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Fusion vs ADR Report

steve55ssteve55 Posts: 86
edited 06/11/2012 - 7:19 AM in Neck Pain: Cervical
Folks, I have fully studied posts on this forum and at the AdR FORUM and my obviosly clear conclusion is that ADR is far superior to fusion in overall outcome. ALl the ADR reports, of about 15 to 20 people all said they immediately felt better and then continued to heal at a fast rate. These people report excellent success rates even up to 3-4 years out. The Fusion reports I have been reading on these boards seem to have only a very few initial success rates,many seem to still have pain out to a very long time after. A few feel even worse after the surgery. There is plenty of evidence of people reporting they are having more fusions now due to their prior fusions.

I have a co worker whose girlfriend had a L level fusion and she still has pain for many years since. We are not seeing these disturbing results with ADR patients. I only saw 1 case of adr turning out worse pain than what the
patien had before.

I was absolutley flabergsated when i read the ADR website how over and over and over AGAIN, PEOPLE'S OUTCOMES ARE CRSTAL CLEAR SUCCESFUL. And i heard that in Europe, the ongoing phrase over there IS "refuse TO fUSE" .

If anyone here has read the adr FORUM, MY GOD, YOU HAVE 2 AND 3 LEVEL AND EVENY MORE LEVEL FUSIONS HAVING SUPERB SUCCESSFUL OUTCOMES, short term and longer term. Why fuse someone just so they cna constinue to feel pain or have more fusions later on in life.


  • Steve,

    Unfortunately so many cervical pain patients simply don't have the option of having multi-level ADR's because of insurance reasons. It's simply not accepted as a "proven" method yet by most companies. Like me, most of them also can't wait for this to happen. The consequenses of waiting are too great when you have nerve and/ or spinal cord impingement. By the time I had my second surgery I had issues with my legs and bladder- I just couldn't go through a fight for anything but what I got.

    In a perfect world insurance companies would do what the doctors told them was the right thing to do in every case. Obviously, this world we live in is not perfect. I do hope for the day that every cervical patient has that option if it's the better choice for them.

    Keep at it Steve, that's how we make change!

  • Which I'd rather do cause it seems to work better and as I'm not covered by insurance of any kind, but I read they couldn't do multiple levels? The general consensus is that at 31 years old, I need a 3 level ACDF but I would much rather have ADR...Where did you find theses? And I wonder if the hospital that I'm planning on having the surgery at, a learning hospital so the cost is little to none for me, does those types of procedures? That I'll have to check into.
  • I asked about ADR, but my doctor said I was not a candidate for it.

    Like its already been pointed out, most insurance companies will not cover ADR... Again, I am also inclined to think that a lot of the horror stories about ACDF also can be because some people wait just to long before they finally break down and have the surgery, and some are not.

    Permanent nerve damage cannot be undone, you only get so much, from what I am told.

    In these ADR studies, things like the time from onset to surgery need to be factored in, as well as age, and other things such as if the patient smokes, or how many other levels already show or have signs of problems?

    From what I have gathered is most ADR are still part of a clinical trial, or whatever they call them, so are we really getting all the true facts, not that I don't trust their studies, but it has been know that some things have been rushed through.

    I'm three weeks out from c6-c7 ACDF this past Monday, and I am doing great, no pain meds but once over the last five days... I have heard more and more success stories, especially on here. I think a positive attitude is also key, if you think you will only get so much out of ANY surgery, chances are thats all you'll get.

    Trust me, I would rather have had ADR, you can always end up getting fused later if needed, but once fused, that's it, no ADR later.
  • The insurance companies are the key to the future of ADR's in this country. There are people who are not candidates for ADR due to facet joint degeneration, but for those of us who are or will be candidates we need the right ins co. BCBS is notoriously anti-ADR and lots of people have them as their ins co. As word gets out that ADR is cheaper and better perhaps the rest of the insurers will catch on to this. I hope for all of us that that day comes soon.

  • hello everyone...

    sadly my sister is suffering from a severly herniated disc in her c5/6. she has been SUFFERING for almost a year now. She is 26 and has tried everything except for the injection. She is seriously considering ADR but Im very nervous for her to get it. I hear some great things and some horror stories. She is so young and has been experiencing some of the worst kinds of pain. Her symptoms are extreme and fit into surgical catigory. There was a poster by the name of OUUUCH who logged her ADR experience on the boards. where is she now? I need to see how she is doing. her ADR is exactky where my sister will be, and i need to save my sister from this agony. someone help!!!
  • I think new technology is always great. I'm not sure that anyone could make a blanket statement as to one or the other. First far more people are fusion candidates than ADR so the numbers can't even compare. More risky surgeries are under taken through fusion than ADR. Furthermore the testing that approved the ADR in the states has all but been thrown out. You need to look at who did the initial testing and who was making payments to them. Also ADR was only approved in the states as of July 17, 2007. So there is no where near enough data to compel one to believe they are the next best thing since sliced bread. Also there has not been long enough time for failures of the disc and to see what happens with them. The bigger issue is to me if they fail how in the world are they getting them out and can the same surgeon who put it in get the disc out. Fusion is still the gold standard. Your correct when you say so may here still having problems but that does not account for the thousands who have left here and gone on with normal healthy productive lives. Usually once someone feels better go back to normal living.
  • Fancypants, I saw some people post about multi level ADR's in the ADR forum, some had 3 and 4 levels and are doing great. You just need to read ALL of the posts in the section called ADR outcome.

    Like one poster said here, you can always undue a ADR if necessary. I have read that the doctors do not consider it a serious issue unless its in the Lumbar region.

    Maybe there are thousands of succesful fusion surgeries. But what I have clearly noticed is about a 95% success rate in ADR's up to 4-5 years out. But I see way more complaints about fusion surgery complications short term and long term. The ADR has very little recovery time while most fusions seem to have recovery times of up to 6 mo to a year or more. It seems the ADR is far less traumatic on the back than fusion. All my instincts tell me that adr is best. Just my opinion based on all the posts I have read at numerous back forums regarding people's experiences with both surgeries.If you have no choice, then fusion is better than doing nothing for sure. And yes, there are many successful fusions out there. It just seems there are also many not so good outcomes with fusions.

    If my Plasma disc compression doesnt work on 7/14 (a new procedure to deflate bulging discs), then Im heading to Germany for a 2 level ADR at a cost of about $45K. Im having to cashout my 401K and borrow money from my folks.Yes, thank god I am fortunate enough to have my folks backing me up on this.

    I believe that the skill of the surgeon matters alot in any surgical outcomes. It seems that all of the ADR patients who went to this Dr bergetelli in Germany are doing awesome. Some of the most hopeless and complicated cases were healed through ADR surgery with him. Apparently, this guy really has god gifted talent and understands the back.

    There is one guy who posted on this board of getting 2 level ADR approved with United. I may try with them but I wont expect too much. He had to fight tooth and nail and his doctor got involved for him too. Many doctors in the US say that even if the insurer approves the ADR, they are coming back and asking for repayment or cancelling hours before the surgery. So, my doctor wont even allow me to do the ADR with him unless I am paying cash, even if I get insurance approval. Im here in Dallas, so I think Ill try going with the TX back institute as I believe they are willing to do the ADR with insurance approval.

    PS- Everyone, please excuse my all caps and severe mispelling on my original post. I was on Ambien at the time. (LOL)
  • Jersey, make sure you get a 2nd opinon, and be sure the doctors you get opinions from do both ADR and fusion. As far as I know, its only if your facet joints are not very healthy and strong do they say you are not a candidate. Be sure to ask why they feel you are not. Also, many doctors dont do ADR, hence some may be inclined to tell you fusion is best for you. They go with what they do.
  • One guy posted this on this forum elsewhere:

    I have met several nice people who have had back surgeries since I had mine. The folks that had the fusions still have serious pain and little range of motion. The folks that have had disc replacement surgeries reported they were doing well. I hope this helps someone.

  • I had the level C6/C7 done.
    and i need to see the NS on the 08th this tueday as my C3/C4
    is driving me crazy with pain right now, but the level I had done is doing great, no pain there at all...
    Now just to get this NS to admit i need something done at 3-4 will be something, but I am not going to rest until he does something...I am so sick of this pain.
  • ADR is not for everyone. Make sure that you research this alternative prior to jumping on board. I'm a 2 level lumbar fusion patient and have more range of motion than I have had in years. It also should be noted that should you need to have the ADR removed, that surgery is a life threatening procedure. There are also only a handful of Doctors in the world skilled enough to remove an ADR. Ask your Doctor if he can also do the revision surgery should that need arise.

  • I have been following this thread for a few days, and find the concept of the ADR quite interesting. However, it seems that you are "pushing" this, and I'd just like to add a word of caution to anyone reading this to please do your own research and make sure to weigh all of your options.

    I have to wonder why the insurance companies won't authorize an ADR, especially if it is true that it is cheaper than the traditional ACDF. I have to wonder why most of the top surgeons in the country don't encourage having an ADR. I have to wonder why you say you will go to Germany to have this done, yet you also stated that you are going to the TX back institute to have this done.

    I don't mean to be confrontational, but it seems like you are pushing this product, and I'm just trying to understand why.

    Would you mind sharing some information on the what-if questions raised by tamtam and Dave. If one has an ADR and then later needs it removed, how difficult is this? Is it truly life threatening as it is rumored to be? I just went through a revision to my first ACDF, and believe me it hasn't been fun. I wouldn't want to take a chance on having an ADR and then needing it removed if the removal would risk my life.

    Please share what you have learned about the risks of this procedure, so that we can accurately make a comparison of fusion versus artificial disc replacement.

    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • It is true that ADR removal in the lumbar spine can be life threatening. in the cervical spine this is not the case. in the lumbar spine apparently the device sometimes adheres to a major vein and when that happens the removal is very difficult. There is no major vein in the cervical spine for this to adhere to so the removal is way more simple. I will probably need one of these things one day and am hoping that the kinks get worked out. Asking about removal in case of device failure is good patient advocacy.

  • ADs for cervical spine, though "approved" by the FDA were conditional approvals, for instance the most recent ProDisc approval came with a provision for a 7-year continued study prior to final approval. Also, you can only do a single level ADR. So if you have problems with, say, C4/5 and C5/6, where it's necessary to remove both discs, ADR is not an option. Patients are also not considered "candidates" for cervical ADR (not even single level) when their diagnosis includes spinal stability problems. ADR may be preferred when it is deemed a viable alternative for Lumbar spine issues since each level of fusion there reduces ROM far more than in the Cervical spine and keeping as much ROM as possible is more crucial. I am not as familiar with ADR in the lumbar spine to comment on types and approvals or longevity, but lumbar ADRs have been around longer so more post-op data is available for study.
  • Cindy, Im glad you asked. Yes, Im guilty as charged regarding pushing ADR, though I also understand that not everyone is a candidate for that and everyone has their own personal decision to make regarding the two options. I also pushed the teeter totter when I first joined this board (big mistake as people thought I was spamming and had something to gain from doing so). Its just that I tend to get real excited about treatments that so many people are having great success with. For example, the teeter totter has about a 80% succes rate with people who use it, though now I know its mostly for those with lumbar pain. I ordered one and felt the pressure point relief only occurs in the lower back with this product so I returned it and got a full refund. Now, I have the same excitement about ADR because I have spent hundreds of hours scouring back forums like this to compare outcomes of fusion vs ADR. And my findings are that ADR's have about a 95% success immediate and longterm(well, admitedly, long term is about 4 to 6 years as I havent seen any posts where people got ADR's longer than 6 years ago. )and it has great success at multi levels too. But what disturbs me is that while many people do have success with fusion, its a hard road to full recovery and a very significant number of people are not having much success, and are needing further surgeries 5-10 years later. Most people who have ADR return to work witihn 1-2 weeks, while fusion patients hurt up to a year out abd return to work at average of 2-3 months.The way I see it, if I have issues with ADR down the road, Ill just undo it and fuse. Cervies are easy to do revision surgeries on.

    About what I posted before about trying to go through the texas back institute, yes, I was planning that because my current doctor wont do the multi level even if I get it approved due to the risk of insurance compnies asking for their money back from the doctor. I read that TX back institute will take that chance. Though Im still not sure. However, things have changed since I posted that. I am in so much pain and discomfort now, I dont know if I can wait 2-6 months battling it out with the insurance companies. I may just bite the bullet, sell my 401k and get over to germany. It depends on whether the new meds can help me or not. I am really doubtful though that I can win a multi level approval despite one member here having gotten that successfully approved before.

    About why US insurance co's dont approve ADR's, ...I think its because the US in general is ultra conservative regarding new technolgies. The insurance co's want to see 7-10 years of outcomes first. Ill admit that ADR may prove to have undesired consequences over time. But based on the fact that Europe has been doing it for 15 to 20 years now, and still is, I feel condfident in taking my chances considering that fusion seems to be a risky gamble as far as Im concerned based on all the posts Ive read at many forums. Too many have bad or lackluster outcomes and more fusions later on. Im not interested on those odds. ADR so far has stellar outcomes with very few exceptions. I absolutely refuse to fuse.

    And as far as the top surgeons not recommending ADR, I dont know about that. My surgeon here in dallas is well known and considered among the best in the world . About him "Dr. Peloza is frequently featured in national and international print and broadcast media such as the "Fox News Network," "ABC News," "Good Morning America," "SAT-1 German Television," "Reader's Digest," "The New York Times," "The Wall Street Journal" and more. He has the distinction of being honored as one of the "Best Doctors in Dallas" 2003-2007 as well as "Best Doctors in America" from 2001 to 2008, the gold standard of physician quality. In addition, he has been honored & cited in the Consumers' Research Council of America as a "Top Surgeon in America."

    And I know that the TX back institute has two world renouned surgeons performing this procedure, I forget their names now, one of them is Dr Guyer I believe. So Im not so sure that the top surgeons in america are recommending agianst it. I think the reason why many are shying away from it might be more because they have yet to be trained on it.Im not saying that most would not be honest just because they dont do it, but I believe many just wont reccomend something they dont do. If they did, they might have a significant diminished income as their patients opt for ADR with another doctor. The ADR is so new that most probably just dont perform it yet.

    And as one poster has confirmed, revision sugery from ADR to fusion (should it benecessary) is only dangerous ofr lumbars. Lastly, ADR has a higher success rate with cervicals than lumbars. Though both seem to have success.

    Cindy, go to the ADR forum for more info. Google ADR support to find it, I dont think we are allowed to post internet links here if Im not mistaken. That forum is full of nothing but 95%-98% successful outcomes with ADR with pain free relief with no complications within 2days to 2 weeks not being uncommon. And I really dont like how many people report feeling their hardware in their throats even after the 1 yr recovery, and I aslo dont like how many people report screws coming loose and failed fusions. No thanks!. I want no part of any of that. ADR so far has no reported complications outside of the rare few cases. This is why I am so excited about ADR over fusion. It is so much less traumatic on the body. Like I said, when I choose a procedure, I rely more on people's experiences and doctors opinions who do both procedures than I do anything else like internet articles and publications. ADR is a no brainer for me. Fusion scares me. Of course, everyone has to make their own decisions here.

    I hope I answered all of yor questions. :)
  • Thanks for your explanations. The more information provided, the easier it is to make an accurate comparison.

    I completely understand that fusion scares you. I am one of those statistics that cause people to be scared. If I had been a candidate, I probably would have considered the ADR. Thankfully though it looks like my revision is working, and I pray that I'll never have a surgeon close to my neck again!
    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • Amy

    I'm afraid you've been misinformed on the possibilty of multi level ADR's. With the ProDisc and the Bryant, it is very possible to stack them. The Prestige disc is not always stackable because of the size of the screws. Many people in Europe and here in the US now are receiving multi-level ADR's. Unfortunately, I'll be needing one some day and I hope the ins. kinks are worked out by then.

  • May have missed this in the postings above, but as of 6-15-08, BCBS is now considering Cevical ADR..Prestige..no longer an experimental procedure, and is now approving.
  • Where did you get this info and how can I get my hands on it?

  • I've seen several references to approvals but I can't find anything. I have Anthem Blue Cross of CA. My NS is willing to help me fight as their policy is clear about them considering ADR to be "investigational & not medically necessary." I'm doing some research and in California I've found that once you've gone through the complaint or greivance process for your insurance company you can request an IMR (Independent Medical Review). However if your denied because the treatment is "investigational & not medically necessary you do not have to go through the insurance company's process. It would be great to find someone who has been sucessful with am IMR regarding ADR. I love to research so I'll add more information as I find it. I have looked through the results of IMR's regarding cervical disc replacement and in every case they upheld the insurance companys decision... :(
  • I saw my NS today and he is telling me that ADR is my best option because of what I do and what I want to continue doing. I am a PGA golf professional (not to be mistaken as a professional golfer as seen on tv....well not yet anyway :) ) He told me that with a fusion I would basically destroy the discs above and below the fusion rather quickly. with ADR I would keep some motion in these discs that will alieve alot of the pressure that would otherwise be put on the other discs. According to my NS he has had alot of success dealing with insurance companies. I go in for an EMG (not sure what expect with this) but I am also excited to hear him say that with ADR I could possibly be back at it within 4-6 weeks, with fusion I would be looking at 12-16 weeks.

  • Interesting information! You are smart for looking at all the options and taking steps to insure that you can be active and return to golf! I am not a golfer (but I have golfer in my family), and I have often wondered how the twisting and turning would affect the neck and back. What caused your problems and what are they? I'm not sure how much success folks have had with insurance companies paying for ADR. You may wanna check the insurance section of the forum. Good luck and keep us posted!--Mazy
  • The twisting motion in golf can be extremely hard on the back but usually not to bad on the neck. (however people justing beginning tend to put alot more stress on their neck)

    I originally hurt my neck falling about 20 feet from a cooling tower back in 2005 but I have been able to deal with the pain part, here in late May I went and saw a chiropractor and that was the biggest mistake I have ever made!!!!! Since then my right arm has been tingling and the end of my thumb is now numb. MY problem is C5-6, in the MRI it does show a little bit in C6-7 but my NS says the problem is C5-6. I assume the EMG that I go in for on the 12th (Aug) will tell them for sure.

    According to my NS he does not think there will be any problem with getting my insurance company to approve it. My NS was one of the doctors working with the FDA in LA getting approval (I'm not sure how exactly he was involved)

    I will check out the insurance forum!!Thanks.
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