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Fusion vs. Artificial Disc Replacement

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Has anyone had either of these procedures? Personally, I had the ADR and a ProDisc C was used. I had a ruptured disc at C5-C6 and a friend of mine recommended his doctor. I had the surgery 6 1/2 weeks ago. I have a little pain still, but nothing like I had before and I am still in the healing process so that pain could completely go away. I am curious if anyone has had the replacement and how it worked for them. Anyone have fusion? I have heard fusion is really painful to have done and heal through. I have a few other discs that need to be "fixed" and I'm not sure which route to go. Thus far, I have had good luck with this "fake" one, but if too many need to be replaced, they suggest fusion.

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I had L4/L5/S1 fused in January of 2001. Overall I've had good results. Was back to work full time (desk job) within 5 months. I did one jump at six months post-fusion and realized it was too soon; started again at one year and did 200+ jumps the following 12 months.

There has always been some pain since the surgery, and it's getting a bit worse as time goes on, but it's nothing like before surgery. It was worth it for me.

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How long were you in the hospital after surgery? After the surgery, how long was it before the pain of the surgery was gone?

I still have some pain in my neck, but it is no longer constant so I can't complain too much.

My fear of fusion is that I would have to go through tremendous pain and it won't work. A good friend of mine had her lower back (not sure exactly which ones) fused and she is no better for it 5 years later. I also don't want to have to take pain meds forever.

I had surgery on a Monday and could have gone back to work on Thursday. I took the whole week off, but only because I had excess time off I needed to use.

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I have a feeling as though we would be comparing apples to oranges, but for what it's worth, I have had a Lumbar Fusion; L3-L5 with a femoral allograft bridge, a pair of rods with screws fixating the site posteriorly, and a cage that was ultimately packed with the ground-up bone chips of what was left of my L4 vertebrae anteriorly.

As you would imagine after all that, YES, there was one hell of a recovery...however, I attribute more of that to a number of other factors, including but not limited to:

1) The need to have the fusion was initiated by a traumatic injury just 5 days before the surgery. I broke my back in a total of 7 places between L1-L5, with the worst of it being confined to a "sunburst fracture" of L4 into >25 recoverable pieces.

2) There existed a concomitant spinal cord injury due to the severity of the compression, contusion and subsequent swelling of the spinal cord over such a large area. As a matter of fact, immediately upon impact, I had no feeling or use of either lower extremity. Feeling slowly returned over the first 72 hours to the point that I could feel sensations (hot/cold, sharp/dull), but nearly two years later, I still have improving autonomic (temperature, moisture, etc...) symptoms on just my foot on the most affected side.

3) To perform the procedure described above, it required 3 separate incsions: a 4 inch linear incision right along my spine; a small incision to place a drainage port to control and monitor my cerebrospinal fluid during and after the surgery; and the biggie--a 13-14" incision that curves up and back from the front corner of my hip bone to just under my rib cage. Basically, they then proceeded to cut through each and every layer of my "core" muscles on this side until they could access the portion of my spinal cord that is normally just behind my internal organs. To this day, I still have weakness, quickly fatigue if sitting/standing too long, and pain if I try to perform activities or exercises that require "core stabilization", as I cannot do this on one entire side.

The spinal cord injury, in both my professional opinion as a physician as well as my personal opinion as the patient in question, was the most difficult complicating factor in my recovery. My Surgeon expected me to be up and ambulating within 24 hours after surgery, as that is standard protocol following a Lumbar Fusion; 7 Days after my surgery, and I still wasn't even able to stand/walk with the assistance of a walker 10 feet back and forth to the bathroom in my hospital room. At this point, it was decided that I would need to be sent to a rehabilitation facility, where I spent the next 3 weeks learning to get in and out of bed, how to transfer to and from a wheelchair, eventually walking with a walker, and they discharged me once I could ambulate safely with just a cane in one hand.

Fast forward through 4 months of wearing a TLSO (the turtle-shell looking back brace), 5 days/week Physical Therapy, Elephant-Sedating doses of pain killers and muscle relaxants and still having constant pain, and I was finally released by my surgeon to discontinue the back brace, and I could resume walking, unassisted, on a treadmill. The goal was to get me back to walking 2 miles by the 6 month anniversary of my surgery.

Today, 23 months to the day later, I do still have constant pain. Do I think it is from the lumbar Fusion? No--not in the least. Does the pain keep me from doing anything that I want to do? No, although it may limit the number of times I can do it or the duration for which I can do it. I was off of my pain medications and muscle relaxants at the 6 month mark in my recovery, and I have regained full use and strength of my Left foot and leg--the one most affected by the spinal cord deficit. As previously stated, I do still have some skin changes on the bottom of my heel, but that is the extent of my neurological issues.

Practically speaking...I am a full 1.25-1.5 inches shorter than I was before the surgery. WOW! I couldn't believe it, either, but simply comparing pre and post-op films demonstrate why...the allograft should have been larger/longer, but with the already fractured remaining Lumbar vertebrae, they couldn't force something in there that would put much pressure on the "anchoring" sites.

On the plus side, I am back to skydiving! I made my first jump 1 day shy of the 3 month anniversary of my accident; I will be the first to admit:THIS WAS THE STUPIDEST THING I HAVE EVER DONE. I spent my entire time in the hospital and rehab and physical therapy facilities staring out the window at the big, blue sky I was missing, and just "needed to get back on the horse", so to speak. So, I showed up at the DZ, wearing my back brace and requring my cane to get over to the plane...made one subterminal hop and pop, and that was all I needed to tide me over for the next six months until the following March when I resumed jumping, even more so than before my injury. I couldn't jump many times in a day, and lying on the ground and trying to move around to pack was more than my back could handle, but by the 18 month mark of my recovery, I was able to make up to 20 jumps in a weekend and pack each time for myself.

Sure, my back hurts everyday, most of the time. It reminds me of how close I came to dying, and how grateful I should be for the life I do have. It inspires me to know that I can overcome anything with persistence, hard work and patience. (And sometimes, it even reminds me not to be stupid ;) )

Thank you for the thought-provoking thread that you started that, for the first time in a long time, allowed me to profoundly and succinctly reflect upon my injury, my recovery, and the effects they have had on me as a person. I hope that some of what I have written helps educate you and make a more-informed decision, even though, as I intitiated this reply with, I'm quite certain that many of the circumstances surrounding my surgery will be absent from yours.

Regardless, I wish you the best with the ADR that you've already ungone. Be patient, do your physical therapy, and you will be rewarded with a satisfactory outcome. But know, that if I can recover from a Fusion as well as I have in as short a time as I have, you will do fine, too, if and when it comes to that.

Feel free to PM me if you ever have any questions/comments that you would like to discuss in a non-public forum.

Again, BEST WISHES for a full and speedy recovery!

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How long were you in the hospital after surgery?



About 48 hours in the hospital total, including prepping and the surgery.

Quote

After the surgery, how long was it before the pain of the surgery was gone?



The sciatica pain (in ass and down leg, pre-surgery) was gone when I woke up; although it's returned over the past couple years it's nowhere near what it used to be.

The muscle pain in my back (which I didn't have pre-surgery) was brutal for about a week, then it got rapidly better. That has never completely gone away, but I also haven't been really good about stretching. Until recently I'd only have one or two bad days every couple of months though.

I have a friend who recently had a fusion in his C spine. He was back to jumping and working (as a firefighter) after six months. Another friend had a similar experience.
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I have had a Lumbar Fusion; L3-L5 with a femoral allograft bridge, a pair of rods with screws fixating the site posteriorly


~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~


Same thing here, I call it my 'rough country' suspension. ;)

I had spinal cord exposed which was painful to say the least, at times my right leg would go numb and I would fall over.

I went into surgery in the best physical shape I could manage and walked out of the hospital 3 days later with only a cane...had to take a year off jumping (364 days actually ;))
but have had NO problems since with regard to pain or mobility.

My surgery was 15 years ago last month.











~ If you choke a Smurf, what color does it turn? ~
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"I have had a Lumbar Fusion; L3-L5 with a femoral allograft bridge, a pair of rods with screws fixating the site posteriorly, and a cage that was ultimately packed with the ground-up bone chips of what was left of my L4 vertebrae anteriorly. "

Substitute "cervical" for lumbar, and I had very similar surgery 9 Oct last year. I had a bone spur that was deforming my spinal cord, bulging and calcified discs, and stenosis at C5/C6. The docs removed all of C5, most of C6, then put in a cage around my spinal cord, a plate in front from C4-C7, and two rods in back. The bone they removed was ground up and used to pack the surgery site. I was in for a total of nine hours of surgery: seven on the front, and two more for the rods in back. I was in ICU for a day and a half, a regular room for another day and a half, and out of work for two months. I had to wear a hard cervical collar 24/7 for three months, which sucked a lot because I wasn't able to sleep well with the collar on.

I haven't jumped yet, and probably won't even consider it for another 3-6 months. My goal is to be current by the Eloy Holiday boogie this year. I didn't have symptoms before surgery, except I could make my back go numb on command if I tilted my head back. No pain, weakness, numbness, paralysis. The doc told me post-surgery I lost 12 % of the up and down movement in my neck, though I can't tell the difference pre and post surgery. I don't see a real need to rush back to jumping. I tried on my rig and helmet a few weeks ago, and can still arch hard and see my handles. As much as I love and miss jumping, I only have one chance to heal correctly, and honestly, being able to feed and clothe myself is much more important to me than jumping. My wife doesn't want me to jump again, and that's a real factor for me too.

I've heard that if the bone graft is taken from your hip, that not only is that procedure painful (more so than the cervical surgery), but takes longer to heal too. The chance of rejection may be less than with a cadaver graft, but my original choice was to go with the dead guy's graft.

As far as my recovery, I was able to walk from post-op to my room, and took visitors the next day. I was on morphine while in ICU, and artificial morphine while in the regular room. I was off all prescription meds completely after two weeks. My pain was located in my shoulders and neck mostly. The procedure requires quite a bit of tissue to be moved aside to reach the surgery sites, so I had to deal with strained muscles and tendons. I have a four inch vertical scar on the left front of my neck from that incision (superglue'd shut), and had sixteen staples for the incision on the back of my neck. Looks kinda like a zipper. The worst pain of the entire process was when the catheter was removed...no lie.

My goal with the surgery was to get things fixed so I could go back to doing the things I love to do. I'm not a doctor and don't play one on TV, so you have to make the choice on your own. In my case, I feel VERY fortunate that I was able to go through the surgery before something permanent happened to me. The sky will be there when/if I'm able to go back up.
Burn the land and boil the sea,
You can't take the sky from me.
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I got into a car accident when I was 21 (1992). Ruptured 3 disc (L2-L5). After a year of PT, I managed to be fairly active until March 2009. I was in constant pain and my spine would rarely straighten (lean to the left). My neurosurgeon told me I was "shit out of luck"... too many levels that needed to be repaired. The remaining disc had long degenerated and I had stenosis.

One day, my ex-wife noticed a small lump in my back 1/2inch from L1. When I touched it, it was like a pain button throughout my lower back and legs. The orthrorpedic doctor and my neurosurgen played it down but being prone to lipomas and after a little research, I was able to convince the neurosurgeon to reluctantly give me an local anesthetic. Pain free for almost 24 hours.

She refused to remove the lump, but I was able to get a general surgeon to remove it. It was deep enough to require going under, but once removed, I haven't had the slightest pain since. I felt better the night after surgery than I had in 18 years.
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I had C3-4 and C5-6 fused using cadaver bone and titanium plates/screws more than 2 years ago. I woke up from the surgery, and the pain was gone. I had new pain from the surgery, but that went away in a few weeks.

Per the doctor's suggestion, I took 6 months off of jumping. He gave me permission to do everything else 6 weeks after surgery. I've been back jumping for 20 months and I've had no problems.

I looked into the artificial discs, and talked to my surgeon about them. In my case, they wouldn't do it because I had 2 levels that needed to be fixed. My surgeon was trained to use the artificial discs, but pointed out that fusion is the "gold standard" that has been done for more than 20 years, so they know the long-term effects. These artificial discs are new, and therefore it will be quite some time before they know how they will hold up over time.

I'm glad I had the fusion. As far as pain goes, it was bad for a week or so, and I needed Vicodin to sleep for about 3 weeks. I only stayed in the hospital one night, and was sleeping in my own bed the next day.
There are battered women? I've been eating 'em plain all of these years...
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I do both cervical fusions (ACDF) and cervical artificial disc replacements (ADR). ARD is usually not recommended for more than one level. Patients that have the fusion/ACDF usually do really well, with very little pain, even with multiple levels fused. Lumbar (lower back) fusions on the other hand have a much longer recovery period and usually more post-op discomfort.

Feel free to PM me if you'd like, I'd be more than happy to answer any questions you might have.
*I am not afraid of dying... I am afraid of missing life.*
----Disclaimer: I don't know shit about skydiving.----
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Has anybody had the cervical artificial disc replacement (Mobi-C or any other) and got back to skydiving? I have a severely herniated disk between C6-C7, didn't go through surgery yet. Some surgeons say I shouldn't skydive with ADR due to forces during the opening, some don't see the problem. Some say the disk can move or fall out during the opening.

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On 4/23/2021 at 4:18 PM, manualride said:

Has anybody had the cervical artificial disc replacement (Mobi-C or any other) and got back to skydiving? I have a severely herniated disk between C6-C7, didn't go through surgery yet. Some surgeons say I shouldn't skydive with ADR due to forces during the opening, some don't see the problem. Some say the disk can move or fall out during the opening.

If you have Facebook, I'd look for the ADR groups.  I'm a member of one, and there are a lot of people who have had ADR, and you could probably get several knowledgeable opinions.  The name of the group I joined is "ADR Artificial Disc Replacement Support And Education Group For the Spine".  Good luck.  

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