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Multiple Disc Replacement and Fusion Reversal

I spent a couple of years trying everything to deal with pain related to three bad discs along with arthritis, bone spurs and stenosis and after trying everything from PT to steroid injections to nerve blocks with no significant relief, it seemed surgery was the only thing left to try. I was told multiple disc replacements are not yet allowed by the FDA so short of seeking treatment abroad, I was left with a fusion as the only option. My surgeon believed I had about a 70% chance of relief and was optimistic because the rest of my spine is healthy.

Unfortunately, after the surgery I had about two months of feeling better and then the pain returned and is actually now worse than before so I have all the limitations of a fused neck plus the pain. I am looking for alternatives and it would seem I need to find a doctor who can reverse the fusion and do a disc replacement instead. I realize that my pain my never go away completely but it's worse now and my ability to exercise and do stretching that would help with the constant muscle spasms is severely limited by the fusion.

At any rate, i'd like to explore my options even if I have to go abroad.

Are there any surgeons who are experts in cervical disc replacement or any other resources anyone can recommend?


  • sandisandi Posts: 6,343
    edited 06/24/2014 - 7:40 AM
    replace the fusion with adr.....that type of procedure just isn't available. How long ago, was your fusion surgery? It does make a difference, because fusion surgery, in the neck or any area of the spine is a long, drawn out recovery process that involves stages of recovery and increased pain for some time.
    Having previous surgery is a big no no for adr, as well as any deterioration or degeneration of the facets or other structures in the spine, and multiple levels are also manufacturer's contraindications for placement.
    If you are under two years post op, you may still see improvement in your current symptoms by giving your body more time to see where you actually wind up.
    Have you tried any nerve pain medications, muscle relaxers or other therapies, aside from injections to treat the symptoms you are having?
  • Some reversals are being done, although maybe not the type I have. I am looking beyond the United States.

    My surgery was at the end of November so it's been about 7 months. The rest of my spine is healthy. Multiple levels are not contraindicated as I understand it; they are simply not allowed by the FDA. Multiple levels are done in Europe.

    I take a lot more pain meds than I'm comfortable with. That was the reason for the original surgery.
  • in Europe, but I would be very careful about going that route, since there aren't long term studies on the outcomes of multiple level adr placement, at least that I have found. Most studies are two year or less in results and contain a lot of conflicting information.
    Revision/removal of fusion to adr, is something that I have not heard of......revision of adr TO fusion, has been done due to not being able to remove the keeled devices without damaging the vertebra or major blood vessels, but have not ready anything regarding doing the opposite procedure.
    7 months out is not all that long in the recovery process for fusion surgery. It can take a year or more, before you see improvement and get closer to seeing what you may be left with pain wise and mobility wise.
    I would make sure to do as much research as I could get my hands on , and specifically whether or not this surgeon has done any of these types of surgeries, how many, and want to talk to the actual patients before I would consider it. But that's me.
  • Spine In SecuritySSpine In Security Posts: 35
    edited 07/02/2014 - 5:11 PM
    More than once, I've heard my neurosurgeon tell people "fused is fused" when they ask about if they'll ever be as flexible as they were pre-op.

    The point being that a fusion is permanent, and the prospect of reversing one is frightening. Removing any instrumentation or hardware is risky enough, but then the surgeon would have to saw your spine apart twice. One cut at either boundary of what was the original disk space to make room for the implant. There's a lot of hyper-critical things like the spinal cord itself, nerve roots, plus major blood vessels that won't take kindly to being nicked with a bone saw.

    If the fusion was done last week, there might be a chance, but even that is iffy. The cage used in my lumbar fusion has an internal ratchet that expands and locks the thing in place, so it may not be easy to remove it.

    Similarly, revising or salvaging a failed ADR is no picnic, but is is possible. Fairly often, the implant is left in place, and a "gutter" fusion is done around it as the keeled devices such as Pro Disc are designed for bone to grow into their ends, so attempting to remove one carries a significant risk of splitting the vertebrae.

    Oh, if your fusion was done for pain control, it might have been done for the wrong reason. My neurosurgeon's philosophy is that they're done for functional problems such as loss of sensation or motor control, and pain relief is a secondary consideration. Your surgeon's opinion may be different, but a fusion is an immensely traumatic procedure and isn't a quick fix.
    August 2013 C7-T1 MED
    July 2013 L4-L5-S1 TLIF
    December 2011 C5-C6 ADR
    April 2009 L5-S1 MED
  • I am approved from United Health Care in Iowa I have until Jan 1st and my husbands company goes back to Blue Cross anyway I have a approval from doctor Kenneth Light from San Francisco California you can google his web address http://www.drkennethlight.com/main/ and to the right of the page is a lady who had 4 levels reversed Im not sure what year she did it by my insurance approved me hope to learn more today will have to be before the first of the year.
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