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ADR causes instability and more pain

Renos64RRenos64 Posts: 77
edited 06/11/2012 - 8:30 AM in Back Surgery and Neck Surgery
Does anyboy have experience that an ADR at L4L5 causes total instability of the lumbar spine and causes severe and more pain? It happen to me and the ADR had to be removed and replaced by a cage/fusion. Also this cage has not fused well and I have to have revision surgery.
If I will advice to do ADR or not? Don't do it!! I have heard a lot of terrible stories of people and where the ADR have to be removed by a riskfull revision surgery.

Regards, Renos.

45 years male, married, 3 sons, living in Europe. No work possible since 2005.
Jun.2003, Chronical pain back, botton, leg, foot right side
Nov.2005, ADR L4L5 with no result and extra pain left side
Febr.2006, Posterial fusion L5S1, Right side pain resolved but left pain worse.
Aug.2006, Anterial fusion L4L4S1, no result but worse.
Febr.2007, removal ADR posterial and placement of cage L4L5, no result.



  • Renos- I do believe that ADRs aren't for everyone. And your Dr should determine that with several test. There are great success with both ADR and fusion.
    You posted that your fusion has not fused. Was there any test done for bone density or facet joint strength? The ADR caused total instability. Was it the wrong size? Was it placed wrong? What did your Dr tell you caused the instability?
    I just want to know because I am looking into getting an ADR over fusion due to my age.
  • Hi gla_gua,
    You are right, I to have heard, great stories from patients who got an ADR, but also with fusions. When a fusion go wrong they can do a revision. But when a ADT go wrong, it is almost not possible or very, very, difficult to fix it. I had a revision surgery and it almost cost my life due to raptorted (damaged) vene during the revision. Due to all scartissue in that area. Even now I had the ADR removed and replaced by a big cage and this is still not fused well because of the necessay size. My surgery told me that the ADR caused a great mess.
    My point is a ADR is very good when it went well, but if you have a problem with the ADR you have a very big problem. Believe me, I have been there!! And I am not the only one. Then a lot of problems will occur after 4 to 12 years, with the same risks during revision. It your decision and your body (and not the Dr.'s body), I yust want to warn everbody. A ADR surgeon will never point out exacly all the risks. Especially these risks.
    Take care, Renos
  • Hi Gla_glua,
    You asked me:"You posted that your fusion has not fused. Was there any test done for bone density or facet joint strength?" Bone density was very good and facet joint also.

    "The ADR caused total instability. Was it the wrong size?"
    Size was perfect, there are serveral sizes.
    "Was it placed wrong?" Yes it was placed a little bit out of the center of the spine, but this was not the cause of the problems. The cause was, that the metal plates of the ADR was not grown fixed to the vertebra's. When I had have my revision my surgeon told me that my total spine was instable due to the ADR because all the ligaments are cut away.

    Oke an ADR can also result in an excellent outcome but the placement and reactions are so fragile. But if anything go wrong (which can always the case, everbody is different) you have an very very big problem, which can almost not be resolved without danger. In Holland where I live, this procedure is even not done due to the danger.

    Succes, Renos
  • Before my fusion I did all the research on ADR's and have to admit, if my insurance covered it and my surgeon did it (Both NO's) I would have gotten it done. I would have taken the chance.

    And then I would have read this and S*** myself!

    I hope everything works out for you! Really!
  • Hi NJ Shamrock,
    Thanks. Yes, I did to my research and even read all the FDA trails and they reported even failures, but the did not tell about the danger of a failed ADR. And how the revision has been caried out. I read also failed ADR stories when I had mine ADR and I also scared the S***, but then this thing was already in my body. I am glad to get rid of this device now.
    I don't want to scare everybody but just warn! Be carefull!!

    How is it now after your fusion? When was is done? I hope it went well for you

    Regards, renos.
  • And I feel prety good. A LOT better than expected. I have the normal upper back muscle issues but they are not to bad and go away when I walk. I am actually not taking any meds at this point except for a tylenol when needed (About two or three a day) and plan on keeping this up (I hope).

    If the additional things I am experiencing like the heavyness in the "Other" arm are related to the surgery than I will be thrilled.

    Hope all goes well with you!
  • My ns does not like adr at L4/5 since they don't line up very well. If you look at an xray or mri L5 is on an angle and L4 is more upright. He chooses to fuse mine but will install adr at L3/4.

    Good luck...
  • I am very sorry for the trouble you have experienced. From the research I've done, ADR works quite well in the cervical spine, but not so much in the lumbar. My surgeon wouldn't even consider it for that reason. Although, everyone is different, and heal differently from various procedures, I have seen studies which show lumber ADR isn't indicated. This back stuff sucks.
  • Hi Nancy,
    I am glad that people like you, are critical and do not accept all the positive talks about ADR. Bare in mind, there is no way back or the way is very dangeous. It cost me almost my life!! I just want to point people to think twice.
    I have heard also from my Neurosurgeon that he did already 30 removals of ADR, placed by others, at people who went very good the first years, but after 4 to 12 years wear occur and this causes infections due to the wear particles in the body. Also he say a lot of instability and facet joints problems. All the revisions were very difficult and critical and had to be done with assistance of a vene-surgeon.

    Regards, Renos
  • Hi khumph,
    Why not do fusion as well at L3L4? When fusion is go wrong you can revise it. Please ask your surgeon what to do when it is going not well? Can he do also removal of ADR? And what the costs are then? If he can not do it you have to look for a surgeon who want to do this procedure but they are very hard to find.
    I too had done a lot of research and red also failures with ADR but I thought that it would not will happen to me. Wrong, it happened to me and I wish my greatest enemy with this problem.

    Regards, Renos.

  • i just want to add my personal experience in regards to an ADR. i had three levels replaced in the lumbar, L-3 to S-1. all due to disc herniation and all lower discs having DDD. additionally ide like to say that this is not for everyone, we are all oh so very different, and if the conditions are not met then there is a greater chance for failure. bone density is a concern in addition to age, and prior history. this is all my own experience and shall not be taken as medical advice. i have never been better as a result of ADR, and anyone looking to consider this very viable option, please do your homework and research all the facts and ask lots of questions of your doc. this was done here in the USA by a very well known Orthopedic Surgeon. he has performed many of this type and made me feel great. right from the first time we met. i spent an HOUR in his office talking bout my options. so good luck to all who are seeking options involving ADR. it worked for me.
  • Hi Triple,
    I am glad it worked out for you very well. That's great. I also heard a lot of great stories, bur also terrible disasters.
    Please everybody, do research, read my comments above and decide for yourself.
  • There is risk for any spine surgery and I happen to set up for this hybrid surgery according to both surgeons that will ork on me. The chief is doing clinical trials for a non-FDA approved disc so he has performed a number of adr surgeries. I have confidence that this will be successful and even asked if I could receive adr at both levels but he does not like adr at L4/5. I have also heard from people that have had failed adr and had them removed and fused successfully.

    Thanks for your caution and concern.
  • I can say this was the best for me and my surgeon. He invented the disc and has used it for years. This is my first and hopefully last surgery, I am totally pain free. I even went home the next morning after surgery feeling well but still on pain meds. The type of ADR is ENDOSKELETON and information on it is on this site. I am so happy I finally found the right doctor after seeing and interviewing 3 total doctors. This ADR is a blessing and so is the doctor. He gave me my quality of life back. I am grateful to have had it done by such a professional and caring doctor.
  • Hi Pika,
    Great and good that it worked out for you so positive. I wish that everybody have such a good experience.
    With my posts I only wanted to say "Be carefull with ADR" because when it is going wrong its hardly to revise without great danger. Also at a lot of patients have the ADR to be removed after several years (4 to 12 years) due to wear and coming lose ADR metal plates from the bone. But everybody thinks or want to believe that it only can occur to somebody else. I thought that also. I do not want to scare but do your research.
    At the end it's of course everybody to decide what to do.
  • Thought I was going on a consultation for a discectomy Friday but ended up discussing ADR. The surgeon I met with was the first of 4 consultations I have lined up. He has ordered pelvic & thorasic MRI as well as a repeat discogram. (had discogram to diagnosis tear in L5 and had IDET done in 11/08).
    For indivudaul who have had ADR, what procedures did you have before ADR? was ADR last resort? I need to make sure I travel every avenue before undergoing this major surgery. This is serious stuff.
    Any and all advise will be recieved with open arms. I have been in pain for so long...every dr I see says I'm a mystery-see signature.
  • I saw 3 surgeons before I decided to have my surgery. I had been to other doctors and they treated my pain with meds and injections and also PT. The injections stopped helping and the pain got worse. I was so tired of being drugged up on narcotics I became a different person and I was too young to spend the rest of my life in pain. My quality of life was unacceptable and I was no longer going to live in pain without giving surgery a chance to help and did it ever. I know it is early in my recover and I hope I continue to do well.
    Best Wishes to All
  • Hi Chronic Pain,
    I did a lot of research and diagnosis prior to the decision to do ADR. Before I had ADR, I did painmanagement, PT, Fysio-Fitness, discogram and toke my time. By at last I could not handle the pain and disfuction anymore. Then a rehab Dr. advice me to do ADR instead of fusion. Others Dr.'s told me not to do ADR, due to the dangers of revision surgery if necessary. Before ADR I could walk for 1 hour, bicycle, and work 50%, but this was not enough so I decided to go for it. But after ADR I was total disable, could only lay on bed and on the sofa to handle the pain. After 2 revision surgeries, I still not oke, because the cage which is placed instead of the ADR is still not fused (Pseudo-arthosis; no fusion by not enough bone growth) and I soon will have an other surgery to stabilize it and lay some extra bone tissue to create a solid bone-bridge. I hope that after 3 years ADR this will be the last I hope I can pich up life again.
    So do your research, take your time and judge the advices of Dr's critical (they can go home at the end of the day).

    Succes in your decision.
  • Hi Renos64,

    It seems like your post sugery pain is what I'm going through right now. I can't walk longer than 10 minutes without my cane, I come home from work and go right to bed with pain meds and heating pad. I push myself daily through my full time job because I can not Not work. I've gotten to a point where I have realized that I'v been to compliant with this...I want and need my life back.
    I am researching ADR but never heard of this cage thing you are talking about-what is that?
  • Hi Chronic pain,
    I am sorry to hear your story which is so similar to our all here. Please focus on your recovery, there will be a better time to come.
    Cage thing?: My ADR is removed from between my vertebra's and replaced by a titanium block or called "cage" which is function as spacer instead of the ADR. Together with bone-tissue transplanted from my hip the purpose was that a steady fusion of the two vertebra's could develop. But now the Dr. thinks that a solid fusion is not developed and so I need an additional surgery to test this and lay some extra transplanted bone-tissue there so a solid bone bridge can develop there. Then I have no micro-movements anymore and no irritation of bone and nerves. So after the ADR surgery this will be the 3rd surgery to revise and fix the failed ADR.
    At how many levels do you have problems? and how many ADR's are proposed?
  • THE MYTH: ADR stands for Artificial Disk Replacement, such as the Charite, Prodisk, or Maverick disk replacement, etc. It seems a great many people confuse other fusion techniques with a ADR but there totally different.

    Some folks are getting scared off from a ADR from research that was done years ago when surgeons were using the early Charite ADR versions. These did tend to migrate in about 20% of the cases and placement was riskier due to untrained surgeons testing the newest innovation. It was also dangerous to due a revision due to arterys sticking to the ADR and to scar tissue in the area.

    THE FACT: ADR is still considered newer technology in the USA and is only approved for 1-level lumbar and multi level cervical. The newer Maverick ADR lumbar disk is considered the better one as it rarely migrates out of position and had had virtually no revisions recorder. The ADR originally was pioneered in Germany and had been used there extensively since the 80's.

    I don't need surgery yet, but when I ever need lumbar surgery, I am seriously going to think about travelling to Germany for ADR replacement rather than fusion in the USA. It just seems to make more sense, I'd rather risk having to have the ADR taken out due to some rare issue than to go through the fusion unknowns.
  • Hi Wally2,
    I had also the latest developed Prodisk ADR without migration risks. I did have my surgery in Germany by an ADR specialized Dr. But all this is no garanty on success.
    and before you decide, do also research what the revision surgery means when ADR failes. And what the risks are of a revision surgery? Is your ADR Dr. able to do this or do you have to find an other Dr.?

    I hope for you that you will never need it!! As I see you medication use, it is for now not necessary.

    Regards, Renos.
  • Renos64,

    My husband is scheduled for ADR. He has already had fusion at 3 levels (L-4,L-5,S1) and as predicted the two discs above the fusion are now ruptured. Another fusion would leave him unable to even bend enough to tie his shoes which is already difficult. I am curious:
    Did you follow ALL post-op instructions?
    Do you eat a somewhat healthy diet?

    It sounds like there was a problem with your bone growth rather than the ADR since neither surgery has produced positive bone healing.
  • My husband had an ADR around 5 years ago (I can't remember the level, just that it was lumbar). Before the surgery he had days that he couldn't walk without a crutch, and he couldn't sit at all. He experienced immediate pain relief after the surgery, and his post op period was 4 weeks, after which he went back to a very active job (he maintains factory machinery). So there are plenty of good outcomes, too.

    With any surgery, there are going to be all sorts of outcomes, including fantastic and terrible. With any board such as this, you're more likely to hear the "bad" stories more often than the good, as the folks with good outcomes are out getting on with their lives. The best you can do is find a surgeon you trust, do your research, and do everything you can to facilitate success of your own surgery.
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