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After discogram - candidate for fusion, but I want ADR(I need some answers please)

scottymacsscottymac Posts: 6
edited 06/11/2012 - 8:44 AM in Back Surgery and Neck Surgery
I have had 2 different discectomy's on L4/5. First in 1998 and second in dec 08, along with laminectomy. Both on same level. I have been in constant pain every since. Sometimes it has gotten so bad I have collapsed from the nerve pain. I have recently sought help from another neurosurgeon. He has done a nerve block which has helped some. He ordered discogram and it came back positive, and he told me I am a candidate for spinal fusion. However this scares the crap out of me! I am moving to Indianapolis from a small town in Michigan in a week. My fiancee will be teaching high school and I am to stay at home to take care of our 4 month old. I am very interested in ADR compared to fusion. Anyone know of any doctors that do this surgery in Indy? And what insurance companies cover it? As of now we have Humana and they don't cover it. We will be switching insurance companies this fall, and I'm hoping it will cover it. Anyone who has had ADR would you please share your thoughts with me, or anyone who has had the fusion. Any feedback would be appreciated on both, from the research I have found it seems that ADR is much better. I use to be an very physically active(basketball, running, golf) and can now barely walk. I have a mild bulge disc at L5-S1 but he didn't think it was an issue, just the L4/5 level. Thanks everyone!


  • Hi Scotty,

    I cannot comment on the ADR, my surgeon said there was no way to get it covered with my insurance. I have United Healthcare. I went with the L4/5 fusion because my quality of life was poor, to say the least. It has been an tough recovery. I am 6 months post op and still suffering from pain. But I am hoping PT and regular exercise will eventually get me past this bump in the road. Good luck and best wishes with the ADR. I am sure you will get some helpful replies.

  • I have both fusions and 1 Artifical Disc and it was very successful...I was lucky enough to get it just before the Governemnt here in Australia where I live pulled funding for them so if you want one, you have to pay $22,000 for the disc now..If your Insurance will cover it, I personally would take the ADR, but thats just my choice.
  • It's tough b/c in the US, I think only 1 insurance company (I could be wrong but I think it's Aetna) covers it and only 1-level and only if you don't have spine stability issues.

    The other thing is that in the US, it's got limited approval because the "statistics" just aren't there yet. They know it works and works well BUT they are sure of when it fails (meaning, if it fails or if it wears out...it has ~20 year life on it).

    I was told I'm too young right now at 41 years old (love hearing I'm young at 41). But I do know a few folks on here have had them in the US and are younger than me. Their doctors aren't worried because they feel they can fuse around it or something like that.

    The other thing I found out is that they are doing those from the front (but I could be wrong as I only spoke to 1 doctor about it) so the surgery requires not only the Neuro/Ortho but also a vascular surgeon.

    There is a doctor by me in CT that is known for them but that doesn't help you.

    I have to agree that ADR seems "more natural" to me from a body mechanics perspective. I went for a revision Microdiscectomy in hopes to buy time until ADR are approved in the event I find myself in your situation.

    Good luck.
  • HI...

    If you search for the member BACKinshape
    He had ADR and when I spoke to him last at 5-6 months post op, he was pleased and he's younger than me.

    I know he was able to give me some insight on what his plan would be if he outlived the Artificial Disc.
  • I had many years of back pain' finaly discogram showed a tear in my l4l5. I worked construction most of my life and also played golf so when i was told about adr being done instead of fusion here in the chicago area in 2004 as a trial basis, i went for it. In my case it was the bigest mistake of my life. Right after my surgery they sat me up and i felt sharp pain on left of the surgery area.Did not think too much of it for this was my 1st surgery ever. The original back disc pain was gone but had a whole greater other issue to deal with. The nerve pain i was geting is worse then any pain i ever had to deal with before my surgery. Dr's realy never had an answer but found 1 dr that is not a believer of the adr and seen many complication from adr also. As its too dangerous to go back in from the front to remove it after its been put in he fused me leaving the adr in l4l5. Needless to say that also did not help the nerve issue flare ups and he mentioned after my fusion surgery that i have a slight nerve damage. I feel i would have done beter with a simple old fasion fusion from the begining before creating this kind of nerve issue that cant be resolved, even after having every injection, nerve stimulater trials that failed, along with pain pump trial that also failed to control the nerve pain. My hardware was causing more pressure in to both my legs so i had it removed this past dec sense i was having a lami done anyway for last long shot to make things beter after i was already fused anyway and fusion hardware is no longer needed in there anyway. There is no fix for me it seems after i opted for the flexicore adr back in 2004. There are a lot of dr's out there that dont see the benefit in the adr i found out a litle too late. There are some that i have talked to who did ok with the adr but i am not 1 of them so sadly i have nothing good to say about it. I wish you the best of luck and hope you make the best decision that works for you. Keep us posted on what you have decided on and how it comes out. Sincerely Yours; Alexhurting
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • SpineAZSpineAZ WiscPosts: 1,084
    Many insurance companies don't cover ADR. And those that do are often looking for a "clean" spine to have it considered as an option, meaning one that has not had any surgical intervention, has no scar tissue, etc.

    I will tell you that I've had a lot of success with fusions.

    Also, it's not only an insurance company's decision but it is the entity buying the insurance. For example, let's say Aetna does cover it. But Company A does not want to purchase a plan with ADR coverage due to the cost. But Company B does want to allow ADR and it is in the plan.

    Do you know what changes in insurance plans you may have available? Keep in mind that some employers reduce what is available. My employer moved everyone in every office all over the US to one insurance plan under one insurance company. None of us knew this was coming until about 8 weeks before the change.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
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