HELP: Desperately Need a Maverick ADR Removed

[Michelle Maree]

Hi Mark,

My heart goes out to you. I live in Melbourne and would like to have ADR in Germany. My concern is that if it doesnt go as planned there are very few experienced ADR surgeons in Australia to do a revision. So I would probably have to go back to Germany.
We are really behind the eight ball here down under and it is very frustrating that we are so conservative with our medical care.So that surgeons arent given the chance to really develop their skills in thes new technologies. Personally if I had the money I would go to Germany or USA for revision surgery or bar that have posterior fusion by a good surgeon here.
Can i ask who did your surgery? And do you know how many they have put in?
I think if they cant remove them they shouldnt be implanting them.
I really feel for you and hope you find a solution soon.
Michelle.

[runner]

Mark,

Not to confuse you, but I realized that I was seeing you on that other forum. i hope MSY, if he can help you, does.
Yes, I agree with you getting and finding the best surgeon for you is what is really important.
I hope people on this forum can help you.
I will keep praying for you.

[mark-perth]

Hi Mark

Thanks for the reply, I have the A-mav disc thankfully but have not had the patch put between the great vessels. Its such a hard decision. My biggest concern is whether the disc could be removed after a Posterior fusion is done as obviously the safest way would be best but not at the expense of loosing available options. Hope your necks going well.

Thanks for the advice

Mark

Ive attached a pic scan of my back 4 days post ADR and at the end of march 2009.

[mark-perth]

Hi Dale
Thanks for the reply. Yes most of the reports say the results for ADR revisions get better results with the disc removed than just fused in place. It is a much more dangerous and difficult operation but I would happily take that choice if it means less pain. From what I understand there is only a very slim chance that either will help totally but slightly better results are achieved from removal. I really dont ever expect to be anywhere near painfree but just want to be the best possible under the circumstances. Hopefully I can atleast not have to live on opiates for the rest of my life.

Thanks for your message,

Mark

[mark-perth]

Hi Runner
Thanks for the kind words and support.
I would be happy to have a posterior fusion if I felt there was a bigger chance of success but I am extremely doubtfull especially when my surgeon doubted whether it would help.
I also am concerned that if it doesnt work I may not be able to get the disc out at all then. Thats probably why I would rather take a bigger risk in the hope of a better outcome. I really dont want to live a life with a morphine pump. Thanks for your help and ill keep you informed how I go with the docs.

Thanks for your help
Mark

[Michelle Maree]

Hi Mark,

I am sorry to be pessimistic, i guess I tell things the way I see them. But looking at your scans.How could they straighten the bones up for fusion if the disc is keeping the vertebra off centre? Wouldnt you need to remove the implant first to realign the vertabra?

[mark-perth]

Hi Michelle

Thanks for your message. I hope you have better luck if you decide to have an ADR than me, Just make sure U understand that it is damn hard to have it removed and alot more costly. I too was originally thinking about going to Germany but was talked out of it.
I dont wish to name my surgeon as I hold no grudge against him, He isnt in your state though. There is always a risk with any surgery unfortunately and even the best have results like mine. My surgeon has stuck by me and is wanting to continue helping me which I really appreciate and I still have the highest respect for him. My surgery took 7hrs so it was not an easy operation. He had done more than 100 lumbar ADR's plus many more cervical ADR's.
The biggest concern I have is that im not too keen on a posterior fusion especially as it may not help and dont wish to be stuck in pain with a crooked disc stuck in me. That will mean I need to have another operation which I really arent keen on. You can see the Xray doesnt look very good and I agree with you about whether a posterior fusion would work. I think that it may be able to straighten up the spine at that level but I cant see there being equal pressure on the ADR for it to be used as an interbody device supporting the spine and not cause any pain. My surgeon has said he will do another anterior operation to remove the disc if the posterior fusion doesnt work and has done 1 Maverick removal but has done many repeat anterior operations which helps. I agree that noone should ever put something in someone if they arent able to remove it. The reason my surgeon doesnt want to do an anterior operation first is because of the huge risk involved which is understandable. My only concern I have with my surgeon is that he isnt able to do a lateral operation if a repeat anterior operation failed, otherwise I would happily have him operate again.
Its impossible to know what to do.
Thanks for the reply and best of luck,

Mark

[mmglobal]

Michelle,

Keep in mind that people can have tilted vertebral bodies without off-center ADR. I've seen several cases of tilted vertebral bodies with on-center ADR. (Even more cases of tilted vertebral bodies with off-center ADR because of the obvious balance issues with the center of the joint that us not under the center of load.)

Also keep in mind that many people have posterior or posterolateral fusions without touching the collapsed disc space. You can have forces acting on the off-center ADR that are completely overridden by the stabilizing forces that may come from a nicely done fusion or posterior stabilization system installed behind the ADR. I've seen successful and unsuccessful fusions leaving the ADR in place. I've seen successful and unsuccessful fusions following explantation of poorly done ADR. I've seen successful and unsuccessful dynamic stabilization behind ADR with Dynesys, DSS and Coflex.

Each case is unique and depends upon what the true pain generators are and how successful the surgery is at correcting the structural issues associated with the poor configuration.

Note that it's possible that the obvious structural issues associated with the tilted vertebra may not be the pain generator or may not be the only pain generator.

mmglobal (it's too confusing having 2 mark's here. Mark, Mark... sounds like a hair-lipped dog barking.)