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Qestion on having fusion or not

jpntd00jjpntd00 Posts: 18
edited 06/11/2012 - 8:32 AM in Back Surgery and Neck Surgery
Hello all. I have not been on here much since my MD on the L5-S1 back in Aug 08. I recovered pretty well and was feeling great. That is until Dec 08, it went out on me again, went to the ER, useless, then to see my surgeon. Well by the time I saw him I was feeling better and he said to take it easy, no MRI or anything to see what happened.

Well got better and went on with life. Well last weekend the back was getting stiff, but I spent the whole weekend in a car traveling and that did not do it justice. But Sunday after returning, it was actually feeling pretty good, till I got home. Then standing in the kitchen, out of nowhere, it poped, you all know that feeling. Well ended up in the ER, couldn't walk, got three shots, did not help a bit. To my Primary doc the next day, another shot, nothing. then to my Surgeon on Tues, got MRI, L5-S1 blew again as well as L4-L5, yeah fun.

Okay sorry so long, here is my delima. should I push a fusion or just keep getting MD's on the disks. I would rather not keep having MD's every year for a couple of years only to be fused anyway. Just looking to see if anyone has a similar situation.
Jason
microdiskectomy in August 2008, L5-S1, Right hemilaminotomy with medial facetectomy and microdikectomy L4-5, June 2009, redo right L4-5 microdiskectomy, September 2010
August 6, 2013 - Three level ADR, L3-S1, Spinal Kinetics M6L done in Germany.
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Comments

  • but I dont think this is something anyone can advise you about. It is something you need to discuss with your Dr and have to decision between you, your Dr and family. Good Luck with whatever you decide to do.
  • jpntd00 said:

    Okay sorry so long, here is my delima. should I push a fusion or just keep getting MD's on the disks. I would rather not keep having MD's every year for a couple of years only to be fused anyway. Just looking to see if anyone has a similar situation.
    Yeah exactly!!! I think many who have had micros, lamis, etc wonder the same thing. I have had 1 micro. Then got in an MVA. Messed up the surgery. Ortho says another micro and possibly lami. Then hope it all heals. Probably will break again later. End up needing a fusion. So why not just skip to fusion.

    Well, here is the logic he gave me. He is not a fan of fusion because it is permanent. He sees ADR as the beginning of promising technology. So if I do another micro. Say it last a couple of years. By that time technology has improved. Something can be done that is better than a micro, but not as permanent as a fusion. I have that option. If I go right to fusion. I give up that option. Fusion can not be undone. You made a life long decision when you agreed to a fusion.

    The flip side is that technology is slow to move and may not help you. You'll get repeated micros until you end up doing fusion anyway.

    Which do you think is the better possibility for you?

    There are more questions and more issues that are between you and your doc. I just thought that was a compelling reason to continue doing minimally invasive procedures. As long as you have insurance that will cover it. For some fusion is simply what the insurance will cover.

    Good luck.

    Graham
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  • And that is the thing. ADR seems the way to go, for two levels, but the insurance will not cover, Anthem BCBS. But how long will the wait to approve, already been doing them overseas for years, but here in the states Med is slow to catch up. Especially when it comes to Insurance. I dont know, been battling the back for a long time now, and every year guaranteed, a disk blows, took me two years to finally find some who would actually help me, just dont want to do MD's for the next couple of years, put my body through that.

    I am only 34 and blessed to be a fast healer now, but i am not getting any younger. I agree that no one here can tell me what to do, not asking for that, just looking for advice. I appreciate it as well. I know my body and I think even if they fused two levels, I would come out okay with minimal loss of range. Besides I am not a pro athlete or anything so a little loss would be okay, take a bit to get used to, but better that having surgery every year.
    Jason
    microdiskectomy in August 2008, L5-S1, Right hemilaminotomy with medial facetectomy and microdikectomy L4-5, June 2009, redo right L4-5 microdiskectomy, September 2010
    August 6, 2013 - Three level ADR, L3-S1, Spinal Kinetics M6L done in Germany.
  • triple disc replacement done here in the states
  • You must have good insurance then, mine says it is "Investigational and not medical needed"

    So my insurance is holding back, but yet they would rather sink more money into a fusion and possible issues with that than replace the disks.

    Hope you are doing well with yours.
    Jason
    microdiskectomy in August 2008, L5-S1, Right hemilaminotomy with medial facetectomy and microdikectomy L4-5, June 2009, redo right L4-5 microdiskectomy, September 2010
    August 6, 2013 - Three level ADR, L3-S1, Spinal Kinetics M6L done in Germany.
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  • adrsupport.org I believe it is. The spineys on there have been battling the insurance co's for a long time and winning. They have evidence you can submit to your ins co that proves a precedent of coverage by many ins co's.

    GL!
  • I will check it out, thank you
    Jason
    microdiskectomy in August 2008, L5-S1, Right hemilaminotomy with medial facetectomy and microdikectomy L4-5, June 2009, redo right L4-5 microdiskectomy, September 2010
    August 6, 2013 - Three level ADR, L3-S1, Spinal Kinetics M6L done in Germany.
  • The insurance companies are weighing the odds. The odds are in their favor that you getting a fusion will cost them less money long term. Not just the cost of the surgery. Fusion is the gold standard with highest success rate. They are playing the numbers. Not what makes your life better. They are a business. They work on profit margins. After about 5-7 years the insurance companies can no longer write it off as "investigational". They'll have to start agreeing to it.

    That said as I understand it ADR can't necessarily be undone either. Maybe not as permanent as fusion. The surgeon can't just go back in there and pull it out and do fusion if it doesn't work. There are issues with it. So do your homework.
  • Sent you a Private message earlier today. Nothing is easy when it comes to treatment decisions on our spines. There is simply no clear cut protocol for anything. 70% of my L5 is herniated and I have a stability issue with a grade II spondylolesthis (L5 is slipping over S1 due to pars fracture). Fusion still remains an elective procedure with no guarantee to reduce back or nerve pain. My doc gives me 50/50 on back pain resolution (that is 50% chance of getting better or even worse) and 75 to 80% on leg/nerve pain improvement and this is with a TLIF procedure (less nerve retraction). I have scheduled this procedure for 3 Aug, but I think I am going to canx as I am managing pain pretty well with just neurontin and the occasionally ulltram, valium and an NSAID - I am a little worried about the numbness and tingling I get in my legs - no weakness - need to ask the surgeon about the chances of permanent nerve damage if I do nothing. I weaned myself off of Mobic over the last month because I hate taking pills. Most folks I read about on this site seem to be in much more pain before turning to surgery. I know there are risks with every surgery, but it sure would be nice to read about more fusion success stories. Good luck with your decision and hope you feel better soon. All the best, Mike
  • I have had two MD and recently had a wallis implant put in. an orthopaedic surgeon wanted to do a double fusion on me, I'm 26! i thought to myself surely there must be a better option, ADR seems to be the way to go for some but i did alot of research on WALLIS IMPLANT and found one of 3 neurosurgeons in Ireland doing it. Its very new to Ireland but its been done in US for 10years with great results.
    So instead of having my disc removed, i had this inserted which is a reversible procedure if it doesnt work so ADR and fusion can still be done down the line if completely necessary. It was performed by a neurosurgeon in April and like you i was worried about insurance but luckily it was covered as it is listed as a partial spinal fusion.
    google it and see what you think, its a disc spacer effectively so if you are worried about the permanent options of ADR and Fusion maybe this is something that could work for you.
    let me no what you think
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