[Artificial Disc Replacement / Lumbar] L4/L5 Stand Alone Artificial Disc Replacement for Progressive Spondylolisthesis (Prodisc)

[cavalier]

5 yr's post -op. Dr B. in Germany did my surgery. I was bone on bone only fragements left of my disc outside the disc space thus the reason for the progressive spondylo. Prodisc - sitting is still my hardest but otherwise I am doing well & have not taken anything since 2 days post-op for pain. Walked 2 miles 3rd day after my surgery after leaving the hospital. Occasional muscle aches now but I feel only due to overcompensation for the 2 discs that are compromised in my neck - as backs hurts more when my arms & neck is worse but muscles only NOT disc pain & I SURE know the difference. IF my neck was fine & my arms I would be jiffy as i was totally pain free for a bit til the neck started getting worse with time.

Jill

[Justin]

Jill,

Congrats at being 5 years post-op! It's great to hear the ADR resolved all of your lumbar issues. Your case of artificial disc replacement used to correct spondylolisthesis at L4/L5 is rare and usually a contraindication for ADR placement at that level--that's why this is so cool!

Do you know what grade your spondylolisthesis was before your operation?

We're going to have to talk soon...I'm very interested in you being almost "bone-on-bone" pre-op. My Dad is in a similar situation (almost bone-on-bone at one level), but he needs a CT/myelogram to help visual his spinal canal and to help determine what surgical intervention he ultimately needs (Drs. Fenk-Mayer and Bertagnoli are currently working up his case).

[cavalier]

Justin - I was not almost bone on bone, I WAS bone on bone -nothing left but fragments outside the disc space totally. At one time back in 04 the Prodisc site had the parameters for a spondylo had to be within a certain grade you would think i would have remembered all of this but I had some family members die about 9 mo's after my surgery & there was alot of other things that went on - I had a surgery for a MMRSA colonized staph infection - that set me way back & I swear after that anesthesia from that surgery i just blanked out some details. I was on the limtis of the ADR though & Stenum said the reason for the progressive spondylo was due to that i no longer had a disc to keep the vertebrae in line they said restore the disc by ADR & this will stop that dynamics. Dr Zigler was the 1st to say I would still do well with the Prodisc only ADR not Charite I needed the semiconstrained & Blumethal who I also saw at TBI agreed - when all of the other USA doc's said 2 level fusion due to L3L4 being herniated already - I thought long & hard on this as I d/n want to be a borderline ADR patient & i asked that but I also had bluging discs in my entire lumbar & I knew what would happen if i went there with a fusion. The reason the L3L4 was so streesed was due to the lack of nothing below & the 2 segments being one overhanging the other. It was a devil of pain I also had kids & needed to drive & be functional so i only took 1/2 a lortab once a day to twice a day & sometimes not as nothing really touched that level of pain. I was given a Fentyonal patch spelling & I took it off as it never took the pain down - so ... point being I had a team here but it was in trials & I was # 3 on the list & that list was not moving after 9 mo's however i was - every 3 mo's for 21 mos' when i 1st insisted that Xrays be taken after my 1st surgery I didnt' even tell my family til 12 mo's went by - I needed to be sure I this was going to keep moving.

Then I sent to Dr Yue & he felt he didn't want to fool with making this call & felt my case needed Dr B. He d/n offer me ADR he offered me Dynesis - I knew it would stablize me but do nothing for pain - problem was Dr B d/n know how bad I was til he got in there MRI didn't show fully - I turned down Dynesis & said I was not making myself clear I had true discogenic pain & needed something to take that place & Dynesis would NOT DO that. I had already been offered a free Dynesis the 1st in Ky & I turned that down - I asked Dr Fenk-Mayer I said i am serious about coming over but I need to communicate better my 1st concern - to my surprise Dr. B. called me - I didn't even know he was going to call - I asked would Dynesis help true long standing disc pain he said no only stablize i said my problem & has always been true disc pain - I told him of what Stenum's theory was - he said there is risk I said & I believe Prodisc is designed to work up to a Grade 3 but again memory is foggy but I said this was from their site - I was at that Grade - he agreed to do ADR instead & said we may have to add Stabilization later on I said if it is a big concern I would do both at once - he didn't want to do that so I said then ADR knowing I would be only the 3rd at that time to have this for this reason.

The rest is history - he had a dickens of a time & i am glad i came to him as he was quite shocked he said to me I never asked - I had the WORST single level & worst disc as it was ALL fragments outside in his 18 yr's he had ever done. I didn't need to ask him I knew I had my body telling me I was in big danger and he said I would have been what I also felt someone ER fusion in less than 2 wk's so all of the delays over which device i BARELY made it in under the wire he cleared his schedule to fit me in he was doing me as a Emergency in doing so & asked me if I could get there in one week - I said yes. We left 2 teenage kids home alone & I still dont know how we did it but we had no choice. I know I had angels working OT. It is NOT how i recommend doing a surgery but it is what happened. I just know a spine doc from the USA was in on my surgery to watch he came into my rooom -afterwards & he said I got perfection that day. He said Dr B had to really work & was not satisified until he got it just right but he had a hard time lining up the 2nd ends. My surgery to give you some idea Dr B says he never watches the clock but i was in there for 6 hr's - I had all of the decompression already done mind you from my 1st surgery - facetomey, discectomy, lamatomey so what Dr. B. said took so long was getting fragments out - he said it was just charred bits the worst he had ever seen.

I'd be happy to talk to you anytime but that is why i say have the world's best experienced doc's involved with a case of bone on bone - I am sure glad i did best darn 27k I ever spent Dr B gave me his money's worth & in the end things I believe worked out the way they were supposed too for me & that is what i prayed for. IF you can imagine how I felt turning down a lifeline from Dr Fenk-Mayer when i was in so much pain & having this stall - but to me it was like a basement wall - when they are built from cement blocks - if you have a block missing of course the wall will start to crumble but put a block or support back in you can then have the entire wall held up again - I thought of that over & over & I felt Stenum was right. I guess we as patients have to decide I had Fusion 2 level, Dynesis, ADR & some doc's just would not touch me period called me a failed surgery & were too afraid to work on what someone else did especially when they heard progressive spondylo - some care more about keeping pristine result records & not wanting to deal with anything more difficult & actually I was glad if they didn't feel comfortable I frankly didn't want them working on me. I knew a spine is alot in common with that cement block wall for dynamics & something as simple as what Stenum said was exactly what was going in my mind restore what I lost & it will work out.

I was cautioned by Dr B I may need a additional stablization at some point if this moved but the keels on this baby & that it can handle a grade 3 in it's original spec's made me feel it was capable. I am in contact with Dr F-M due to my neck now if you need any records from them for you to see you can have them get my permission & it can be sent to you. It saved my L3L4 as well so far & that also made me feel is was about restoring intergrity - spondylo's happen or retro's due to the loss of a disc & my case so far is proof it can work. So many doc's because they have not done this for this application say no. I know Zigler here & Blumenthal also shared with no hestiation they knew I had a Grade 3 but said no for Charite but yes for Prodisc. I still remember Jack Zigler saying I would be his poster girl - IF I could have waited but again it was out of his hands due to the trials. But I am a poster girl I waited & fought this for 10 yr's & literally was running out of time in not wanting to do a 2 level fusion I came close a couple of times as it was hard but I felt when I heard of ADR coming in 2000 to try to hang on by my fingernails, again my building background it made sense restore the dynamics. I never had the spondylo until I no longer had the disc & now I dont once again. Hope this helps - Jill

[cavalier]

Actually Justin - I did use my basement cement block analogy with Dr B. in saying how I saw it & he said it made some sense when we talked by phone. I really appreciated it - as he felt it was due to the spondylo that was the cause of my pain - I told him it was worse but my problem was long standing disogenic pain & after 3 discograms that always showed the same & it was always the center right where my disc should have been. Having nothing there didnt' stand to gain me relief & when he said I would not have any relief of pain with Dynesis only which is the same conclusion my own searches had shown - I knew which had to come 1st.
Trust me I knew i was only the 3rd in the world at that time used like this - that Dr B. knew of - but I was already so far at rock bottom - I had little quality of life left & knew the risks & had enuf opinions & spec's by the manufacturer to indicate I could have the device stand alone & I could gain. But some USA doc's also felt I was not pushing the device limits & this should be able to stand alone.
I needed those nice long keels on both ends
That is why I have tried to come back to let people know. I also know much of the success was in the skill of the alignment I got. But the device is doing it's job. Jill

[Justin]

Actually Justin - I did use my basement cement block analogy with Dr B. in saying how I saw it & he said it made some sense when we talked by phone. I really appreciated it - as he felt it was due to the spondylo that was the cause of my pain - I told him it was worse but my problem was long standing disogenic pain & after 3 discograms that always showed the same & it was always the center right where my disc should have been. Having nothing there didnt' stand to gain me relief & when he said I would not have any relief of pain with Dynesis only which is the same conclusion my own searches had shown - I knew which had to come 1st.
Trust me I knew i was only the 3rd in the world at that time used like this - that Dr B. knew of - but I was already so far at rock bottom - I had little quality of life left & knew the risks & had enuf opinions & spec's by the manufacturer to indicate I could have the device stand alone & I could gain. But some USA doc's also felt I was not pushing the device limits & this should be able to stand alone.
I needed those nice long keels on both ends
That is why I have tried to come back to let people know. I also know much of the success was in the skill of the alignment I got. But the device is doing it's job. Jill

That's for sharing your truly remarkable story Jill! Your situation at the time of surgery was very unique.

Here's to many more years to of good health and to your ProDisc!

[cavalier]

I could have withstood alot less drama - but i am not the only one who the more you look the more varied opinions can be & it is important for folks to realize that.
In the end I stood only to gain as hard as it was to keep waiting - nothing like waiting for some confirmation of what surgery may give you the best results. ALL surgery is a risk but trying to improve what odds we have helps.
Jill

[Fuzzy]

I also was almost bone to bone at 4/5 with 1 milimeter left, that was lying in the mri machine. Standing I felt bones crunch at certain moves. Wrong move and bang I 'll be flat in level 10 pain. USA surgeon told me it would grow together and then it would hurt less. Live with it, 2 level fusion maybe when I could not walk anymore.
Needless to say I went to Germany where dr. Zeegers spent 5 hours picking the pieces out of my spinal canal. Luckily I ended up with only 1 level fused and 4/5 with adr. The relief was instant. I could now stand for more then 15 minutes and it felt like i had something to stand on. I don't get these US docs. They didn't like my neuro symtoms it seems that complicates their chances for good outcome so better not even take it. Gotta love the Dr.s over in Europe who are as compasionate as to take on difficult cases and accept the challenge to help a patient feel better. Oh yes, well worth the money spent (including loan interest and being able to work to pay it off).

[cavalier]

Sounds as if we are sort of in the same boat again - I have Cervical 2 levels identifed by Dr B already, 3rd TBD by disco - just trying to figure out how to come up with 38k to 53k if insur. wont pay.
But yes there was a big difference in some of the doc's attitides not all here in the states were like that but yes i was told to live with it & other doc's called me a failed back & said they were too afraid to touch me - I felt OK good I would rather they tell me that then to take on a task they are not up too I was up standing for about 15 mi's within a couple of hr's after my 6 hr surgery. I walked 2 miles on the 3rd day & the 2nd day I was all over the hospital with the IV pole at 1st then off of it. Good luck with your visit. Jill

[Fuzzy]

It took me a week to be able to able to walk to the hotel lobby. I did make it to xray on day 4 but it was a struggle. It was still obvious that something mayor was fixed and something else (neuro symptoms form my neck) was still there. I am looking at 2 adr's with the a possible third, to be determined by dr B.s discography. I am scheduled for July 24 in Bogen and working on those loans!

[KBear]

Fuzzy, I had no idea you were needing more surgery, sorry to hear that. I will pray that everything goes wonderfully and you are pain free again. Kathy