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ADR or ACDF

AnonymousUserAAnonymousUser Posts: 49,578
edited 06/11/2012 - 7:24 AM in Neck Pain: Cervical
:??

Hi everyone, I am new to this forum and deciding on a surgery this month. I am a 32 year old female, 2 cervical herniated discs at C5-C6 and C6-C7. I have seen 5 surgeons thus far for opinions on surgery. I am more confused as ever ! Can any of you please please provide me some feedback on either ADR or ACDF ? I was leaning more toward the ADR multilevel surgery, as I have been hearing about complications with fusion. Any help would be great !!

Here forever in pain :S
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Comments

  • Deed10- I have not had any type of surgery as of yet. I have a large bulge at c5-6 and minimal bulges at c6-7 and c7-t1. I have researched the ADRs and fusions.

    Fusions are good to take care of the discs compressing on the nerves but later on down the road the disc above and below the fusion go bad.

    The research I've done on ADRs is that they take care of the problem and act as your natural disc do absorbing shock. No movement losses. The only thing is that the ADRs only last an estimated 20 yrs. The research is still being done. The problem is what happens when they go out. I've read horrible stories where ADRs where placed wrong or moved and most Drs will refuse to take them out. Because of the dangers of making a mistake and paralyzing a the patient.

    Only one level ADRs are being done right now in the US. In Europe and Asia they will do up to three in the cervical region.

    It is a big decision to make and only you can make it. I would research as much as possible and make an educated choice. Me personally being young like you, 29, I am going for the Adr when my time comes for surgery. I feel that in 20 yrs they will have come up with something better on taking them out. I am looking for something that is going to give me the best chance at getting my life back and keeping it for a long time. Not just for a couple of years, more like a couple of decades.

    Read around in the forum. A lot of the people here have had fusions. You can read their outcomes. Some are doing great others not so great.

    I hope you find what you are looking for. Try this web site adrsupport.com Most of these people have had Adrs. Some with good outcomes some with bad.

    In the end you are going to out weigh the pros and cons.
    Clarissa

  • I recently had an ACDF at C5C6. I was given the option of the ADR, but I chose not to be a "guinea pig" at the start end of new technology. Too many questions and not enough long term data for me. I figure if I do have failure of my fusion or problems with the disks above or below in the years to come (which is definitely a con of fusion)they will have more info on the success rate of the artificial disks and I might consider it if I need to.

    The other big concern is cost. Check with your insurance company to see if the ADR is covered. Since it is a new technology, a lot of insurance companies won't pay for it because there's not enough data to show it is any better than a fusion. They aren't willing to fork out 2-3 times as much $$$ for a procedure that has an alternative, cheaper treatment.

    Good luck. BTW, I am two weeks out of my single level ACDF and doing great! Already back to work part-time and feeling much better than before surgery.
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  • I am waiting in hopes I can have 2 level ADR. In Europe they have been doing them since the 1980's for every 1000 Europeans that get ADR only 35 in the US get them. I disagree with the FDA on "We dont know the long term effects" BALONEY!!! They know very well the long term effects in Europe, they also know the long term effects of ACDF resulting in more ACDF later on. My Chiro told me that he reads the medical journals in Europe as well as the US, and says the European journals are more "honest" than the US journals. Not exactly sure what he meant by that but I will take ADR over ACDF any day... As long as this country catches up with Europe and lets me have it! OK just my opinion on what Ive read, and obviously my frustration over all this shows in my post! I guess the best thing to do is research your options, talk to your docs, and choose what is best for you and your situation.
  • I had a Prestige ADR at C5-6 on 10-2-08 and I feel wonderful! I had to fight with my previous insurance and then took a different job (with different insurance) and it was covered. I don't know how the recovery is for ACDF but I know that with the ADR I was in the hospital overnight and then off work for 9 days and went back with no problems. I haven't had any PT. At this point I am not supposed to lift a lot but that is my only restriction. My arm pain comes and goes pretty infrequently and my neck pain is gone. Sometimes I will have some muscle tension. If for some reason you had to go from an ADR to a fusion due to complications with the implant it is less risky in the neck then the back (so I have read). I am only 26 and my MD wouldn't do a fusion on me because as I get older I would need more and more. With the ADR I don't feel any loss of motion, I can't even tell I have anything artificial in, I actually feel like I have better motion because I don't have the pain to restrict me. I used to work for an orthopedic spine surgeon that worked on a study for ADR in the lumbar spine so I was totally on board after seeing results first hand.

    If you need multiple levels you would definitely need to go to Europe because they don't even have any clinical trials for multi-levels in the cervical spine yet. When I was researching for my appeals I got a ton of info, let me know if you want me to email you some links.

    Did any MD recommend doing one level ADR for now and waiting it out until the US can do the other level? That would be the only chance for insurance to cover it. Otherwise it would be out of pocket to go to Europe. One patient a few years ago paid $30,000 for 2 level lumbar ADR (hospital, implant, surgeons fees, anesthesia, everything) plus airfare and any accomodations before/after her hospital stay.

    As far as cost of ADR in the US being billed to insurance, it is cheaper than an ADCF. An ADR is billed as an anterior discectomy with insertion of an implant (not a fusion). Also, it saves them money because you have less hospital time, no rehab, no brace, etc. My surgeons bill was less than $8,000 and the hospital bill was $34,000 and then of course some misc. bills (anesthesia, x-ray, etc.). My portion was my deductible, $250. If your insurance is going to cover it then it is like any other surgery, your deductible and any co-insurance.

    My MD said that the full recovery from ADR is two months because all you are waiting for is the soft tissue to heal. With an ACDF it is 6-12 months because you are waiting for it to fuse. I see increased costs right there.

    Hope that was helpful.
  • Ok heres the deal! I'm a 44 year old male. I am a building contractor that requires great physical demand. For fun I'm an avid snowboarder like you see in the movies and 16 mile day hikes in the summertime in the sierra's above my house is typical. In june of 08 I was told "Your neck is jacked"
    and offered a 3 level fusion by 3 different surgeons. "It is the GOLD STANDARD her in the U.S." Right! Folks it's time to think out of the box We are in a global market now. I did my home work and off to Stenum Germany I whent 08-22-08. I want to tell you "THE GERMANS ARE AMAZING" The hospital was supper clean, new and state of art. The docs are actually very conservitve and honest they won't opperate unless they feel it's absolutely necessary. The staff treats you like family they were very kind. Stenum popped 2 implants in my neck and I was back to work 2 weeks later forgetting I ever had a problem in the first place.
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  • It's been 7 months since my ADR surgery in Germnay it's winter here Reno/Tahoe and i have been hitting the slopes hard. "I'M BACK" droping 25' cliffs on 55deg slopes I had some really good wipeouts at Christmas I did a head plant earning me 7 stitches in my lip. What I realize is that my implants are very durable " They can take a licking" I still feel great I'm ready for more. If I had been fused my head would have broken off. On another note the FDA is clueless they are broken like the rest of our government. I'm presently in the appeals proccess with my insurance to be reimbursed for my out of pocket expence of the surgery.
    I'll keep posting any questions please feel free to contact me.
  • I had my surgery done last Wednesday 2/11/09 Went with the pro disc c...Amazing!!!!!! I stayed the night only because I react to anethesia. The next day no cervical collar when moving slowly around the house or watching tv. I was driving by the following Monday no problems, can turn my head left/right almost fully, back to work Thursday no restrictions..doc told me I can golf this weekend, just don't go playing football...
    I also have issues at c4/5 and 6/7 but he (my doc) believes it wont be long before multi level will be approved..so I shall wait and get 6/7 done later..or maybe not if I stay how I am doing right now...neck paing gone..still a little tingling down my arm but the doc says this is normal as the nerve is settling down

    I hope it all works out for you, and in my humble opinion, I would try adr one level on the worst one and see what kind of results you get who knows it may work out for you as it seems like it will for me :-) Hang in there I know it sucks!!
  • Turbodog- It is great to hear from someone who has personal experience from having a double level adr done. What make are your adrs? How much did you pay if you don't mind me asking? What levels did you have replaced?

    You were offered a 3 level fusion you posted earlier. Why did you just get adrs at two levels? What about the other level that didn't get an adr? How are they doing?

    I hope you continue to have great success with your recovery. Keep us posted.
  • Longswl- You sound great. What kind of work do you do? Just asking to know physical level. When I do become a surgica canidate I am going to get what I can. As you said if one is all I can get I'll go for it.

    I am able to control a lot of my pain through maintenance but you know how that goes.

    Thanks for your experience. I always feel hopefull when I hear about good results.

    Best wishes on a good and speedy recovery,
  • discs. I was very interested in them myself when I was doing research before surgery. I was told that this was not an option for me. Not because of the multi level but because of all the other issues with my spine. I wish it was different but I am very happy to see folks doing so well and having such great results. I worry all the time about damage to adjacent levels to my fusion but I waited as long as I could get away with before having surgery. I lost a lot of range of motion and even after months of PT have very limited up/down motion and my side to side is at 70 to 75% which is about as good as it will get for me.

    Anyway, glad to see good results with the artifical discs. From what I understand there are even more incredible ones coming.

    LJ
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