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Thread: Artifical disc BELOW Scoliosis fusion

  1. #1
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    Default Artifical disc BELOW Scoliosis fusion

    Hello Everyone:

    This post is regarding lumbar Degenerative Disc Disease (DDD) which has occurred because of, and below, a long Scoliosis fusion. (I know many of us are in this position.)

    I'm in the US, but I am asking everyone in the world who has had scoliosis surgery this question: Do you know anyone who has had a long Scoliosis fusion (thoracic and lumbar) and who has then had an artificial disc placed BELOW their fusion for treatment of Degenerative Disc Disease? That is, an artificial disc placed WITHOUT fusion in the lumbar, unfused area. I know it's been done at least once, because I have a research article on it.

    If you have any info, please post or message me.

    Thanks!

  2. #2
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    Default Re: Artifical disc BELOW Scoliosis fusion

    Hello,
    I will be 5 weeks post op tomorrow and I had L4 and 5 removed and replaced with false discs and then fused from T4 to L5.
    I am not real sure if that's what your asking or not? It's a 14 disc fusion I've been told that it's a big one.
    Hope I answered your question.
    Krier

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    Default Re: Artifical disc BELOW Scoliosis fusion

    Hello:

    I hope you are feeling OK! Yes, that is a big surgery! I am also fused 14 levels.

    It sounds like you had artificial discs AND a fusion at the same lumbar location. This is not exactly what I was asking, but it is interesting. Had you previously had Scoliosis surgery years ago, or was the 14 level Scoliosis fusion done at the same time as having your L4-5 worked on?

    Also, does anyone know what the difference is between having artificial discs with a fusion over it, and just a standard fusion? What is the point of an artificial disc if the area is going to be fused anyway? Thank you!

  4. #4
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    Default Re: Artifical disc BELOW Scoliosis fusion

    Hi,

    If the fusion is not on same level as the artificial discs they might be motion preserving which would be nice if that is the case. Maybe asks the type of disc so that it might still let u move the disc.

    I'm also quite worried bout the unfused areas.

    Ange

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    Default Re: Artifical disc BELOW Scoliosis fusion

    This is my first surgery, no priors. L4 and 5 were completely degenerated from the rotation progressing. Being as they were degenerated he replaced them and then fused because had he not replaced them the pain that those discs were causing would have only increased. The new fear is that L5S1 will degenerate from the strain of the massive fusion on top of it. But....fingers crossed I NEVER have to go back to be opened up! Whew....that sure separates the boys from the men! Lol! "I am from Oklahoma, huge western fan"
    I am not sure but I think by including them in the fusion it makes it stronger, but I am a total rookie don't take my word for it. Also, Thier made out of plastic, "the artificial discs" they can't be seen on the xrays. Ed, screen name Rod Stewart has them as well and he is quit the guru on it.
    Krier

  6. #6
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    Default Re: Artifical disc BELOW Scoliosis fusion

    Quote Originally Posted by Tableone View Post
    That is, an artificial disc placed WITHOUT fusion in the lumbar, unfused area. I know it's been done at least once, because I have a research article on it.
    Tableone, I believe you mean a moveable artificial disc, see article below....
    http://orthoinfo.aaos.org/topic.cfm?topic=A00502

    I am not aware of anyone with one of these “under” a full fusion mass....

    Every single site I have been on states “No deformity or scoliosis”. This of course doesn’t mean that no-one has tried it.....There are now scoli surgeons all over the world. Amazing what awareness and money can do.

    In the threads that were discussed years ago, the issue of “particulates” was mentioned.....and resulting infection.

    AAOS article on “Off label” use of medical products....
    http://www.aaos.org/about/papers/position/1177.asp

    Ed

    The American Academy of Orthopaedic Surgeons (AAOS) believes that surgeons may prescribe or administer any legally marketed product for an off-label use within the authorized practice of medicine in the exercise of appropriate medical judgment for the best interest of the patient. If surgeons use a product for an indication not in the approved or cleared labeling, they have the responsibility to be well informed about the product, to base its use on firm scientific rationale and on sound medical evidence, and to maintain awareness of the product’s use and effects. Surgeons should appropriately counsel patients about the benefits and risks of the proposed treatment, and alternative treatments that might be available. In the case of an adverse event with an off-label use, surgeons can submit a report to the manufacturer and/or the FDA. Orthopaedic surgeons should disclose all conflicts of interest to patients, institutions, and medical associations and adhere to all state and federal laws and regulations.

    55 yr old male
    T70 L70 double trouble
    A/P T2-Pelvis BMP Jan 2008

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    Default Re: Artifical disc BELOW Scoliosis fusion

    Tableone

    Is this the article you mentioned?
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3082672/

    Here is the authors contact info....

    Centre for Spinal Studies and Surgery, Queens Medical Centre, Nottingham, UK
    Bronek Boszczyk, Phone: +44-115-9249924, Fax: +44-115-9709991, Email: ku.shn.hun@kyzczsob.kenorb.
    corresponding authorCorresponding author.

    Ed

    55 yr old male
    T70 L70 double trouble
    A/P T2-Pelvis BMP Jan 2008

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    Default Re: Artifical disc BELOW Scoliosis fusion

    I suspect that the "artificial disc" that Mrs Krier had put in was likely to have been a PEEK spacer, which is like a plastic disc put in to help restore height to the disc space where your own disc had degenerated away. I had one of these put in at L3-L4 during my last surgery, which was a one-level XLIF (anterior fusion) with pedicle screws placed posterially to keep things strong and stable.

    Moveable artificial discs have been around for several years now but they are mainly used in cervical and upper thoracic spines. I haven't heard of anyone having a lumbar artificial disc placement yet but there may well be someone out there who has. The main issue has always been that the lumbar spine is under so much more pressure than the upper spine.
    37 years old, diagnosed with infantile idiopathic scoliosis at 6 months old with curves of 62(T) and 40(L) degrees. Casting and Milwaukee braces until surgery at 10 - ant release/pos fusion T1-T12, halo traction. Post op cast and then TLSO. Further surgery at 18 (ant release/pos fusion extended to L3 to include lumbar curve, costoplasty) and 25 (another costoplasty). Fusion extended to L4 at 33 (XLIF with 4 pedicle screws and two short rods). Pre-op curves: 76(T) and 70(L). Post-op curves: 45(T) and 35(L). Diagnosed with Ehlers-Danlos Syndrome aged 34; scoliosis almost certainly due to this rather than being idiopathic.

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    Default Re: Artifical disc BELOW Scoliosis fusion

    Hi Tonibunny

    Look at the “lower” x-rays in the link I posted.....That’s a Prodisc they installed at L5-S1.
    http://www.synthes.com/MediaBin/US%2...sc-LJ6206D.pdf

    So we do have at least one person......and in England......

    I posted the author contact info, do you know that person up in Nottingham?

    Its been over 4 years, I’m wondering how that person is doing?

    Maybe you could send a friendly e-mail asking for a possible gleaming report on behalf of all of us....or perhaps a phone call? Now, I'm really wondering about this......

    Purty pleeeeeze......I'm on my knees.....He he

    Ed

    55 yr old male
    T70 L70 double trouble
    A/P T2-Pelvis BMP Jan 2008

  10. #10
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    Default Re: Artifical disc BELOW Scoliosis fusion

    Sorry Ed, I'm not very with-it at the moment! Also I can't get my iPad to display your link (this will be a prob with my iPad rather than your link as I haven't updated it properly for a very long time and it's annoyed at me).

    I don't know Bronek Boszczyck in Nottingham, but I do know his colleague Michael Grevitt. This might be because Mr Boszczyck doesn't focus on spinal deformities and doesn't treat typical cases of AIS at all, but mainly works with other spinal issues instead (tumours and neurological stuff etc). It's been really good to look him up though because his info states that he is someone who does do reconstruction and revision surgeries on adults with previous spinal deformity corrections - and these surgeons are very thin on the ground here in the UK, so I'm really grateful for you posting about him. We have members who are feeling a little cut-adrift since one of our most experienced guys has decided to focus on scoliosis in children only.

    Anyway, I shall certainly try to contact Mr Boszczyck about this, and if I don't hear from him then I can ask Mr Grevitt if he knows anything/can find out for us
    37 years old, diagnosed with infantile idiopathic scoliosis at 6 months old with curves of 62(T) and 40(L) degrees. Casting and Milwaukee braces until surgery at 10 - ant release/pos fusion T1-T12, halo traction. Post op cast and then TLSO. Further surgery at 18 (ant release/pos fusion extended to L3 to include lumbar curve, costoplasty) and 25 (another costoplasty). Fusion extended to L4 at 33 (XLIF with 4 pedicle screws and two short rods). Pre-op curves: 76(T) and 70(L). Post-op curves: 45(T) and 35(L). Diagnosed with Ehlers-Danlos Syndrome aged 34; scoliosis almost certainly due to this rather than being idiopathic.

  11. #11
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    Default Re: Artifical disc BELOW Scoliosis fusion

    No worries Toni, one day at a time.....

    This topic was brought up around 5 years ago on NSF after the Prodisc was launched. There has really been little or no scoliosis related information on this matter, and many scolis are very, very interested. I hope there is some good news with this example, some sort of hope for those that might cross that road in the future.

    I hope people realize that this is a long shot and that there will be certain parameters that will determine surgical methods. Its not like one person has it done, it’s a success, and a million scolis get on line. Long term studies, take a long time.....and many surgeons just wont take the risk.

    I am excluded in all of this since I’m fused all the way down to my pelvis.....I personally don’t feel that being fused to the pelvis is that bad. I have no problems with it now....

    Hope and knowledge play an important part for all of us.....

    Ed

    55 yr old male
    T70 L70 double trouble
    A/P T2-Pelvis BMP Jan 2008

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