Lumbar Disk Replacement

[GopherM]

Does anyone have any experience with the new method of replacing lumbar disks through the side (instead of the conventional abdominal or open back incisions)?

Doctor says one day hospital stay but I'm wondering what the recovery period and post-op pain is going to be like.

 

[Roman]

I've heard about the new procedure, but have no expirience with it. I'm sure that it will be fine, and I wish you a speedy recovery. I'd think the more invasive proceedure of the past, would have a longer healing time. Are you getting this done in Anne Arundle?

 

[GopherM]

I've heard about the new procedure, but have no expirience with it. I'm sure that it will be fine, and I wish you a speedy recovery. I'd think the more invasive proceedure of the past, would have a longer healing time. Are you getting this done in Anne Arundle?

It will be more to the middle of '14 when I have it done. Gotta go through some therapy first. The recommended surgeon operates at Georgetown University Hospital. I just like to have all the info I can up front, especially from anyone that may have been through it.

 

[glhs837]

Well, expecting that I'll need a new disc someday, I did some research on the replacement from the front, not the side. I have to do some looking, but I cant see how the side method would let them have the sort of access and alignment that the front does.


Just did a quick search, cant seem to find anything about side entry.......

 

[GopherM]

Well, expecting that I'll need a new disc someday, I did some research on the replacement from the front, not the side. I have to do some looking, but I cant see how the side method would let them have the sort of access and alignment that the front does.


Just did a quick search, cant seem to find anything about side entry.......

Here is the link to the surgeon that performs this new procedure of gong in through the side.

Dr. Seyed B. Kalantar, MD - Washington, DC - Orthopedic Surgery | Healthgrades.com

 

[glhs837]

http://www.aimisspine.com/en/surgical-technologies/total-disc-replacement/8


Okay, think this might be it, no time to evaluate it yet.........

 

[glhs837]

Okay, here's the deal. From what I'm reading, it does have potential, but right now, it's in the clinical trial phase, and is right now in an "investigational device" status. Meaning by going with this, you are part of the clinical trial for it. Did you doc mention this?

Not sure me any my spine are wanting to be part of a clinical study.

South Florida Spine Institute

XL TDR® Is an Investigational Device That May Be Right for You.
NuVasive® has developed a minimally disruptive surgical device called XL TDR for the treatment of DDD. Participants are now being enrolled in a clinical research study for this total disc replacement device. The study is intended to evaluate the device's safety and effectiveness.

What Is XL TDR?



XL TDR is a metallic prosthetic joint, or total disc replacement, that replaces a degenerative intervertebral disc. Like fusion, total disc replacement is designed to supplant the primary function of the disc – to maintain vertebral spacing to protect the nerves and spinal cord. Unlike fusion, though, total disc replacement seeks to maintain one of the secondary functions of the disc – providing motion in the spine. Once implanted between the vertebrae, XL TDR is designed to relieve pain and restore height while replicating the motion characteristics of an intact healthy disc.

Where Is the XL TDR Clinical Research Study Being Conducted?
There are clinical research study sites located nationwide. Read more about this clinical research study at Home - ClinicalTrials.gov. This multi-center clinical research study is a prospective, controlled trial designed to evaluate the safety and efficacy of XL TDR by comparing outcomes of patients with this device to literature-reported results of similar devices that have been approved by the FDA to treat disc degeneration.

 

[Gilligan]

When I had major back surgery back in 2010 (St. Joseph's in Baltimore), the surgeon would not recommend disk replacement, going instead with mechanical supports (Globus instrumentation) and vertebral fusions (2). The operation was an unqualified success.

His rationale for taking that approach was that he didn't consider the replacement disk technologies and methods suitably mature or reliable.

Four years ago....for what ever that is worth.

 

[glhs837]

When I had major back surgery back in 2010 (St. Joseph's in Baltimore), the surgeon would not recommend disk replacement, going instead with mechanical supports (Globus instrumentation) and vertebral fusions (2). The operation was an unqualified success.

His rationale for taking that approach was that he didn't consider the replacement disk technologies and methods suitably mature or reliable.

Four years ago....for what ever that is worth.

I'm hoping to make it another two or three years on my recent disc surgery, in which time I hop the disc replacement does just that. I really like the idea of replacing the joist, not just cutting away the rotten parts or sistering it, but wan to make sure it's a long term fix. TDR was only approved in 2008, I think. Not sure of what history it has overseas.

 

[Gilligan]

but wan to make sure it's a long term fix.

That's the good thing about fusions....they are very permanent.

I had 5 fusions in '81 (bad accident) and then two more in 2010 (more accidents). The second operation actually "fixed" some residual nerve issues left over from the first one; issues that adversely affected the operation of my left leg and included a heck of a lot of chronic pain. All better now.

 

[glhs837]

That's the good thing about fusions....they are very permanent.

I had 5 fusions in '81 (bad accident) and then two more in 2010 (more accidents). The second operation actually "fixed" some residual nerve issues left over from the first one; issues that adversely affected the operation of my left leg and included a heck of a lot of chronic pain. All better now.

What is the cost in flexibility lost?

 

[Gilligan]

What is the cost in flexibility lost?

Surprisingly little. With everything fused from S-all Ls- T11 (7 fusions total) I can still bend over and touch the floor. The motion is all in the hip joints.

 

[GopherM]

Good info...thanks to all.

I am starting therapy this week so I can forestall the surgery for as long as possible. I first herniated a disk in '88. Aside from the periodic back pain episodes that have actually gotten better, the main issue I am having now is numbness and discomfort in a foot. The doc thinks that building up my core muscles and strength will take some of the pressure off.

Primary ortho doc did not mention anything about clinical trials. He just said it was a new procedure with great success and that he was not qualified to perform it yet.

 

[glhs837]

Good info...thanks to all.

I am starting therapy this week so I can forestall the surgery for as long as possible. I first herniated a disk in '88. Aside from the periodic back pain episodes that have actually gotten better, the main issue I am having now is numbness and discomfort in a foot. The doc thinks that building up my core muscles and strength will take some of the pressure off.

Primary ortho doc did not mention anything about clinical trials. He just said it was a new procedure with great success and that he was not qualified to perform it yet.

Yep, one of the senior partners in Georgetown is part of the trial. Saw that in my search. I'm seeing Dr Zahir tomorrow for a follow up, I'll quiz him.


https://www.doximity.com/pub/faheem-sandhu-md

Actually, when you go to the clinic.gov site, says trial end prelim information date was last year for I imagine stuff like hospital stay, initial follow ups. But no results have been posted. And no dates have been given for when any data will be released.


XL TDR® eXtreme Lateral Total Disc Replacement for the Treatment of Lumbar Degenerative Disc Disease (DDD) - Tabular View - ClinicalTrials.gov

 

[GopherM]

Yep, one of the senior partners in Georgetown is part of the trial. Saw that in my search. I'm seeing Dr Zahir tomorrow for a follow up, I'll quiz him.


https://www.doximity.com/pub/faheem-sandhu-md

Actually, when you go to the clinic.gov site, says trial end prelim information date was last year for I imagine stuff like hospital stay, initial follow ups. But no results have been posted. And no dates have been given for when any data will be released.


XL TDR® eXtreme Lateral Total Disc Replacement for the Treatment of Lumbar Degenerative Disc Disease (DDD) - Tabular View - ClinicalTrials.gov

Dr. Zahir must be in favor of it because he is the one that referred me to Dr. kalantar. I will be visiting his office in early January for further evaluation. Doc Z was very excited about the method. Sounds like he must have gotten some sort of feedback on the procedure and results.

Post us back here after your visit with him.

 

[wunsent]

After 6 years of getting the run around by various doctors, my husband was finally referred to Dr. Dix at Maryland Brain and Spine in Annapolis. Dr. Dix was absolutely wonderful. He confirmed that my husband had a degenerative disk in his lower back that was also herniated. After trying shots for pain, he recommended surgery. It was long overdue. The surgery was done with two incisions on either side of his spine. The disk was replaced with cadaver bone particles and required a 3 day hospital stay. His recovery was amazing and we saw tremendous changes in him regularly. Nine to twelve month later, he was back to his normal self with minimal pain.

If you decide you need a second opinion or aren't sure about taking that was suggested, I highly recommend you see Dr. Dix.

 

[glhs837]

Dr. Zahir must be in favor of it because he is the one that referred me to Dr. kalantar. I will be visiting his office in early January for further evaluation. Doc Z was very excited about the method. Sounds like he must have gotten some sort of feedback on the procedure and results.

Post us back here after your visit with him.

Well, actually, he wasn't aware of it. Told me that I'm not a candidate for any TDR, since I just have a damaged disc, not a degenerative one. Good news is he cleared me for PT, and now I can start working out as long as I am wary of compression loads on the spine.