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Thread: Alternative to sacrum fusion/artificial disc replacement

  1. #1
    Join Date
    Aug 2012
    Location
    San Francicsco Bay Area
    Posts
    127

    Artificial disc replacement below long scoliosis fusion

    Hi Everyone:

    This posting is for everyone who has had Scoliosis surgery and now has lumbar degeneration below their fusion as the result of the long fusion.

    I have spent the past year researching and talking to surgeons all over the world about ARTIFICIAL DISC REPLACEMENT BELOW LONG SCOLIOSIS FUSIONS. Sadly for me, and it is a very great disappointment to me, I have now found out that I am not a candidate for this surgery due to the fact that I have a high level of facet disease. The surgery could be done on me, but it would not help my pain. (There is new facet technology which might help me which I will post in another thread about) However, I thought it was important that I share everything I have found out about this surgery in case it might help others.

    As soon as I can figure out how to do it, I will also make a blog or something and post it on the web along with all the many details.

    Briefly: There is a surgical alternative to fusion to the sacrum below Scoliosis fusions and it is called Lumbar Artificial Disc Replacement. (ADR) It has been around about twenty years. There is a tremendous movement in the spinal community (sadly not most deformity surgeons) to maintain spinal movement instead of just fusing. Some insurances are even now paying for ADR surgery. All the regular literature states that any spinal deformity, or fusion surgery adjacent to the area of degeneration or collapsed discs, rules out the possibility of this surgery. This is simply not true. Three of the best known Scoliosis surgeons in the USA have done this surgery on patients who have had Scoliosis surgery. Other deformity surgeons in Europe have also done it. I myself am in email touch with someone who has it below her Scoliosis fusion.

    In regular patients who have not had Scoliosis surgery artificial discs last for many years with the studies still out as to exactly how long they last. When artificial discs are placed BELOW a long Scoliosis fusion, more stress is placed on the Artificial Discs and this is why many Scoliosis surgeons say that it can't be done, or isn't done. But in Europe it has been done many times, and as I said, done here as well. One Scoliosis surgeon here in the US has a patient who he placed an ADR at the L5-S1 level and it has lasted seventeen years. When the artificial discs finally wear out, the area does have to be fused.

    ADR can be used in someone who has a balanced lumbar area below their Scoliosis fusion and does not have a high level of facet disease and who does not have a propensity for osteoporosis. The ADR actually give increased motion to the replaced joints and I'm sorry I never got to experience this.

    This surgery is not a choice that everyone would make as it might not be a permanent solution, but it is one that I very much would have made. To be pain-free in my lumbar while still remaining flexible, indeed more flexible than I was before down there, is something I would have elected to have, even if it meant getting fused to the sacrum twenty years from now. I would have done whatever I needed to do it - gone into credit card debt, borrowed money, whatever I had to do to get out of pain without being fused. We all feel differently about our bodies and flexibility, and I just don't like being fused. I never have, and it has never felt comfortable for me.

    This surgery is an anterior-only approach surgery. The cost is about 70,000 US dollars for a two level ADR and $35,000 US dollars in Europe. One level would be cheaper.

    I am enclosing the only two articles on the web about this although the most experienced Scoliosis surgeon who also does ADR has actually not written about it. If anyone is SERIOUSLY interested in this surgery, please email me and I will give you further info as to which surgeon to contact, both in the US and Europe, and how to contact them.

    Best wishes to everyone. I hope this information helps someone.

    http://www.ncbi.nlm.nih.gov/pubmed/20803157

    http:www.ncbi.nlm.nih.gov/pubmed/17414900
    Last edited by Tableone; 03-26-2015 at 01:37 PM.

  2. #2
    Join Date
    Mar 2010
    Posts
    2,755
    My hospital does them. I'm not sure if they do them for fused patients or not, but it was offered to me at one point. I didn't think I wanted to even see the surgeon about it because I only had a bulging disc at the time. Now the disc is ruptured with the disc matrix spilled into the spinal canal. I also have spina bifida occulta at L5 and it's my L5/S1 disc that's ruptured so I don't really know if I would be a candidate now. I see a neurosurgeon in may. Maybe he'll say something.

    I'm really sorry that you missed out on your opportunity. :-(

    I hope you can find a way to get pain relief. It's hard to function in constant pain.

    Rohrer01
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

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