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Old 10-08-2014, 04:30 PM   #3
ChuckStr
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Location: seattle wa USA
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Re: Fusions plus replacements?

I've heard of mixing Disk replacement with ACDF. A surgeon I've consulted recommended a 3 level acdf because of spondylethesis (slippage of the vertebrae) but said he could address any adjacent segment problems with disk replacement should they arise.

A disk replacement for those that dont know, is replacement of the disk with an artificial one made of various materials (metal, plastic, ceramic). This allows preservation of movement, and shorter recovery times, and no chance of a non-fusion happening. Of course it is possible that these disks can slip and put pressure on surrounding nerves or the spinal cord. This is why it is imperative to have an experienced surgeon doing this to use the correct size disk replacement and place it correctly to minimize the chances of slippage.

My surgeon is about as experienced as they come in disk replacement. He was part of the initial trials of 2 of the artificial disks and was one of the first surgeons in the country to do a 2 level disk replacement. This brings up another potential drawback of ADR, which is lack of long term efficacy results. The initial results are very encouraging but they just haven't been in use long enough to have good, reliable long term data as with ACDF and other types of fusion.

I've never heard of mixing in a single surgery and doing separate acdfs at two levels seems strange. I would be concerned if your spine showed any evidence of instability. Either way I'd get opinions from people who have done a lot of ADRs. This isnt something for a novice to try I don't think.

As far as neurontin, I've known several people who have had good results with it foe spinal nerve pain. The big obstacle seems to be side effects but if you can deal with those it may help although not everyone gets relief.

Good luck and let us know how you get on...