5 minimal loss of disc height with severe right facet arthropathy and moderate left facet arthropathy, L5/S1 moderte loss of disc height with large diffuse of disc bulge, etc, etc. I was fused from C-3 to C-5 in 2010, so far with decent success in that area.

The lumbar area is causing numbness and tingling in all parts below the waste and my mobility is threatened. Each day my legs become weaker, and frequently I trip or fall owing to one leg or the other just temporarily quitting. Sexual function is compromised.

My local medical system's surgeons don't want to touch the situation for all the usual reasons having to do with the domino effect regarding fusions, and they are loath to recommend ADR. My information has been sent to Bogen from where I have a proposal for multiple ADR from L3 to S1 with an inter operational decision to be made as to whether to use ADR or fusion between L5 and S1.

Like everyone else, I'm at the cross road of decision making. I am very fit and lead a very physically active life. Neurologists suggest I do nothing owing to their observation that my general fitness is so high for my age, however only I can know the accelerated rate of my deterioration and it is the main issue together with the increasing pain.

It seems i have only two options: 1. Allow the general deterioration to continue and perish, or 2. Move toward private surgery. Questions are: What to do and who is the best?

[Maria]

I cannot say who is the best however I can recommend that you contact Mark Mintzer here (mmglobal) and communicate with him as he has worked with many of the top spine surgeons abroad and here in the US and would likely be able to give you the best insight there. You can reach him by clicking on the "Contact Us" far right underneath the Ispine last hardware type photo.

I too would be concerned if I was experiencing progressive weakness and a decline in function so I hope you will communicate with Mark soon and see what insight he can provide you. The other thing you might want to do is a search on the surgical outcomes part of the forum here to read about other people's surgeries (in case you don't get any rapid replies re your questions). Back when I was considering ADR and/or ADR and fusion I would have liked to been able to go to Dr.Zeegers or Dr.Bertagnoli in Germany though there are a number of other spine surgeons you may want to consider. This is where I think Mark can be of great assistance to you.

Good luck and keep us posted!
Maria

[AncaMaria]

Clinical Trials Underway for New Treatment for Lumbar Spinal Stenosis Patients

Surgical options depend on the severity of the spinal stenosis in the lumbar region. A spinal decompression or lumbar laminectomy procedure removes a small portion of the lamina, a section of the vertebral arch, and trims facet joints to give more room to compressed or squeezed spinal nerve roots.

Spinal fusion surgery uses small pieces of bone fragment that are fused along the narrowed portions of the lumbar spinal column. These bone fragments, when fused to existing bone structures in the spinal column, increased stability. However, this technique often reduces range of motion and mobility for the patient.
The newest technology in the treatment of lumbar spinal stenosis is the facet replacement implant system, designed to allow anatomically correct reconstruction of facet joints after decompression procedures or removal of damaged or destroyed facet joints. The replacement implant has been designed to substitute the original facet joint, enabling "normal" facet joint motion and mobility while at the same time promoting optimal stability.

Clinical trials are underway in the study of the ACADIA™ Facet Replacement System to determine the efficacy of this method, sponsored by Globalist Medical. The primary objective of the study is to compare, evaluate and assess success rate of the anatomic facet replaces system compared to posterior spinal fusion control procedures in patients diagnosed with lumbar spinal stenosis. The clinical trials are currently in Phase 3, gathering information regarding effectiveness and safety of the procedure. The study, which began in October 2006, is estimated to conclude in October 2013

Is fusing components of the lumber spine more effective in treating lumbar spinal stenosis than the new facet replacement system? Results of the study will be announced upon its completion. The facet replacement system is designed to be anatomically available in a reproducible surgical technique that eliminates pain, allowing surgeons to remove sections of damaged bone while still preserving facet joint motion and mobility.

Individuals engaged in the study range in age from 21 to 85 years old.

Candidates for the facet replacement system are those who have been diagnosed with lateral recess, lateral, or central canal stenosis in the lumber or lower spine, and have undergone a minimum of six months of non-surgical treatment.
Spinal pain and weakness severely limits mobility, range of motion, and for some, quality of life. The natural aging process may affect the structure and support in the lumber spine. Lumber spinal stenosis treatments or surgical procedures reduce pain, increase mobility and range of motion, and optimally, strengthen the support structures in the lower spinal column. The facet joint replacement system is designed to do just that, especially beneficial to those in their 50s or 60s or to younger individuals who have experienced spinal damage due to trauma, extreme sports, or falls.

The newest technology incorporating the ACADIA™ Facet Replacement System is not yet offered as a proven lumbar surgery option. Determinations will be made following the conclusion of the clinical trials in October 2013, but results to date have shown increased efficacy and success.

PlacidWay, an international medical resource and provider based in Denver, Colorado, focuses on providing patients, regardless of origin, accessibility to affordable spine care technologies, treatments, procedures and surgeries. Staying abreast of new technologies and options in spine surgery enables them to pass this knowledge and resources for affordable medical care to consumers.