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I cancelled my ALIF and I'm looking at Artificial Disc Replacement

kendrakkkendrak Posts: 79
edited 06/11/2012 - 8:38 AM in Back Surgery and Neck Surgery
I cancelled my surgery after talking with my neurosurgeon. He told my husband if I was his daughter, he'd be looking for a way to come up with the money to do the ADR. We are looking at a Dr. in France and the doctors in Germany. Any suggestions out there?


  • I could be incorrect, but I think a member here by the user name striker ( sure hope I got that right ) is also looking into a ADR.

    * If I am wrong, please someone correct this post for me :)

    I do know that the member who is looking into this posted such and the thread he posted had a lot of information and some links to more information posted in it.

    I assume you can find this thread through a search here.

    Sorry I am still pretty new here and don't know my way around the boards really well yet...
    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • I think that is who Humpty was talking about. You can type in ADR in the search box at the top of this page and find lots of info there. Good luck.
  • extensive reading about ADR. The lure of being able to move normally after getting your discs fixed is very enticing, but there have been a few folks on here who went through the expense and agony of an ADR to have it fail and have to revert to a fusion anyway. If they work, I suppose they are grand, but I think I've only seen one person on here who was happy with theirs. Could be the others just don't come by to post any more.

    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • Hi I am 37 yrs old and just had ALIF single level L4.L5. I also had the option of fusion or disc. After alot of research I found out that many surgeons don't trust the polypropelene in the artifiical disc to last intact after several years whereas the fusion is tried and tested. On a personal note I have a colleague who had the artifcial disc and is in constant pain. I am only 7 days out from fusion and my back pain is so much better ! I am troubled by new sciatica though and hope its just post op root irritation.
    Hope my experience helps
    Best of luck
  • I in hopes of having a child in the future wanted to opt and had my hopes for the Disc Replacement. I saw a well known Dr at UCSF in San Francisco and he said he didn't recommend the replacement pretty much because of what Clio said. If something went wrong or didn't work it is not so simple to remove and chances of being paralyzed increase. Now that was my case for a L5-S1 level, he said that my area of the back was too far gone and didn't want to take any chances. The fusion has had so much more experience and long-term data and higher percent of success rate. I was disappointed however I didn't want to take any chances. Good Luck and do whatever you and your doctor see is best based on your individual condition. 8>
  • It's good that you're looking into the ADR - it'll help you make a decision that's right for you.

    A few years ago, I asked my pain specialist about ADR, and he said it could only be done for one level - how correct that is now, I don't know.

    I used to work with a girl who had it done after she'd had an accident, and it didn't work for her.

    Hope you can find a good surgeon in either France or Germany who can help you.


    XLIF L2-4 20.8.15
    ALIF L4/5 2009
    Laminectomy/discectomy L4/5 2008
  • Hi

    3 weeks ago I had ADR and it has worked brilliantly....no more back pain like before! Obviously, I am still recovering and if I do too much in the day, I get dull aching around the whole back area, which is relieved with painkillers. Before, I was in agony, so I know the op has worked.

    Here, in the UK, there are several doctors that specialise in ADR (My doctor is EDITED) and he is absolutely brilliant. You do need to make sure you find someone who has a strong interest in this type of surgery and I know in France and Germany they have been performing this type of operation for about 17 yrs, whereas in the UK, it is only about 8 yrs.

    I chose this surgery as I also have a herniated disc at L3 L4 level (it is causing me no pain though - had a discogram to prove it)and with spinal fusion, this would have put more strain on this area. With ADR, it is the same as having a normal disc, so no pressure on the surround discs.

    I would recommend it to anyone, especially knowing several people who have had fusion and are now limited on movement and feel stiff!

    Good luck in whatever you choose!

    Post Edited by Authority Member haglandc
    Names of medical professionals not listed with Spine Health is not authorized
  • Thanks so much, I've been debating for months and months. I have to go outside of the states and pay cash for the 3 level surgery. At this point I do trust my neurosurgeon. I am selling my car, and our toys to make it happen. I am looking into using the doctor that invented the Pro-Disc, I found him by Facebook. Too funny. Thanks for all of the input.
  • Hi Kendrak

    That's a good positive post from sgm6670 and this will give you confidence to go ahead with the ADR. It'd be great to have no pain and flexibility.


    XLIF L2-4 20.8.15
    ALIF L4/5 2009
    Laminectomy/discectomy L4/5 2008
  • Before you decide, please read also the stories where ADR failed. In principle ADR is great when it work out well, but if it failed (more then 20%) you have a very big problem. The problem is that there very few doctors who are able and are willing to remove the ADR and replace it for a fusion, since it is a dangerous surgery. I had one ADR and had to be removed after one year due to severe pain. Further I know some other people who had the same problem.
    I dont want to scare you, just warn you. Please think twice!!

  • Hi Kendra - I also was highly keen on the ADR - particularly since my surgeon helped develop on of the systems. However - I wasn't a candidate because of the damage on more than one level. It's my understanding that this procedure is only being done where one level is involved. Perhaps this is different in Europe. Goood luck!

  • Hi kendra - have you been able to estimate the costs of the surgery going abroad? I'd be interested in comparing the costs of the 3 level ADR, versus the savings of having the insurnace cover the less attractive fusion here in the states.
  • In parts of Europe the ADR is even not allowed, due to the risks of this treatment.
  • i am looking at ADR too..in fact i have just had an MRI i get the results on the 26 nov then i see the ADR consultant on the 22 dec i can pm you his name but he is in the uk so i don't know if that would be of any use to you.one thing i have been told is ,the ADR operation is the last resort and it is an unknown quantity ..what i mean by this is should it fail there is no back up and it take a surgeon with nerves of steel to go back in and try to sort replacement //replacement disc out,its not an easy task and is deemed a life threatening operation ..i have done my home work and i will only have it done if there is no other option .they say that the replacement should last a life time ..but as an engineer i know that even the best parts wear out ,the disc is a 2 part alloy shell and a Polly insert of some sort {there are various makes but they all do the same thing} and metal against plastic will wear i don't care what the sales people say about there product it will fail.i think if you are in your 60 and fit then i would go for it but as i am only 43 i will need some convincing that its the right thing for me to do .at the moment i am getting b y on large amounts of Oxycontin .its a massive operation and if i WERE YOU I WOULD NOT RUSH INTO IT
  • three level lumbar disc replacement l-3 to s-1 i have never been netter and no problems.
  • As you read previously, my operation went text book perfect. I did masses of research before ungoing this operation and spoke to lots of people here in the UK who had had the operation and they were all pleased with the outcome. With any surgery there are risks involved and this has to be a last resort, but so does any other spinal op.

    ADR has been around in the UK for about 8 yrs with a very good success rate and Europe for about 17 yrs. I chose this surgery because I also have problems at L4 L5 level with a bulging disc and fusion would have put immense pressure on this disc and I would be looking at another operation in the very near future to fix it. With ADR you are having a new disc in, so no pressure on the surrounding discs!

    Good luck in whatever you choose, but ADR was a huge success for me and I am so happy that I am now pain free (4 weeks post op!!!).
  • Wow the prices have gone up substantially in the 2 or 3 years since I have been aware of ADR's! The dollar vs. euro exchange also does not help.

    If the ticking time bombs that are my lumbar discs one day finally give out, I too will be looking to go overseas and just paying cash. I would probably choose one of the famous dr.s you mention as well.

    Kendra, have you seen any of the other message boards that are specific to ADR's?

    What about nucleus material replacement procedures? Are you a candidate for something like that? When I consulted about ADR with Dr. DLM in Santa Monica, CA one of his partners was doing these injectable fillers into the discs.

    In post 7, it is mentioned that an ADR doesn't put pressure on the discs above and below, however that statement should be refined/clarified.

    An ADR is not a shock absorber like our natural discs. It will transmit weight and shock just like a fusion. It is the movement of a natural disc that it mimics.

    Straker, I follow what you're saying about the poly material wearing.
    As an engineer, what is your opinion on the ADR's that are 2 piece metal-to-metal contact? (Maverick)

    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • Paul, After my evaluation my price with Dr. B went up even more to $65,000 for the 3 level ADR.

    I think my Neuro mentioned that some research, which may not be valid, (but it's out there) that the metal on metal may leach small ions of meatal into the blood which could cause birth defects on a fetus. This concerns me as I am only 33 and want more children. I know that Stenum is really into the M6 and Mavericks. My neuro is really into Pro-disc.
  • SpineAZSpineAZ WiscPosts: 1,084
    If you do the ADR be sure you have a doctor here who can intervene if you have problems or need further surgery. My concern is that as the procedure is not yet widely used here , any problems that result from overseas surgery may not be accepted well by surgeons here.

    There have been many articles written lately on medical tourism and there are some insurance companies here in the US that will not cover any treatment for complications of an out-of-country surgery that was done in a non-emergent situation.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • straker said:

    one thing i have been told is ,the ADR operation is the last resort and it is an unknown quantity ..what i mean by this is should it fail there is no back up and it take a surgeon with nerves of steel to go back in and try to sort replacement //replacement disc out,its not an easy task and is deemed a life threatening operation..
    This is the scary part that brings ADR right into your face. Especially people in the US who are taking off to Europe to get an ADR done. What happens if there are complications? You pay another $50K for the surgeon to look at it and try and fix it? Or worse the surgeon won't talk to you and sure as heck won't touch you? I would want some assurance post-surgery as to what they will do to back up their work IF something didn't go right. You are cross-continent now with back issues. most docs here in the US and for sure insurance companies are not going to pay to fix the damage. You went against the rules of insurance companies. They'll write you off and walk away. Then to have that determined that it is life threatening to go back in and try to remove it and do a normal fusion. I think you have one very serious decision in front of you. I don't envy you at all.
    straker said:

    i have done my home work and i will only have it done if there is no other option .they say that the replacement should last a life time ..but as an engineer i know that even the best parts wear out ,the disc is a 2 part alloy shell and a Polly insert of some sort {there are various makes but they all do the same thing} and metal against plastic will wear i don't care what the sales people say about there product it will fail.i think if you are in your 60 and fit then i would go for it but as i am only 43 i will need some convincing that its the right thing for me to do .at the moment i am getting b y on large amounts of Oxycontin .its a massive operation and if i WERE YOU I WOULD NOT RUSH INTO IT
    I agree. I work with suspension for cars that are raced on track. We mix stainless steel, aircraft grade aluminum, titanium, and various poly bushings, and teflon coatings.

    The poly takes quite a beating in the cars. But only for a few years. Now we also delrin in some. This is considered a polymer but with the strength of steel with the equivalent of teflon coating. Delrin is almost indestructible. I'm really surprised this is not used. We also use heim-jointed links. This is metal on metal. You can be assured even when machined as smooth as glass. There is wear and tear. The bearing I am talking about are articulated joints. Similar to knee, hip, elbow type joints. Some similar to spinal discs.

    I agree with Straker. If you were 60 years old. I'd roll the dice and believe it will last. My mom is getting an artificial hip next month. She is 82. It is metal/poly combo. We are betting it will last her lifetime. If I was in my 30s I would be scared to death to believe any of that hardware will last you 50 years or more. I don't but it. The catch really becomes if it wears out. Can you swap it out? Will technology in 10-20 years allow that. You are gambling long term that this is all doable and supportable for the rest of your life.

    Good luck with your decision.

  • Just to tack on one more thought to Z06's comments...almost all the companies that manufacture instruments for spinal surgery, and implants and hardware for surgeries work on a worldwide basis, cooperatively. ADR has been in use longer in Germany and other European countries due to licensing agreements and the vagaries of federal regulations. I'm not sure why the FDA has been much more cautious in approving its use. But it is considered in its "early infancy" and it does not have a long-term track record. Surgeons are afraid that it will not last and there doesn't seem to be a consensus on what one does when it wears out...how do you replace the disc replacement?

    The Germans and other countries in Europe are using the same artificial discs that are used in patients here in the United States. There are only a handful of manufacturers in the world.

    I asked my surgeon, who does research for Medtronics, why the Germans have higher success rates than here in the US. He said it is a matter of statistical data. Bad outcomes and such are not handled in Germany. Patients who have unsuccessful outcomes have to travel to Holland to have the disc removed or the surgery redone.

    Someone may have already told you this in one of the other posts...there are a couple people on the board that went to Germany for the surgery. Have you read through their threads to see what experiences they have had?

    Good luck to you in your research and decision making. I'm glad I don't have that option available to me!

    Take good care --
  • I can't remember the website name now. But if you play with the keywords regarding ADR, Germany, etc... You should find the site. It talks openly about ADR. Specific hospitals and I believe doctors. They are not so rigid on that site like they are here. They also have a section about travel to help you with costs, places for family to stay, etc. That site my be most beneficial to you in planning.

  • my doctor and the last neurosurgeon that i saw last week {i see the uks top ADR surgeon on the 22 dec }the last surgeon told me that ADR is very experimental and we don't do it here {in his hospital} but the other surgeon i saw at the same hospital told ME that they do ADR at the same hospital and that they have had mixed results .i have since learned that this hospital has a terrible reputation for ADR and has killed people whilst doing this operation !!!!panic!!!.i wont be going there for any more surgery ..the new surgeon with the excellent reputation is in a different hospital with a dedicated ADR physio team and good support for the patient .my doctor has told me that he thinks ADR would not help then when i saw him again he said {when i told him i was still in loads of pain} well go for it then !!! ...panic...!! so i will see the new surgeon and see what he has to say .even if i am suitable for ADR would i have it ?????? after 2 failed operations ...Paul you asked about the 2 plate metal ADR i think that the active L and pro disk have the advantage even thou that have the Polly bush .i think that metal against metal will also wear {just look at a car engine if you neglect your oil!!} the spine is a masterpiece of engineering and mankind's efforts and recreating it are very crude .i think that in 10 years the technology will have improved beyond comprehension ..just look at the Sony Walkman v ipod every one wanted a Walkman with a c 90 tape in it with all its hiss remember ? now if your ipod wont hold 5000 mp3s you don't want to know!.its going to be the same with new joint replacement my worry is that unlike a Walkman that you can give away or bin you cant throw away your back ..its a mine field and anyone that has to contemplate this kind of surgery is at the end of the line ..as i have said its a very hard decision to make and you need to trust the surgeon 100% .after the last operation i don't know if i could trust again ?? but we will see
  • Please think long and hard before you do decide that an ADR is right for you. I had a one level ADR at L4 L5 in May of this year and most days my pain levels are worse than they were before surgery. My surgeon thinks that the with the restored disc height and movement provided by the artificial disc, it is aggravating arthritis in my facet joints that was either missed or just not visible prior to surgery. I did ask my surgeon before surgery how we would handle it if the ADR surgery failed or just didn't work out, he said "no problem, we just go in, take it out and fuse". Well now I am looking at a (very serious and potentially life threatening) fusion surgery, my surgeon is saying instead of removing the artificial disc, he will leave it in and put screws and rods in my facet joints and try to pack some bone chips around the artificial disc and see if the can fuse around it. We have exhausted all other treatments and now I believe my choices are either live with it and go on pain management or go ahead with the fusion. I have an appointment with him tomorrow to go over the results of a bone scan that I had done 2 weeks ago just to be sure we "are in the right area". Scary! I also have an appointment with another surgeon next week to get a second opinion, this surgeon has experience with the ADR in the cervical area only but said he can advise me, we will see. I am only 42 years old and am tired of all of this I just want to get some sort of pain relief and try to get back to somewhat of a normal life...whatever that is. I wish I had known then what I know now, I would have insisted that the surgeon just fuse me in the first place, but he said that I was a great candidate for an ADR. Bottom line - please do your homework before you decide that an ADR is for you.
  • I have checked prices.In Germany; Stenum is about $45,000 for 3 level and Dr. B is about $66,500. Dr. M (who invented 5Pro-disc) in France is $111,000. I am leaning towards Dr. B in Straubing. He has done 4,000 ADR's and most of them are multi-level.

    Thanks for all of your responses. It is obviously weighing heavy on my mind.
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