Cervical fusion revised to ADR - 10 month update

[mmglobal]

Originally Posted by mmglobal

Originally posted on adr support forum 10-February 2006:

On my last trip to Germany, I met an American man who was in Bogen to have a cervical fusion revised to ADR. He had and ACDF performed w/anterior plate at C5-6. (I don't know how long ago the fusion was.) The segment was immobilized by the plate, but the anterior column had not fused. He also had adjacent level degeneration at C4-5. The surgical plan was to remove the plate. If the segment could be remobilized and the endplates were in good enough shape, that level would to be revised to ProDisc-C.... otherwise it would be re-fused. ProDisc-C was planned at C4-5.

I just got off the phone with the patient. I could tell by his "hello" that things were going well. He's just over a week post-op and already feels better than before the surgery. He has some expected post-op symptoms but those are at levels that make him hopeful that he'll have a better than expected recovery. Amazingly enough, he flew back to the states just a few days after the surgery (...not recommended, but he seemed to tolerate the trip well.)

I've discussed the possibility of revising fusion to ADR with the surgeons for years... theoretically possible, but only in rare cases. What makes it possible in this case is the total non-union type of failure and the relatively good facets that allow the doctors to believe that the segment can be remobilized and function well with an ADR. Bertagnoli has done this in a lumbar case before, but this was his first cervical case. I've also heard of an Aussie doc who's revised failed fusion to ADR.

I'm inviting this patient to come and share more of his story here. Hopefully, he'll have more details for us. I just wanted everyone to know that we are out of the 'theoretically possible' stage.

I do not want to give those with failed fusions false hope of revising to ADR... the conditions in which it will be possible are pretty rare. Also, this patient isn't even 2 weeks out yet. I hope that he'll stay down long enough to let everything heal and the new plates integrate into the bone at the revision site. I assume that because of the compromised endplates, he is at higher risk for complications and he needs to be very smart about his recovery. No peak loading... no testing limits of range of motion.

A very interesting case!

Mark

I just got off the phone with Mike. He's 10 months post-op and his life sucks. He's been in bed with the flu for a couple of days and had to delay his trip out to California. Actually, it's just the last couple of days that sucks... life is pretty good since his revision surgery in Bogen last January.

"I'm doing awesome... going to the gym 3-4 days a week, riding my bike. No regrets at all! I still have some minor pain, but after my surgeries and years of much worse pain this is nothing. I'm doing great!"

I was fortunate enough to be able to observe his surgery. It was truly amazing.

Hopefully, he'll be along soon to write his own update!

Mark

[specmike]

Mark, thanks for the welcome and congrats on getting this new community started. People in our situations need all the help they can get.

I'll post a good synopsis of my case later. I'm flying out of state for business tomorrow.