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Artificial Disk Replacement

Hi All,
I have been following this forum every once in a while since my back started giving me problems 2 years ago. It is slowly getting worse even with conservative treatment and I am starting to convince myself that surgery is in my future. I have been gathering information from all your journeys on this forum and it has been a great help. My question is that not many people seem to be offered or are getting ADR's (artificial disks). I have seen a couple of news stories on them and they seem like the way to go if you have DDD. There have been few people on this forum that have had it done but not many.

Is there a reason for this or do they not work? I would love to get your feedback on this subject.




  • My surgeon said I was a perfect candidate for an ADR for a large herniated disc at c5/6, but my insurance wouldn't cover it, only a fusion. He said that a lot of insurance companies won't cover it just because it's so new in the states and there haven't been that many done. He also said that a lot of surgeons don't even offer it for just that reason. It will be nice when it becomes more common, I think a lot of people would benefit better from that then an ACDF.
  • I asked my pain management doc about it last year before having a microdiscectomy this year. She said that it was generally indicated only for people with problems in a single disc. Since I have issues in two discs, plus facet joints, she didn't think it was a good idea for me. Hope this helps.
    Microdiscectomy L5-S1; Jan. 28, 2013
  • I am from Canada, but believe that in the states, insurance will only cover one level... If at all. It seems to be alot more common, and many travel to England, Spain, and Germany to have it done, but it costs 35,000 and up to have it done.

    I did have adr surgery, but did not have success with it. I think that one of the reasons is that I have moderate facet hypertrophy, and many surgeons will not offer adr surgery if you have any problems with your facets. That is just my experience, many have had success with adr.
    Do you have any issues with your facets?

    Wishing you all the best in your search. Please be sure to get multiple opinions before having surgery if possible. Please let us know how you are doing
    >:D< >:-D< : Karen
    L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
    discectomy/lami July 2011-unsuccessful
    adr L5-S1 Feb 2012
  • I have been to a neurosurgeon and ortho to try to decide what to do about my herniated c6 c7. After researching both. I am fearful of the metals and plastics used. I am a good candidate for a replacement though.

    The positive results in a study against a ACDF were comparable from what I found.

    I am 38 and healthy besides this cervical situation. I have not had children yet and have read the metals used in the device may casue birth defects or one may be allergic to them. I do have sensitivity to metals like nickel and as I have aged I have developed new allergies to foods and additives so I am afraid down the road I may even become allergic to the metals if I were to go that route.

    I am leaning toward the fusion as it is titanium.

    Hope this was of some help,

  • Hi All, thanks for the feedback. I am not that close to surgery but like a good Boy Scout I like to "be prepared". my neurosurgeon just mentioned that he believes that it might be in my future. I read about ADR's and thought they looked fantastic. So when I found this great forum I thought there would be all sorts of people talking about their ADR surgeries. There are very few and none recently (can't remember his name but he had a hybrid). This leads me to believe that maybe ADR's are not the best solution.
    I am from Canada and can't find anyone from our great land that has had this done. With all this great new technology I guess the technology of fusions is also getting better.
    Thanks for all the people who post helping each other out. Great site.
  • From Canada as well. It is not very common to have adr surgery here. There are only a few surgeons in the whole country that perform adr surgery.
    >:D< >:-D< : Karen
    L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
    discectomy/lami July 2011-unsuccessful
    adr L5-S1 Feb 2012
  • I'm sending you a pm with a link to more info. Look for it in your mailbox.
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • Hi, Mark. I'm a fairly healthy 30 year-old woman who had artifical disc replacement surgery in 2008 at the C4/5 level. The disc had been previously herniated from a fender bender years before and I had just completed epidural shot therapy before I had another car accident which caused the disc to further herniate. I actually worked at a hospital doing worker's compensation under an orthopedic surgeon who specialized in spinal issues. He recommended ADR vs. fusion. He said I would have more mobility with an artificial disc vs. fusion, but with the artificial disc and considering my age, there was a greater risk that the discs around the artifical one would weaken, and cause a waterfall effect, where I would with all probability have to have another ADR in the future. I had the surgery, stayed one night in his hospital, and left the next day. I had minimal pain during recovery and regained mobility within a few weeks.

    I managed to be fairly pain-free for a year or two, but it has slowly crept back in. Of course, I've gained 70 pounds over the last two years, so that doesn't help cervical issues. I saw my surgeon last spring and he attempted two MRIs to see why I was in pain. But, apparently the metal in the disc threw the MRI off and he was not able to get a read, so I had to have a myelogram and CT, which was a VERY unpleasant experience. And the CT from that was inconclusive as well.

    I have since decided not to go back to my surgeon. I almost feel like ADR was not the best route for me, but instead he saw an opportunity to do the surgery. Maybe that's paranoid, but people I know who have had fusions do not seem to have nearly half of the pain that I experience on a daily basis. My pain is very localized. It's on the left side of my spine near the C4/5 - C6/7 level. It is a specific spot that feels like it is very deep below my skin and it is a constant dull throbbing ache. Sometimes it's tolerable, sometimes it screams at me, but it's always there. I plan on finding a new surgeon and hoping a new consultation will reveal something (either a new herniated disc or some explanation as to why I'm in so much pain) that can resolve this.

    So, hopefully what you can get from my novel--artifical disc: great mobility, quick recovery time, but can screw up any future MRIs and force you to have myelograms if there are future problems.

    Good luck!
    He felt as though his life was a dream, and he sometimes wondered whose it was and if they were enjoying it.
  • Hi Mark, when I was first trying to determine what surgery was best for me I asked him about ADR. My disc issues are primarily at L5/S1. I ended up doing a single level fusion. When I asked he said that he doesn't do them because of the research saying that they were not effective at that level and that many patients have more problems either directly or indirectly related to the ADR. The specific issues is the way that it is implanted and holds on to the vertabrae especially at my level (due to the amount of weight it has to support). Keep doing your research and maybe if/when you have to have surgery the technology will have improved.

    Single level L5/S1 360 fusion with 6 screws and a rod (10/29/12)
    Diagnosis: Grade 1-2 spondylolithesis, Pars Defect, L5/S1 disc tear anterior and posterior, DDD, spinal stenosis
  • Hi Mark
    I had an artificial disc inserted in June 2011
    I returned to work as a plumber after four months and have resumed playing baseball and swimming
    I have a plastic disc in serted at T6/T7 and fusion
    The problem i still have is numbness in legs hips and feet
    But better than i was

    Good Luck
  • and i have had multiple spinal surgeries the last on was the dreaded ALIF and its failed from a pain relief point of view .i was not a candidate for ADR as was proved with a discographies make sure than any consultant who offers AND has plenty of experience and many have not and make sure a discography is done before you agree to ADRa fusion is the next best {i say with a bitter taste in my mouth } just be careful i had one of the UK'S best spinal consultants and i am now fit for nothing and in severe pain{intractable pain } ALL THE TIME .
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • Had ADR inserted at l4l5 in 2004. Bigest mistake of my life , created a whole set of new pain symptoms nerve pain legs hurt all the time, Was fused leaving in the ADR in as no doctor in the right mind will remove it I was told,
    To date I am worse then I was before my surgery and nothing more they can do for me,
    They sold me on the ADR hook line and sinker, If I knew then what I know now about ADR I would never of taken the risk,
    It can make you or break you !

    I feel I would of done much beter with fusion from the start as it's only 1 level and I know many people who had fusion and are fine, I went in thinking ADR will get me back to work,golf, boating, sports, And ended up puting me on ssdi for life,
    And a he'll of a lot of pain to deal with,

    Always consult with more then 1 doctor,
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • Hi Mark & Everyone,

    This is my first post here, but I too am in the same position where I am unsure if ADR is the correct route for me. I am in Australia and I have DDD at 3 levels; L3/L4, L4/L5 and L5/S1. I am only 21 years old and have already had two operations (micro-discectomy L4/L5 and bilateral laminectomy at L4/L5), both which gave me temporary relief, but now my discs are too far gone.

    I have been very strict with my conservative treatment - i.e. exercise routine, physio, losing weight, pain management doctors, etc, however that is not working any more. I have been seeing a very good neurosurgeon for the past two years and he has recommended ADR or dynamic stabiliser, and I have seen an orthopaedic surgeon who has recommended fusion. I would be operated on at L3/L4 and L4/L5 as these are the worst discs.

    Being so young, I am worried about future complications with both options; however, I am leaning more towards ADR.
    Not many people have had ADR's because it is a relatively new treatment in regards to fusion (which has been around for over 100 years), however, I think with more time it may become a better option.

    I read a really good paper which compared the two options (ADR and ALIF) and it contained a flow chart which recommended if you were under 60 years old, not obese, had no abdmonial scarring , 1-2 level involvement, no stenosis, no listheisis and no significant facet joint osteoarthritis (OA) that ADR was the way to go. However, if you did suffer from listheisis and facet OA that ALIF was the way to go.

    Results from ADR after two years have been said to be comparable, if not better than fusion (Patel, V, 2008), and compared with fusion, ADR may impede the development of adjacent segment disease (Allied Health, Biomedical, USA).

    If you're interested in reading the paper with the flow chart, here's the link - http://www.mdconsult.com/das/article/body/404728469-2/jorg=clinics&source=&sp=23242346&sid=0/N/744356/1.html?issn=0030-5898

    Good luck with your spine, and if anyone has any recommendations of ADR over ALIF or vice versa, please let me know :)

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