The moment of truth (Insurance Approval for Two-Level Artificial Disc Replacement and One-Level Fusion)

[pochofeo]

Today the impossible happened. I was approved for three-level adr-fusion-adr hybrid surgery. The fusion element was added to the mixed only very recently. Problem is that after thinking about it I do not want the fusion. I'd rather have 3 discs. Yes I know that sounds terribly spoiled. But is it delusional? Was I approved because of the fusion component? Will I risk it all by asking the surgeon to resubmit the request as an all adr operation? Is it a better strategy to request two-level adr then go back for the third later on?
I actually don't have much time to work it out becasue my insurance runs out in three weeks!!!! I desperately need to consult with someone that can give me some advice. I've been waiting for this for two years and I don't want to screw it up or to end up with the very surgery I've waited this long in order to avoid. Aaaahhhh!

Frank
fgarcia0007@gmail.com

[KBear]

Frank,
Personally, I would not get more than 2 levels of adjacent ADR's . From what I have researched and heard, there is just too much chance of too much movement and ending up in more pain than when you started. There are people that have that many levels with no problems, but there are others who that spelled disaster for them. If I were you, I would jump on the ADR & Fusion hybrid. Just my opinion and my preference though, so research it and make the best decision you can.
Kathy

[Greg]

Congratulations on the approval....considering the FDA has only approved ADR for one level it is incredible that you were approved for 2. I think you'd be pushing your luck with 3 levels and if you only have 3 weeks of insurance left they might delay the approval process and you end up with no surgery. I agree with kathy about trying to not get more than 2 ADR's. It might not be disaster but you chance would definitely increase. What insirance do you have? And what levels are getting what done. If it's L5/S1 that's being fused than you should keep it that way. There is little to no movement at that level so to get an operation to preserve motion where its not needed wouldn't be the best choice in my opinion. ADR's are a great and wonderful but not always the best choice. Best of luck to you.

[pochofeo]

Thanks for The post
The surgery is at c3/4 to c5/6
At c4/5 movement matters
But more importantly fusion doesn't always work. It depends on bone growth and on that bone staying there. Much less dependable than a piece of plastic

[KBear]

Thanks for The post
The surgery is at c3/4 to c5/6
At c4/5 movement matters
But more importantly fusion doesn't always work. It depends on bone growth and on that bone staying there. Much less dependable than a piece of plastic

ADR also depends on bone growth, if your bone does not grow into it properly, it can move out of place and be disastrous. Fusion has a bad reputation for not a good reason. It was the gold standard for years and there is a reason for that. There are plenty of ADR patients who would do anything to go back and just have a fusion in the first place. I would seriously research it with an open mind.

[Cindylou]

Frank, again, we are not doctors, but.....I had 3 lumbar discs installed 3 years and 4 months ago and have only seen my facets really take a beating. I am currently pursuing rhizotomoy of my lumbar facets after I meet the demands of my insurance, by having two facet blocks first. Good luck!

[claudia]

Congratulations on your insurance approval! I think you have been given good advice. I am no expert but I recently found out by an Xray that I have a congenital fused vertebrae in the middle of my neck (I don't remember the level but I think it was C3-4). I never even knew it was there, my point is that you would not lose much movement with just a one level fusion. Good luck with whatever you decide to do!

[pochofeo]

.
Yes facets are so overlooked i can't believe it. Cervical facets have different bio mechanics relative to the disc. However I think you problem is not with disc vs fusion but with the fact that perhaps your facet joints were not addressed. Have you looked at the many lumbar facet dynamic stabilization devices out there? Might save you the rhizotomoy
- Perfx-2™ Dynamic Stabilization System
Applied Spine | Stabilimax: The New Dynamic in Motion Preservation
Zimmer Spine - International - Wallis Posterior Stabilization System
Medtronic Sofamor Danek, Inc

[trkdoc714]

Frank,

IF you have the insurance approval AND the confidence in your surgeon AND you are comfortable with the procedures both in historical and clinical trial results, go for it!

I'm assuming you'll end up with an ADR on either end of the fusion (would this be called a fusion sandwich?), which makes sense in regard to motion dynamics and negates the motion limiting result of fusion by preserving and actually increasing the motion of the adjacent levels.

Good luck and please keep us up to date on your journey!

Bob

[Susanna]

I concur! I have to tell you that I have four levels fused in my neck. And I have noticed very little problems moving my neck and my pain in THAT part of my body is gone. Most people have a hard time believing that I have had a four level fusion. They did have to remove parts of my facets as well due to nerve impingement.

All that to say that one fusion will probably not even be noticeable. Plus you don't want so much movement that it is too much, which is what I've heard has happened with too many ADR in a row.

Take it from me. When your insurance is gone, you can't get it covered. Don't play around, have the surgery while you still have the insurance!

Good luck
Susanna