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    Spinal Fusion after disc replacement on same level L5-S1
    catpardue posted:
    I was wondering if anyone knew the success rate of a fusion on a level that had an artificial disc. I had the Charite' disc replacement in 2006. I then developed spinal stenosis and pain procedures stopped working, such as rhyzotomies, facet blocks, etc. I just had fusion performed at the same level, my L5-S1. I didn't realize until after my surgery it was at the same level as my artificial disc. I have some concerns as to how it can possibly fuse with that titanium disc there. Any help would be appreciated. Has anyone heard of this? I have several followup questions for my doctor at my 6week followup. I am 3 weeks post op now.
    bj1208 responded:
    hi and welcome to the support group -

    I've never heard of this being done - normally when a fusion is done the disc is removed and hardware is put in-place.

    Fusion surgeries have a high rate of success and the outcome is to stabilize the spine. Fusion surgeries can only hope that the pains will be reduced and/or completely gone.

    I had a single fusion L5-S1 done in 2008 - my surgery was a success as I did fuse 100%. However, damage in my spine area was more severe than they had hoped as they couldn't do anything to reduce my pains.

    It could be that your surgeon may have removed the artificial disc if it was noted that this disc was not put in-place or maybe it was moving around.

    At any rate, it would be beneficial to address this question with your surgeon. I have been on this support group since 2006 and have never heard of this type of procedure done if the hardware was placed to help stabilize the spine and artificial disc.

    Once you do see your surgeon, please let us know exactly what happened during ur surgery. Take care - Joy
    painloopy responded:
    I had a Charite disc replacement in 2006 also and still have a ton of chronic pain in L5-L6, facets, and SI joints but they can't figure out why. My doctor has recommended this same procedure to me of fusion around the disc replacement but said it would only give me a 50% chance of changing my pain level so I didn't choose to do this. Another person at the same office had it done and I don't know how hers came out (confidentiality agreements). So obviously - this is an option. My doctor says they just put the rods around the artificial disc to stablize it but they would not do the bone graphs or cements, etc, to fill in where the artifical disc is. That disc space would no longer be able to flex as it did before.
    I'd be VERY intersted to know whether this works for you. I don't have spinal stenosis but still curious since I've asked around and can't seem to find anyone else who has actually had it.
    catpardue replied to bj1208's response:
    They ended up fusing the facets, instead of the entire vertabrae. So the back portion near my back is fused/fusing and my front side of my disc toward my stomach still has the disc which was immobilized by the cage. It is apparently very hard and very dangerous to try to remove those artificial discs and would require removing a portion of the spine. The pain is much better than it was a few weeks ago, still have a long way to go, but getting there. I appreciate your response to my question.
    catpardue replied to painloopy's response:
    They ended up fusing the facets, instead of the entire vertabrae. So the back portion near my back is fused/fusing and my front side of my disc toward my stomach still has the disc which was immobilized by the cage. It is apparently very hard and very dangerous to try to remove those artificial discs and would require removing a portion of the spine. The pain is much better than it was a few weeks ago, still have a long way to go, but getting there. I appreciate your response to my question.
    KJB63 replied to catpardue's response:
    Hello Catpardue,

    I just found this discussion - I hope you're doing really well now, five months after your surgery. Would you be willing to update your progress?
    I had the Charite implanted at L5 - S1 in 2005 and am currently considering fusion to deal with the pain and arthritis. I'd be very grateful to hear how your fusion surgery has affected you.

    Thanks much,
    bj1208 replied to KJB63's response:
    hi and welcome to the support group -

    please remember that with any back surgery there is no guarantee it will work. and fusion surgeries are done to help stabilize the spine. they do have a success rate of about 45-65% for stabilizing and fusing. There is no guarantee that back surgeries will reduce/eliminate pains.

    You can click on my name or pic and read my story. I had single fusion L5-S1 done in 2008. my surgery was a success as it relates to stabilizing and fusing, however they could not do anything to my pains in my lower back or the nerve damage in both my legs.

    I'm not trying to discourage you from the surgery, but you should research fusions on the internet and ask numerous questions to your surgeon. I'm glad I had mine done (had a lot of damage to the disc) and would do it again if I had to.

    Hope this helps - oh and we have not heard from Catpardue since this posting - we do hope he/she is doing well.

    take care - Joy
    catpardue replied to KJB63's response:
    I am very happy having had the fusion after the disc replacement. There is not a lot of information out there regarding having both at the same level. I would do as much research as possible and can only speak to my situation, but I have about 70% relief. Still have issues with my sacroiliac joint, but rhyzotomies should help that, the blocks they just performed at that level helped a lot. If you do it, be sure to complete your physical therapy, I didn't think it would help as much as it did. But I have seen a marked improvement since i started 4 weeks ago. I'm hoping to be over 80% of relief once PT is completed. I had developed spinal stenosis, so immobilizing the area is what needed to be done. It really does probably matter what your diagnosis is. Mine was done minimally invasive and saved on recovery time. Good luck with whatever decision you make. Chronic back pain is no fun.
    freewaybaby replied to bj1208's response:
    Hi everyone...
    My son has a Charite' disc in his back since they first started implanting them. That was in Nov. 2004 and I certainly hope they have improved since then. He has pain 24/7 that has caused psychiatric break a few years ago and his life is at a standstill. That said... he also has nerve pain down both legs and was on Gabapentin for this part of the pain. He also uses Duragesic transdermal and tramadol for supposed arthritis as well as psychiatric meds as well. The neurologist recently put him on Nucynta for the nerve pain in his legs and it has done wonders for that. Unfortunately, it doesn't relieve any of the other pains and issues, but it DOES work for the nerve pain in the legs. I notice you say you have nerve damage in your legs. I don't know if that entails pain or not, but just wanted to mention Nucynta in case you do have pain from nerve damage and haven't tried it yet. My son KNOWS he is addicted to most of his meds and I really thought he would not report a change in the nerve pain, but he did and has taken himself off the Gabapentin. Now, it seems the main issue is anxiety; don't know whether the back pain causes it or not. Not much seems to work on the anxiety or the back pain. Please check into Nucynta (they did have a 2 week free trial script in November/December...maybe still do) and I hope it helps!
    bj1208 replied to freewaybaby's response:
    Hi and welcome to the support group -

    I hope you son can find something to help with the anxiety - just about anything can cause it and most people that have severe chronic pains tend to have anxiety attacks.

    I do have pains in my legs along with the nerve damage - the Gabapentin really does help with mine. I can tell a difference if I miss a dose (take 3600mg a day~~1800 in morning and 1800 at nite) so I know when I start having leg pains that I have missed my dose and its usually the nite dose.

    I do take some heavy narcotics already 240mg morphine day; 120mg oxycodone; .25mg xanyx when needed; Soma 4X daily and 3600mg Gabapentin daily. With my hubby's Union plan, based on quarterly hours worked, we have to pay for meds out of pocket and submit claims for reimbursement so I need to have generics prescribed.

    The combination I am on has been working great for the last 4 yrs. I know here soon I will be looking at having the pain pump implant done as I am at the highest dosage and cannot be changed.

    thanks for the info - hope you son finds his medium~~
    ~~ Click on my name or picture and read my story ~~

    Take care ~~ God Bless ~~

    ~~ Joy ~~
    painloopy replied to freewaybaby's response:
    Hi freewaybaby, This is most helpful to know. I do have nerve pain down both legs to my feet and have not heard of Nucynta. I will definately look into this one now though. I've tried neurontin (aka gabapentin), tramadol, Lyrica, and Cymbalta but they either did nothing or had bad side effects.
    Right now I rely on ice, Lidoderm patches and also have a spinal cord stimulator and it does help more than any meds so far to a point. Once the nerve flares go past level 6-7 then forget about it - nothing will touch it.
    I also have anxiety and depression issues and found that meditation (my therapist showed me a great one that involves breathing and loosening all the muscles systematically) and wellbutrin work best but still can't handle much in the way of over stimulation - like going out in crowded places without high anxiety.
    Most of us on this board are addicted to our meds - I don't know how we wouldn't be considering the narcotics involved. Thanks so much for sharing this info - I will look into Nucynta.
    FireKitty responded:
    I hate to piggyback on your question, but after reading all of the replys, I am starting to get scared. I had a disc replacement done in 2009. It was all find and dandy, and still may be, but I've been incurring an increased amount of pain lately. Nothing is really making it better. I should maybe start my own, but now I am wondering how many people have had to have the fusion after the replacement and about how long did the replacement last? Trust me, I've put alot of miles on mine and I have not found any long term studies as to the life span of these. Are the problems just with that particular brand? Mine is different, then again, was done overseas. I am only 30 and do not want to go through anymore with this.
    bj1208 replied to FireKitty's response:
    Hi FireKitty - welcome to the support group -

    the original post was over 10 months ago and don't believe we have had any new updates from this member.

    You may want to do a GOOGLE search on disc replacement problems and/or complications and see what it shows. You may find a forum that would have more posts from people who have problems etc.,

    please keep us posted what you do find~~
    ~~ Click on my name or picture and read my story ~~

    Take care ~~ God Bless ~~

    ~~ Joy ~~
    catpardue replied to bj1208's response:
    I have responded when asked a question. I am not on here very often. I have 4 responses to people in this feed alone since I posted the original. I had my fusion at L5-S1 in April of last year, I am almost a year out. I am about to have stem cell injections to hopefully repair the bone/joint because I have degeneration. I was 30 when I had my disc replacement and had a lot of success at first. After fusion I have lost weight which has helped, but still have nerve damage, spinal stenosis, and degeneration. I can't take a lot of the meds listed above because I have a 3 year old and need to be able to care for her coherently. I will post an update on the stem cell injections. They use regenerated (can't remember actual term) skin cells and revert them back to early stage before they determine what type of cell they will form. I'm really excited by this procedure and really hoping it will helping with my residual shooting and stabbing pain in the area.
    bj1208 replied to catpardue's response:
    Hi Catpardue - my apologies as I have gone back and read that you have been posting.

    I am curious as to the stem cell injections you will be having. Do you live in the US? I had thought they were not approved for the mid/lower spine?! My primary doc has a notice in his office about stating that they can do these in the upper neck/head area but not the mid/lower spine.

    I know yoiu mentioned not being able to take some of the meds listed above and wonder if you are referring to Gabapentin? I know when I first started on this med it did make me feel a "groggy/drunk" feeling but that went away after the first week of taking it. Then as I dosed up (slowly increased dosages) I hardly had any side effects.

    It has been 5 yrs since my fusion and I have DDD in my entire spine, blown out T11 & T12 left facet joints and also at L4 & L5 both sides, blood vessel tumor at T9. It seems once you have injured your back and have an operation a domino effect happens.

    Do keep us posted on the stem cell injections and how you are doing.
    ~~ Click on my name or picture and read my story ~~

    Take care ~~ God Bless ~~

    ~~ Joy ~~

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