I'm not a doctor, but I've done a lot of research on this. I think the technology for disc replacement is not advanced enough. There is a disc called the Axiomed Freedom disc that may be promising but it's not FDA approved yet. Most designs now don't have shock-absorbing capability so they don't mimic a normal disc. I imagine this can still lead to adjacent segment disease even without a fusion.Some discs can also move from their original location which is obviously bad because doctors probably won't want to do a revision because of the scar tissue. Some discs can also cause osteolysis which means the bone near the disc dies. Also the anterior approach has it's own risks no matter which disk you use. In men this can lead to sexual dysfunction. The artificial discs seem to work best in 1 level replacements although it has been done in 2 levels. More than two levels you're pretty much getting a fusion. Whether it's a fusion or a disc replacement, it's a major invasive surgery and both have risks.
Great video, I like the idea that you ask why or how it happened, I've long thought my cervical spine was damaged after a motorbike accident but who really knows.
Good analysis, Doctor. Kinda common sense BUT I haven't heard it elsewhere! You have made an impression on me to 'drive carefully' on the rest of my discs for the remainder of my lifetime. I suppose that means no more extreme ski-jumping etc lol...but that was in my younger days anyway. I will indeed treat my body as far more mortal now. I am looking forward to being with my Lord Yeshua in the next realm, BUT... I'd prefer to be in less pain before I make my exit! :)
Praise the Lord brother. Im also looking forward to being with Him , the King of glory. Im going for a c5c6 fusion in a few months unless God heals me beforehand. We serve a mighty God and anything is possible.
Yes me too I have 3 2.5 mm herniated discs and two facet diseases im so scared I want pain free life before I exit to lord Yeshua im in pain in lower back left side 🙏
Do you have an updated video for 2021 on the artificial disc replacement surgery? My doctor is recommending this surgery and I'm not if I should do it.
In 1997 after an accident in my car ,I was told I had degenative disk disease in my neck. I got therapy at the VA hospital later I got shots for pain. Had problems with my arms shoulders and hands. Took EMG, MRIs ,everything, steroids the whole nine. I was a truck driver for 16 1/2 years. To make a long story short, Jan. 2014, I had a Anterior Cervical Diskectomy & Fusion, c3-C4, C4-C5, C5-C6. In other words I've got 3 artificial disks, a titanium plate (cage) & 8 screws in my neck. The operation was good. but I an now in cronic pain in my neck, not the pains I had before. I did short term & long term disability, my job had to let me go. My doc. informed me I may need another one in 1 or 2 years, I've got 2 more that are going bad below the 3 that were fused. The whole operation took 3 1/2 hours, once inside things were worst then they thought. In 17 yrs. 1 disk spread to 3 that went " BAD ". I waited as long as I could dealing with the pain and all, I was really bad off. I got depressed, still dealing with depression. I now take 2 pills for my depression, 1 pill for my heart a bars blocker to slow my heart down, 2 pills for blood pressure, 1 pull for muscle spasms, I also take Hydrocodon 3 or 4 times a day. I've gain a little wieght, I went from 180 to 195, I'm not as active as I once was. I can't work, I'm 59, I'm on SSDI, social security disability, so my whole life changed. If you need them to cut you, get at least 3 opinions, that's what I did, I just pray no one ends up like me. I fell in that 25% where you may have other issues, I still have tingling in my hands and arms, they both still get a little numb. But none of it along with the pain is near what it was. The cervical (neck) is a better operation then the back, there's not as many problems. Like I said I happen to fall in the % that happen to have the problems that I did. GOOD LUCK GUYS and have a blessed day.
Ismael Al-Hakeem Rasul. Thanks for your comment. I have had the same surgeries that you've had. In general, my pain is a lot less than it was, but the surgeries never seem to end. I've had 4 back surgeries that started in 2009 after an injury at a store. Next month they want to do 2 more on my neck and then 6 weeks later, they will have to do one more on my lumbar spine to stop the pain in my lower back, knees, legs and feet. My whole cervical and lumbar spine will be fused. The surgeons knew this would happen when they did the first surgery, but they said nothing to me about this. I'm on SSD and was on medication for depression because of the pain, also. I stopped taking the depression medication because I didn't like the side-effects. I feel better since I stopped taking it. I'm 63 and my surgeries started when I was 57. Ask your pain management to give you the fentanyl patch. It's helped lessen my pain. I still take the hydrocodone, too. I just wonder what's next, after all the disc have been fused. Do they fuse the thoracic disc?
Brother i really feel for you. Im believing in miracles. Jesus is the healer. I too am in s compromised way with my spine. Life changing to say the least.
hello Sir. I fully understand you.. my back surgery went wrong big time. loss the use of my left leg. 75 percent. bowel bladder issues. the pain in so much worse. in total disability now. thank God for my dog. you found out who your true friends family are.. in pain 24 7..now no Doctors will give me the time of day... God bless everyone here.. Amen..
12 yrs ago would make this video, 2011-2012. I'm sure things have changed in 12 yrs. I have an appt on the 14th to see what treatments are available to me regarding issues at the L5- S1. hopefully this is an option. But 10-12 yrs. of disk herniation may restrict my options but fusions is definitely not one. I'm looking for the least amount of hardware. It all depends on my film etc.
Have you heard of Enande in Germany? My wife has a badly herniated disc on L5-S1 or L4-L5, I can't remember. But we heard of Dr. Ritter Lang at Enande/Stenum in Germany and they have many many good testimonials. We are tentatively planning on getting a disc replacement in April. th-cam.com/video/rjOa05G28ZU/w-d-xo.html
Update: Watching this really scared me before I decided to do a lumbar hybrid: L5-S1 alif and 4-5 adr (active L artificial disc). I was worried about the scar tissue, iliac veins, not being able to revise etc. But 2.5 years post op all has worked out well for me. I did have a synovial cyst which surgeon did leave behind at L5-s1 (as it was embedded in my spinal cord). That cyst was a major problem for over a decade (couldn't stand or walk very long) and for two years post op it was causing even more pain, until it finally ruptured a few months ago in feb and at that point I had a new back. 42 now, surgery at 39, after two microdiscectomys in my late 20s early 30s. I'm glad I did this hybrid alif/adr surgery. It was a long road to recovery, but I feel i've been given a new life. I can carry a hand basket in the grocery store, I might actually be able to pick up a grand child someday. For 16 years of my life i endured and was limited by significant back pain that left me physically impaired, which perhaps inadvertently preserved the uninjured portion of my back for this new chapter. I waited to do a fusion out of fear and also I wanted the science to develop as much as possible with adr in mind. I would do it again, but if it were now, I might wait for the Axiomed lumbar adr to be fda approved which seems imminent - it has a spongy nucleus, more shock absorbing. Guess I will do that at 3-4 if I ever need to. Still feel good going with Active L over prodisc at l4-5. My l5-s1 alif is a spineart Scarlet
Thank you for sharing your story with us! Highly appreciated and glad your hybrid worked out for you. May I ask who did your surgery? I myself am waiting patiently for the Axiomed Freedom Disc but it just keeps getting delayed year after after 😢. I've considered fusion on my L4-L5 over ADR but I mentally bounce back and forth between the two. I have a semi-physical job and I'm si scared of losing my job over ADR. How is your lower back pain before vs now now?
There's already laboratory created discs successfully implanted and working...on goats. We need to speed up the process of making it possible in humans
I'd love an update to your video, given more time on these implants. Thank you for the time you've taken to do this. I need a two level fusion or replacement in my C-spine. I wish I had a time machine to try both. Another thing I'd like is an opinion on all the disc replacement options nowadays.
Well I had the Freedom Lumbar disc replace 11 months ago and have pain in both legs now. More activity, more pain. I wish I never had it done!! Think real hard before you have this done! They will not remove the disc , you are stuck for live with it! And no Doctors with see you after you have this done.
Is that the Axiomed disc? Where did you have it done? I thought it wasn’t approved in the United States yet. I’ve been doing research on the Axiomed disc vs LP-ESP in Germany and haven’t found much on the Axiomed disc. I thought it looked promising. Do you know why you have so much pain?
I know it’s been ten years since this video has been made, having said that, has there been any advancements in disk replacement? I’m asking because I know that in Europe, spine surgeons use the LP-ESP, which is a visco-elastic disk that’s more rigid and simulates more the mechanics of a normal disc. Does your practice offer the LP-ESP? If not, why not? Thank you
@@sarajah4him I believe the one that has had more failures in the lumbar region has been the M6-L but it’s been a while since I’ve done any research on it
unfortunately it still sounds like even for young people like myself that lumbar disc problems can really only be partially fixed by a fusion which leads myself as an avid grappler and someone who depends on flexibility for their job just how badly crippled you end up after a fusion lets say l5-s1 will you ever bend again or should you just go out and pre order a wheelchair and say its been a good run
I have had 2 surgeries L5/S1 in the past 11. I have many of the issues mentioned by others such as stenosis, spurs, muscle atrophy, arthritis DDD herniated disks and the like and the list goes on. I have maintained physical therapy, chiropractic care, spinal injections, steroidal treatments and pain management tactics to no avail. Now my disk has disintegrated and left my L4/L5 bone on bone with nerve root impingement. I have mortifying pain that radiates from my lower back through my buttocks, hip and down my right leg. My leg is heavy and extremely week and once again I have a pronounce limp and often have to walk with a cane. I am only 43. I now have to prepare for the TLIF because it would appear that the nerve or a nerve that assists in controlling the bladder and bowel is having issues as I am pretty close to having no control over either. I suppose there are good and bad to every surgical procedure and it is best to avoid having them if possible as we do not know the success rate by guarantee. Everyone's body is different and will respond and heal as their genetic code instructs it to, I hope this helps for myself and certainly hope that all of you feel better and get well soon :) Wish me luck and the best of luck to all of you
+Laura Richards I know this is way late but good luck and I have said a prayer for you, I hope it worked out. I have experienced some of the pain and loss of control you have described and would not wish that on my worst enemy my heart goes out to you. I will be going through surgery on my cervical tomorrow, have been lucky so far with my L4-L5 injury of 10 yrs ago just a few flair ups and with PT I have managed to get by. Let us know how ya are.
@@davidmarcade9356 Hello there im scheduled for L4&5 fusion on Nov-8-22 im more confused now seeing what most people say about it but please tell me how are you doing after all this time you've had surgery thanks.
My question is: If the person who has nothing wrong with levels above L5-S1. Could they get a fusion of L5-S1 and not have any future problems? Just like you are saying that the disc replacement with healthy levels above or below could expect no future problems above and below?
Thank you, very good explanation. Except that Shocks and struts do the same thing, comparison would be the cars springs, and shocks/struts, with out shocks/struts the wheels and body of the car bounce uncontrolled.. This was good for me to find, my spinal surgeon basically said the same thing regarding candidacy for disk replacement, Im looking at a C5-6 Disk Replacement (Prodisk-C) as I am 44 and we can take my disk injury back about 20 years ago with having Whiplash 3 times within a 8 year period, and all the headbanging in the 80's probably did not help ether. Waiting now on Insurance to approve then I get upgraded. Thanks again for posting.
The vein along lumbar spine not moving is an anecdotal conclusion. Just saw ADR replacement/corrective disc surgery in which they took out the failing g disc.
Dr. Aslie, do you still believe Fusion for L5/S1 is better over Disc Replacement for a 33 year old male? I am scheduled for Fusion this November but am wondering about the Replacement. You were my doctor about 4 years ago. -Braden Roberts
Some Artificial discs have shock absorbers built in to them as well as retaining motion the Lp-esp disc is one of those. This information is incorrect and old. It should be removed as it can have a big influence on people’s decisions. Every back surgery is different from person to person and so are there symptoms so a generic overview like this is misleading. He should know better. Go to 3 surgeons for opinions then do research yourself to make the best decision to suit you and your lifestyle.
Great thoughtful vid, who would have thought to consider the cause of the disc issue informing the type of treatment, duh! I am wondering where the research is currently 9 years later? Considering L5 S1 replacement with prodisc L. Thoughts? Experience? should i go fusion? My disc issue is the result of injury wear and tear. also runs in family however if I didn't do to my body what I did, I am sure my back would be fine and pain free today at 40yrs old. have had two microdiscetomy left and right L5 S1 over the past 12 years.
Beautiful, succinct, and to the point! Doctor that was a great presentation! You saved me the misery of wondering and or regretting that my girl friend had a lumbar fusion! I can't thank you enough!
Dr. Ardavan. Thank you. You are the first doctor who expained on simply way to understand. I have fusin from L4-L5,L5-S1... . But stil a little herniated L 2 and L3. Im affraid problems will goes on uper segments. Ok.... now I underdtand, to be very carefuly, to prevent another herniations. . .. Fusion means to be a little hanecape, but it works. Thank You.
Dear Dr., I know you are a very busy surgeon and I understand if you cannot answer. I am a 32 y/o female who has 7 year old twins and a widdow. I hurt my back lifting some medical equipment at work. I am a rep in the OR. ( I do not work in spine). I work in general sx and Batiatrics. I have had a EMG, and a MRI. They both show moderate disk bulge central posterior left greater than right L5 and SI. The pain was holding steady for the past year at about a 4/10 with 800 mg ibuprofen 1-2 times a week. Over the 4th of July I went for a light jog and the next day I was in so much pain I had to go to the ER. I cannot to a SLR on the left past 30 deg hip flexion and cannot do a bridge or sit up on my own in bed without 9/10 pain. I cannot sleep or drive. I do not know what to do. I’m wondering what your thoughts are. It has been over a year since my date of injury.
I had a 2 level fusion can't remember exactly but was S1 to L5. Very traumatic experience. I see you like to use cars as an example. An engine mounting will be great, flexible but ridget.
Hello to all,has anyone had a resent L4&L5 fusion? what is it like? please tell me your experience..I'm scheduled for Nov-8 and not liking what most people are sayning but maybe old technology vs new are so different...anyone outhere plz coment,Blessings to all.Thanks.
I have degenerative disc disease, and 2 discs that I'm supposed to have replaced. The l4 l5 and l3 l4, they are bone-on-bone and the disks are pressing on the root nerve causing pain down the back of my legs and side of my legs. I've been in bed for about two years because I can barely walk. Now I'm afraid because I don't know what I should do with my situation. I'm in pain 24/7. I've been in a few car accidents back when I was 17 and a couple of 21 and one at 43. I'm 54 now. I am terrified because I don't know what to do.
Doctor thank you for bringing a perspective I had no awareness of regarding this issue. I have one lumbar disc that is completely bone on bone, very painful. Trauma related. Must have surgery. I also have cervical damage in 4 discs which is even worse with nerve compression. I have found a good surgeon but don't know what is the best route for me before giving him the go ahead. I am a teacher and a dancer. I want my life back. Surgery to be done in the next month or two. Please send message to facebook. Crystal Backmon
crystal backmon Wait till you get the answers u need. Your surgeon should be understanding. Do it when YOU r ready. I recently had total knee replacement on both knees. The metal was hard to get used to only when I could feel it, like when I would kneel. Other than that, you don't notice it at all. The types of materials changed over the years and have advanced dramatically. The doctors in-the-know use the 30 yr prosthetics instead of the 15 year ones. Research! Incidentally, I have a girlfriend in TX who had neck fusion and loved it. I also know of a patient who had the problem with the neighboring discs as described in this video. Difficult decision, I know. I have to say that PTherapy definitely has improved. My knee says so.
My name is Chris Rivas From the Alamo city San Antonio Texas I have severe spangles and noses I have had steroids Coflix Surgery Ipaduro None of these things have helped Now I have to have EMG They will find what they're looking for I know how much damage I have To my spine and my disk And doctor has told me also The only thing that is left is a decompression lunbar Laminectomy 😪😫 That is the only thing left Well there's a lot of medical things that they can do I've been looking at this during my pros and cons This is what I need to have some kind of life But my life will never be the same
Finally a doc that understand mechanics of the spine. The first few gens of the artificial discs had too much movement, every time a patient moved, the ADR would move first before all other discs causing facets to wear out. Plus like he said, if you have DDD, weather you do fusion or ADR, you will be in pain from other discs going bad
I had an injury at work,ended up months later having a fusion,it went great except for tingling and numbness in my left hand,mostly in the last three fingers,one doc said it as a pinched ulnar nerve in my left elbow,I had surgery for bones spurs in my right shoulder and the same doc says the tingling in my left hand was from the injury in my neck ..so he wants me to go back to the doc that did my fusion..on the papers I got he thinks I may possibly have polyneuropathy....so I am waiting on my Workmen's Comp case worker to set me up an app.,she took her time on getting me help in the first place when I got hurt at work,and I think it may have caused more damaged..waiting around (I reported it in November of 2013..,nobody would help,so I went to HR at work and immediately he got ma an app,but didn't have surgery until Feb of 2014)
I hsve been teaching disc replacement surgery for more than a decade. I have been a lead investigator in many clinical trials for total disc replacement. This a poor example of a surgeon, attempting to educate the pubic on a technique that requires talent and experience This is a step backwards in patient education and clinical trials,
With all do respect DR Janssen,I do perform this surgery. I do believe it is an addition to spine surgery. However, I don't believe the indications are as broad as we are told by surgeons who have financial connection to these companies. I am not a poor example of a surgeon. I have four original patents which are extremely hard to do these days.One of them laminar plating system, the only system in the world for osteoporotic spine. always been top of my class. double major in Berkeley.Did my spine training at harvard. However,I understand and accept how controversial this topic is.
Thanks for uploading this video.I am a 30 year old male.Injured in 2010, It took them over 2 and 1/2 years to approve surgery.I went with the disc-fusion on the L5S1.I went through the recovery stages & 7months out the pain was worse then before.They found that the L4,5 was now bad & 3months from that, the 3,4 went bad as well.I am now looking at more surgery & asking what well work best? I also was told by the NCS both legs are permanently damaged.It hurts to do anything&everything.Input PLZ
I had to listen to it a few times to understand it but if I did you are saying that disk replacement works best in patients that had a traumatic type of episode that “punctured” their “tire”, correct? And the other tires are fine and will continue to be fine, correct?
I wish I could like this 100 times. You're the first video I've found to answer some of my questions. I've been in several car accidents. My neck is the opposite of a healthy one in xray views. I could tell you all the exact places per the reports, but what for? I'm suppose to have neck fusion but I'm not convinced in doing it for the exact reasons you stated. So I've put it off and tried to live with it without treatment. My concern is my right arm pain for work purposes. I thought well of ProDisc until I started researching further. Dr. Light made it seem so perfect. But I think it will be years b4 they work out some of the probs. So now I'm not sure if PT is the way to go, or McKenzie method, or chiro, or what the hell.
I had a double fusion in my neck after a bad car accident C5 and C6 and all the pain in my arms armpits and chest is gone and I've never had any issues arise from that surgery!
@@grahamesmith9139 How long have you had the neck surgery? Still no pain? I too heard bad things happen after spinal fusion so I'd rather do stretches but lower back pain never subsides I now feel light groin pain after 1 year 4 months
this makes sense, what you are saying......nine years on and now with year 2020, have they advanced somewhat with safer method for disc replacement to lumbar area so that reversal can be an achieved ...?
the problem is scar tissue. For a disc replacement it has to go through the belly and past the iliac blood vessels. The risk is tearing these vessels during a revision. That’s why most doctors would just do a fusion if the disc replacement fails.
Hi Dr.I want to know how long the recovery is for a disc replacement. I'm sixty years old jumped off a military truck and injured my back. No surgery just pain meds and rest. My back has hirt off and on since. Good days bad days. In 2010 I was in a car accident which eventually caused me to have to have a hip replacement had that five years ago. My last x-ray showed that I have four bulging disc, Cauda Equina Syndrome, sciatica L2, L3, L4, L5 degenerative getting worse as the numbers get bigger. I'm to see a surgeon soon, but I definitely don't want to have a surgery that would take me a year to recover. Are there specifically new implants that are better than the first original implants and what is your suggestion, constantly lose bladder and bowel functions
thank you, informative. title should be changed because those of us that get fusion have the disk replaced with spacers and bone. The device you show looks like something I saw recently, Mobi-C . My neurosurgeon said I was too old for that. He wants to fuse 2/3 and 4/5 to relieve the pain,pinsand needles, numbness in my right shoulder and arm. I m going crazy, I have to decide soon.
How old are you? M6-C can be used in patients up to 75 yo in the current FDA study recruiting now. However needing surgery on more than a single level is an exclusion criterion. If you replaced a cervical disc rather than fused could it be at only a single level? There's the rub.
We DESPERATELY need to update the design of these replacements. The inside of a natural disc is like silicon rubber, and the outside is like a much tougher, fibrous plastic. Why don't we have a disc designed with two layers like the natural one?
@@DavidSain1 M-6 has a major design flaw where by the the core tends to displace because it is not well contrained (the woven mesh in M-6L is not strong enough to keep the core centered if you experience any instability in the segment). This was well mitigated by a different disc manufactured in France: LP-ESP. I just got one three months ago and riding my mountain bike like there is no tomorrow. Good luck!
Greetings Dr. Asli (per video verbal intro). * Question: Rather than utilizing a mechanical fixed disc replacement, why isn't a more realistic design used ? For example, a molded prosthetic resembling the same consistency of an actual disc made from a synthetic compound ? It would offer the same flexibility while also the same movement control of a natural disc. For example there currently is a material, "hydrogel" that has a gelatinous consistency. It is comprised of tiny glass pieces of fiber woven together into a fabric, binded together by hydrogel (contact lens material). This material yields a material that is both as flexible as jello and as durable as metal. Jian Ping Gong, professor at Hokkaido University can attest to the benefits of this existing innovation, and further explain detailed specifications associated with this hydrogel composition. This Hydrogel composite is certainly a game changer and must be seriously considered for disc replacement procedures as soon as possible. Even though the current mechanical disc mfg's will lobby hard against its acceptance, regardless influential proponents such as yourself Dr. Asli will be very instrumental toward advancing the improvement of disc surgery.
Great video. Been Reading a hole lot about spine surgery. Had a surgery l5 s1 for herniated disc No fusion or artficial disc. Just remove a partian of the disc the pressed against the nerv. I am plain handicapped after this. I live in sweden so sorry for My english. This dr feels like a good guy, My dr want even see me after the surgery. Feels like when you get these surgerys your stuck in a loop. Its sucks but Thats life sometimes. Happy new year byw
daddyp 4 years later, how is your back doing today? is it got any better since the L5-S1 surgery? reason i'm asking, i need to do the same procedure in my L5-S1. cheers.
Right. I have 1 femur longer from traction , 2 herniated l,4l5 , s1. And my fascia around my low back muscles have been destroyed. Finding a surgeon won't be easy.
Excellent video but is over 10 years old. Is there an update somewhere that may indicate if recommendation for disc replacements in the lumbar spine has changed or not? Is it still not recommended or has the technology and knowledge improved to the point where it may now be a recommended procedure? It is very important and any information would be greatly appreciated. Thank You
HELP HELP i got 3 times herniated surgery bud it come back efter 4-6 mont. the 4th surgery was fusion with scew and some bone cage. it help 60% but i have no stability can even take my shoes on. is possible to remove the fusion and make new M6L Lumbar surgey in replace????????
Thank you so much that’s really help me to understand. I am 51 years old my docter said I need two level fusion I need a second opinion do you think it will work for me or will the fusion be a problem later in life that I would need another surgery
I hope you did not do the spinal fusion. Please do not do a spinal fusion. I would definitely look into the artificial disc replacement. Please do not do a spinal fusion. I saw your comment was six months old .
This video is 10 years old! and way behind the current research. I also don't find his metaphors to be accurate. Do plenty of research and talk to people who have done both.
thank you very much to explain all so well. i have torax lumbar degenerative scoliosis and i am not sure about the fixation operation. pain is always there but worse is not beeing able to keep myself up , walking and simple homework. when is it time for doing such a severe operation?
Good video to proof my speculation. I got my spine fused because of trauma but my family members almost all have degenerative disc problem and they warn me about revisit surgery in the future
I have had 2 surgeries at the L3- L4 level. Both were microdecompressions. The 2nd surgery was about 2 months ago, but I'm experiencing a lot of numbness in my feet, and its getting worse. Yesterday my physician told me that disk replacement is not an option for me because I have mild case of spondylosthesis at that level, plus disk replacement doesn't work well at L3-L4. But I am a candidate for disk replacement at the levels above and below. What do you think?
ABDALLA AHMED MAHER dude don't get a fusion. It's a old method that's fatal. I have a fusion on my l5 and s1 its not a good look. Get a dics replacement u will still be motion and mobility. That's everything 🙅🏼♂️🙏🏻♥️🦋
The Spinal Kinetics M6L (Lumbar) has tension rotation properties to simulate a real human disc. Avoiding more facet amplified rotation Degeneration. The US still has not approved it yet. However, Europe’s CE medical listing exists for over ten years now. Just says FDA is slow.
Interesting...I'm 59 and 10 weeks in to multilevel cervical fusion from probably a auto accident where I had neck injury but went away in few weeks. Accident 16 years prior to surgery! Is fusion on someone my age the correct procedure...To late but still would like to know???
What if you have injury on cervical and lower lumbar disk due to an accident. I'm in treatment but it's been several months and it feels like about the same. I'm sleeping better but the pain is constant when I sit or lay down for a while. I just had an MRI done so I may have to do something else about this
Hello doctor, I have a damaged disk in my neck and I’ve seen a doctor who wants to do disk replacement, and my second opinion doctor is offering fusion just wondering which would be a better option for 40 years old. Thanks
So what kind of procedure for DDD of cervical c 3,4,5,6,7. due to trauma and aging. Walking weird off and on. Pinch nerve with certain movement in which my body goes numb. Problem turning head to the right, feel like disk goes out of alignment, then it straighten itself out when it feels like it. Fusion or replacement, or do nothing?
I already had a 3 leval fusion of 4,5,6,7disk.. now my spine above the fusion is going to be fused as well.. my question is does this operation involve the brain stem?
Thank you for this clear explanation of disk replacement and fusion. The difference between ddd or traumatic injury to disk . Would degenerative disk disease be hereditary factor from 🧬 ? If so how would patient proceed to preserve the healthy disks in spinal colum?
This video is extremely outdated. M6-L disc by Spinal Kinetics trumps everything this doc believes to knkw about artificial lumbar discs. Too bad FDA doesn't allow it in the US and you have to pay $40k out of pocket in Germany to get it installed. I am currently looking at that option. [EDIT: I ended up going with the LP-ESP disc instead of M-6L; I have seen several failures of M-6 and those scared me; Several good surgeons in Europe swear by the LP-ESP disc and prefer the design over M-6).
Adel Cervical is no problem in the US up to two levels, but for three you may need to go outside. Try Dr Cavel in Barcelona, Ritter-Lang or Biren Desai in Germany. Prof Rischke in Zurich is great, but rather expensive. All of these are great.
Artur Curyllo Thanks for your quick reply. I just suffer from the pain in my neck that does not go away. There are currently no hand tingling. I want to follow up with a trusted good doctor to avoid future surgery and improve this constant neck pain.
Adel Depending on the extent of the damage to the discs you may get away with a microdiscectomy in the neck. Stay careful afterwards amd you might be fine...but if your symtoms return after a microdiscectomy you might be better off with replacing the discs to artificial ones. I am not a doctor and cannot give medical advice but this is the trend I see.
ty doctor very informative, im strugling with that decision right now. not sure witch one to decide i have L3-L4 herniated, laminechtomy is no longer an option. i had that done 10 years ago.
You are real outstanding doctor who explain very clearly more than I went through 3 doctors . Thank you for this video and other video you also explain should we do fusion or not
Indeed great video and easy to understand..I has question, I had my back surgery due to degenerative disc between L5 and S1, and my spine surgeon had to put a inter laminar device which is a hard silicone block called INTRAspine manufactured by cousin brother. Before the surgery, the doctor giving some options either to do spine fusion, or INTRAspine, but also rejected for disk replacement for same reason you pointed out. So how do you categorized the interlaminar (there are few in the market, such as coflex ? I mean what is the patient experience after few years.
Thanks for this video. How do you like the M6-C, please, dear doctor? I Like the shock absorption profile mimicking nature's own. My main concern--other than being nervous about any artificial implant--is that metal so differs in properties from bone. Even with osseointegration, if a cervical metal disc is dislodged in oh, a car accident, e.g., couldn't it endanger the spinal cord quite a lot?
Good question. It is actually REALLY difficult to move the artificial disc between the vertebrae once it is there, even before the bone integration with the disc end plates. There is a lot of pressure between the vertebrae to crush a really hard nut (about 1000 lbs in the male lumbar spine; cervical has less lressure, but still enough to hold the disc tight). If you get into an accident so bad that the spinal cord is at risk of getting pinched, it will most likely be from a displaced vertebral body more than an artificial disc displacement. This is what I hqve vathered after a good year of research. I just got my LP-ESP in Germany at L5/S1 qnd love it! Playing sports like there is no tomorrow.
Did you get it with Dr. Desai? I also need the L5-S1 and as of now he seems like the best doctor and also the best disc. wow playing sports like no tomorrow that sounds good! I hope I will be a candidate, I do have moderate facet arthropathy at L4-5 and L5-S1. Did you feel like you got suspension in that disc? right now I feel like a old car that the shock absorbers have gone on. I would love to ride my horse again!
@@treelore5100 I went to Dr Schmitz in Dusseldorf. Same price as Desai (about $23k for one level) but Schmitz is a very talented and commited neurosurgeon. Both are good but Schmitz operates out of a private clinic so you are not risking the infection you might at a public hospital where Desai works. Each is good so I would send in your images to both. Feel free to email me for more information at curylloartur@yahoo.com. I am going to Tennessee to ride my dirtbike the week of Nov 26. I am 14 weeks out. I was riding my mountain bike at 5 weeks. You will be riding your horse again. Too bad most insurance doesn't want to cover this procedure abroad, but it was still best money ever spent.
:-) thank you! I copied your email address down so if you need to delete this you can (if you want). I may well email you some questions as I get nearer. Getting my MRI today. Next will be working on getting a bone density test. I had a look at Schmitz website and that private clinic sure looks like an upgrade! I am surprised he can keep the cost the same. I am going to think you had a good selection of hotels as it's in the city? I would think they will have very good high speed internet. He also looks to be a good age not too young or too old. I got happy tears reading you saying I will ride my horse again! as you know this is emotional and life changing if all goes well. I just went on facebook and joined the group just waiting for my application to be approved.
I traveled to Barcelona Spine Center in 2016 and had the Spinal Kinetics M6L lumbar implant and paid $26k and returned in 2018 for a double level cervical ESP discs and paid $35k. VERY happy.
Hi I am 34 and broke a bone in my lower back at the age of 11, after having kids i started experiencing lower back pain due to grade 2 spondylolisthesis at L5/S1 and have seen numerous doctors. Some say a fusion and some disk replacement, i am very confused and would like to get another opinion, please can you help? Nadia
Dr since it's 9 years later, how do you feel on lumbar disc replacement now?
Oh man, I just asked him a question and I see that’s it’s been two years and you have not gotten a reply…
I'm not a doctor, but I've done a lot of research on this. I think the technology for disc replacement is not advanced enough. There is a disc called the Axiomed Freedom disc that may be promising but it's not FDA approved yet. Most designs now don't have shock-absorbing capability so they don't mimic a normal disc. I imagine this can still lead to adjacent segment disease even without a fusion.Some discs can also move from their original location which is obviously bad because doctors probably won't want to do a revision because of the scar tissue. Some discs can also cause osteolysis which means the bone near the disc dies. Also the anterior approach has it's own risks no matter which disk you use. In men this can lead to sexual dysfunction. The artificial discs seem to work best in 1 level replacements although it has been done in 2 levels. More than two levels you're pretty much getting a fusion. Whether it's a fusion or a disc replacement, it's a major invasive surgery and both have risks.
Had my double disc replacement in Nov 2004 in JHB-SA(L4/5+L5/S1)(Had other fusions etc as well).
And ....... ????? What happened?
Great video, I like the idea that you ask why or how it happened, I've long thought my cervical spine was damaged after a motorbike accident but who really knows.
so? both ways are not good.. what we will do? my doctor suggested me dynamic stabilitation , more easy operation and less complications
Doctor I am 13 days post ACDF. I am still having, neck and shoulder and back pain.
Good analysis, Doctor. Kinda common sense BUT I haven't heard it elsewhere! You have made an impression on me to 'drive carefully' on the rest of my discs for the remainder of my lifetime. I suppose that means no more extreme ski-jumping etc lol...but that was in my younger days anyway. I will indeed treat my body as far more mortal now. I am looking forward to being with my Lord Yeshua in the next realm, BUT... I'd prefer to be in less pain before I make my exit! :)
Praise the Lord brother. Im also looking forward to being with Him , the King of glory. Im going for a c5c6 fusion in a few months unless God heals me beforehand. We serve a mighty God and anything is possible.
Yes me too I have 3 2.5 mm herniated discs and two facet diseases im so scared I want pain free life before I exit to lord Yeshua im in pain in lower back left side 🙏
remember this was ten years ago... the Drs today disagree
Thank you for the reminder this is 10 years ago. I will need to focus my research to more recent.👍
Y666666hhhj ka aa
Do you have an updated video for 2021 on the artificial disc replacement surgery? My doctor is recommending this surgery and I'm not if I should do it.
In 1997 after an accident in my car ,I was told I had degenative disk disease in my neck. I got therapy at the VA hospital later I got shots for pain. Had problems with my arms shoulders and hands. Took EMG, MRIs ,everything, steroids the whole nine. I was a truck driver for 16 1/2 years. To make a long story short, Jan. 2014, I had a Anterior Cervical Diskectomy & Fusion, c3-C4, C4-C5, C5-C6. In other words I've got 3 artificial disks, a titanium plate (cage) & 8 screws in my neck. The operation was good. but I an now in cronic pain in my neck, not the pains I had before. I did short term & long term disability, my job had to let me go. My doc. informed me I may need another one in 1 or 2 years, I've got 2 more that are going bad below the 3 that were fused. The whole operation took 3 1/2 hours, once inside things were worst then they thought. In 17 yrs. 1 disk spread to 3 that went " BAD ". I waited as long as I could dealing with the pain and all, I was really bad off. I got depressed, still dealing with depression. I now take 2 pills for my depression, 1 pill for my heart a bars blocker to slow my heart down, 2 pills for blood pressure, 1 pull for muscle spasms, I also take Hydrocodon 3 or 4 times a day. I've gain a little wieght, I went from 180 to 195, I'm not as active as I once was. I can't work, I'm 59, I'm on SSDI, social security disability, so my whole life changed. If you need them to cut you, get at least 3 opinions, that's what I did, I just pray no one ends up like me. I fell in that 25% where you may have other issues, I still have tingling in my hands and arms, they both still get a little numb. But none of it along with the pain is near what it was. The cervical (neck) is a better operation then the back, there's not as many problems. Like I said I happen to fall in the % that happen to have the problems that I did. GOOD LUCK GUYS and have a blessed day.
Ismael Al-Hakeem Rasul. Thanks for your comment. I have had the same surgeries that you've had. In general, my pain is a lot less than it was, but the surgeries never seem to end. I've had 4 back surgeries that started in 2009 after an injury at a store. Next month they want to do 2 more on my neck and then 6 weeks later, they will have to do one more on my lumbar spine to stop the pain in my lower back, knees, legs and feet. My whole cervical and lumbar spine will be fused. The surgeons knew this would happen when they did the first surgery, but they said nothing to me about this. I'm on SSD and was on medication for depression because of the pain, also. I stopped taking the depression medication because I didn't like the side-effects. I feel better since I stopped taking it. I'm 63 and my surgeries started when I was 57. Ask your pain management to give you the fentanyl patch. It's helped lessen my pain. I still take the hydrocodone, too. I just wonder what's next, after all the disc have been fused. Do they fuse the thoracic disc?
Get back to me I have similar problems
Brother we serve a mighty God. Find yourself a pentecostal church and go there for prayer. Jesus Heals. It must be a pentecostal church though
Brother i really feel for you. Im believing in miracles. Jesus is the healer. I too am in s compromised way with my spine. Life changing to say the least.
hello Sir. I fully understand you.. my back surgery went wrong big time. loss the use of my left leg. 75 percent. bowel bladder issues. the pain in so much worse. in total disability now. thank God for my dog. you found out who your true friends family are.. in pain 24 7..now no Doctors will give me the time of day... God bless everyone here.. Amen..
12 yrs ago would make this video, 2011-2012. I'm sure things have changed in 12 yrs. I have an appt on the 14th to see what treatments are available to me regarding issues at the L5- S1. hopefully this is an option. But 10-12 yrs. of disk herniation may restrict my options but fusions is definitely not one. I'm looking for the least amount of hardware. It all depends on my film etc.
Have you heard of Enande in Germany? My wife has a badly herniated disc on L5-S1 or L4-L5, I can't remember. But we heard of Dr. Ritter Lang at Enande/Stenum in Germany and they have many many good testimonials. We are tentatively planning on getting a disc replacement in April. th-cam.com/video/rjOa05G28ZU/w-d-xo.html
How'd your appointment go
Excellent video. Thank you for the detailed explanation.
yes im also a marine, and the v.a sugested fusion, I just dont know that is a scary, scary operation...
How did it go?
Update:
Watching this really scared me before I decided to do a lumbar hybrid: L5-S1 alif and 4-5 adr (active L artificial disc). I was worried about the scar tissue, iliac veins, not being able to revise etc. But 2.5 years post op all has worked out well for me.
I did have a synovial cyst which surgeon did leave behind at L5-s1 (as it was embedded in my spinal cord). That cyst was a major problem for over a decade (couldn't stand or walk very long) and for two years post op it was causing even more pain, until it finally ruptured a few months ago in feb and at that point I had a new back.
42 now, surgery at 39, after two microdiscectomys in my late 20s early 30s. I'm glad I did this hybrid alif/adr surgery. It was a long road to recovery, but I feel i've been given a new life. I can carry a hand basket in the grocery store, I might actually be able to pick up a grand child someday. For 16 years of my life i endured and was limited by significant back pain that left me physically impaired, which perhaps inadvertently preserved the uninjured portion of my back for this new chapter. I waited to do a fusion out of fear and also I wanted the science to develop as much as possible with adr in mind.
I would do it again, but if it were now, I might wait for the Axiomed lumbar adr to be fda approved which seems imminent - it has a spongy nucleus, more shock absorbing. Guess I will do that at 3-4 if I ever need to. Still feel good going with Active L over prodisc at l4-5. My l5-s1 alif is a spineart Scarlet
11 years the disc evolution
Thank you for sharing your story with us! Highly appreciated and glad your hybrid worked out for you. May I ask who did your surgery? I myself am waiting patiently for the Axiomed Freedom Disc but it just keeps getting delayed year after after 😢. I've considered fusion on my L4-L5 over ADR but I mentally bounce back and forth between the two. I have a semi-physical job and I'm si scared of losing my job over ADR. How is your lower back pain before vs now now?
There's already laboratory created discs successfully implanted and working...on goats. We need to speed up the process of making it possible in humans
Where can I find this info?
Not possible in 10 yrs
I'd love an update to your video, given more time on these implants. Thank you for the time you've taken to do this. I need a two level fusion or replacement in my C-spine. I wish I had a time machine to try both. Another thing I'd like is an opinion on all the disc replacement options nowadays.
look up Dr lanman. he said you can but im confused. he needs to update his video
Well I had the Freedom Lumbar disc replace 11 months ago and have pain in both legs now. More activity, more pain. I wish I never had it done!! Think real hard before
you have this done! They will not remove the disc , you are stuck for live with it!
And no Doctors with see you after you have this done.
Is that the Axiomed disc? Where did you have it done? I thought it wasn’t approved in the United States yet. I’ve been doing research on the Axiomed disc vs LP-ESP in Germany and haven’t found much on the Axiomed disc. I thought it looked promising. Do you know why you have so much pain?
Hi, does the lumbar disc replacement work with spondylothesis ?
I know it’s been ten years since this video has been made, having said that, has there been any advancements in disk replacement? I’m asking because I know that in Europe, spine surgeons use the LP-ESP, which is a visco-elastic disk that’s more rigid and simulates more the mechanics of a normal disc. Does your practice offer the LP-ESP? If not, why not? Thank you
my understanding is that currently disc replacements are far better and have better outcomes than fusions for 1 level and 2 level replacements
Is that the one that has been greatly failing , they didn't research it long enough now they have all these failed surgeries?
@@sarajah4him I believe the one that has had more failures in the lumbar region has been the M6-L but it’s been a while since I’ve done any research on it
ESP has unacceptable high rates of Osteolysis in male patients. A big fail if you ask me
unfortunately it still sounds like even for young people like myself that lumbar disc problems can really only be partially fixed by a fusion which leads myself as an avid grappler and someone who depends on flexibility for their job just how badly crippled you end up after a fusion lets say l5-s1 will you ever bend again or should you just go out and pre order a wheelchair and say its been a good run
I have had 2 surgeries L5/S1 in the past 11. I have many of the issues mentioned by others such as stenosis, spurs, muscle atrophy, arthritis DDD herniated disks and the like and the list goes on. I have maintained physical therapy, chiropractic care, spinal injections, steroidal treatments and pain management tactics to no avail. Now my disk has disintegrated and left my L4/L5 bone on bone with nerve root impingement. I have mortifying pain that radiates from my lower back through my buttocks, hip and down my right leg. My leg is heavy and extremely week and once again I have a pronounce limp and often have to walk with a cane. I am only 43. I now have to prepare for the TLIF because it would appear that the nerve or a nerve that assists in controlling the bladder and bowel is having issues as I am pretty close to having no control over either. I suppose there are good and bad to every surgical procedure and it is best to avoid having them if possible as we do not know the success rate by guarantee. Everyone's body is different and will respond and heal as their genetic code instructs it to, I hope this helps for myself and certainly hope that all of you feel better and get well soon :) Wish me luck and the best of luck to all of you
+Laura Richards
I know this is way late but good luck and I have said a prayer for you, I hope it worked out. I have experienced some of the pain and loss of control you have described and would not wish that on my worst enemy my heart goes out to you. I will be going through surgery on my cervical tomorrow, have been lucky so far with my L4-L5 injury of 10 yrs ago just a few flair ups and with PT I have managed to get by. Let us know how ya are.
How are you now?
@@davidmarcade9356 Hello there im scheduled for L4&5 fusion on Nov-8-22 im more confused now seeing what most people say about it but please tell me how are you doing after all this time you've had surgery thanks.
In other words there is no cure for my two worn lumbar discs ! This is terrible.
My question is: If the person who has nothing wrong with levels above L5-S1. Could they get a fusion of L5-S1 and not have any future problems? Just like you are saying that the disc replacement with healthy levels above or below could expect no future problems above and below?
Thank you, very good explanation. Except that Shocks and struts do the same thing, comparison would be the cars springs, and shocks/struts, with out shocks/struts the wheels and body of the car bounce uncontrolled..
This was good for me to find, my spinal surgeon basically said the same thing regarding candidacy for disk replacement, Im looking at a C5-6 Disk Replacement (Prodisk-C) as I am 44 and we can take my disk injury back about 20 years ago with having Whiplash 3 times within a 8 year period, and all the headbanging in the 80's probably did not help ether.
Waiting now on Insurance to approve then I get upgraded.
Thanks again for posting.
The vein along lumbar spine not moving is an anecdotal conclusion. Just saw ADR replacement/corrective disc surgery in which they took out the failing g disc.
Dr. Aslie, do you still believe Fusion for L5/S1 is better over Disc Replacement for a 33 year old male? I am scheduled for Fusion this November but am wondering about the Replacement. You were my doctor about 4 years ago.
-Braden Roberts
Thanks for the good explanation. It helps to see more objectively and to choose carefully.
This is 11 years old. Anything a little more recent?
Some Artificial discs have shock absorbers built in to them as well as retaining motion the Lp-esp disc is one of those. This information is incorrect and old. It should be removed as it can have a big influence on people’s decisions. Every back surgery is different from person to person and so are there symptoms so a generic overview like this is misleading. He should know better. Go to 3 surgeons for opinions then do research yourself to make the best decision to suit you and your lifestyle.
Great thoughtful vid, who would have thought to consider the cause of the disc issue informing the type of treatment, duh! I am wondering where the research is currently 9 years later? Considering L5 S1 replacement with prodisc L. Thoughts? Experience? should i go fusion? My disc issue is the result of injury wear and tear. also runs in family however if I didn't do to my body what I did, I am sure my back would be fine and pain free today at 40yrs old. have had two microdiscetomy left and right L5 S1 over the past 12 years.
Beautiful, succinct, and to the point! Doctor that was a great presentation! You saved me the misery of wondering and or regretting that my girl friend had a lumbar fusion! I can't thank you enough!
Dr. Ardavan. Thank you. You are the first doctor who expained on simply way to understand.
I have fusin from L4-L5,L5-S1... . But stil a little herniated L 2 and L3.
Im affraid problems will goes on uper segments. Ok.... now I underdtand, to be very carefuly, to prevent another herniations. . ..
Fusion means to be a little hanecape, but it works.
Thank You.
Dear Dr.,
I know you are a very busy surgeon and I understand if you cannot answer.
I am a 32 y/o female who has 7 year old twins and a widdow. I hurt my back lifting some medical equipment at work. I am a rep in the OR. ( I do not work in spine). I work in general sx and Batiatrics. I have had a EMG, and a MRI. They both show moderate disk bulge central posterior left greater than right L5 and SI. The pain was holding steady for the past year at about a 4/10 with 800 mg ibuprofen 1-2 times a week. Over the 4th of July I went for a light jog and the next day I was in so much pain I had to go to the ER. I cannot to a SLR on the left past 30 deg hip flexion and cannot do a bridge or sit up on my own in bed without 9/10 pain. I cannot sleep or drive. I do not know what to do. I’m wondering what your thoughts are. It has been over a year since my date of injury.
I had a 2 level fusion can't remember exactly but was S1 to L5. Very traumatic experience. I see you like to use cars as an example. An engine mounting will be great, flexible but ridget.
Hello to all,has anyone had a resent L4&L5 fusion? what is it like? please tell me your experience..I'm scheduled for Nov-8 and not liking what most people are sayning but maybe old technology vs new are so different...anyone outhere plz coment,Blessings to all.Thanks.
I have degenerative disc disease, and 2 discs that I'm supposed to have replaced. The l4 l5 and l3 l4, they are bone-on-bone and the disks are pressing on the root nerve causing pain down the back of my legs and side of my legs. I've been in bed for about two years because I can barely walk. Now I'm afraid because I don't know what I should do with my situation. I'm in pain 24/7. I've been in a few car accidents back when I was 17 and a couple of 21 and one at 43. I'm 54 now. I am terrified because I don't know what to do.
Doctor thank you for bringing a perspective I had no awareness of regarding this issue. I have one lumbar disc that is completely bone on bone, very painful. Trauma related. Must have surgery. I also have cervical damage in 4 discs which is even worse with nerve compression. I have found a good surgeon but don't know what is the best route for me before giving him the go ahead. I am a teacher and a dancer. I want my life back. Surgery to be done in the next month or two. Please send message to facebook. Crystal Backmon
The idea of metal in my neck frightens me. Isn't there a better material that can be used?
crystal backmon I am 52 and MRI shows narrowing of canal in the cervical but besides spurs, the bones themselves are of good density. Just FYI
crystal backmon Wait till you get the answers u need. Your surgeon should be understanding. Do it when YOU r ready. I recently had total knee replacement on both knees. The metal was hard to get used to only when I could feel it, like when I would kneel. Other than that, you don't notice it at all. The types of materials changed over the years and have advanced dramatically. The doctors in-the-know use the 30 yr prosthetics instead of the 15 year ones. Research! Incidentally, I have a girlfriend in TX who had neck fusion and loved it. I also know of a patient who had the problem with the neighboring discs as described in this video. Difficult decision, I know. I have to say that PTherapy definitely has improved. My knee says so.
My name is Chris Rivas From the Alamo city San Antonio Texas I have severe spangles and noses I have had steroids Coflix Surgery Ipaduro None of these things have helped Now I have to have EMG They will find what they're looking for I know how much damage I have To my spine and my disk And doctor has told me also The only thing that is left is a decompression lunbar
Laminectomy 😪😫 That is the only thing left Well there's a lot of medical things that they can do I've been looking at this during my pros and cons This is what I need to have some kind of life But my life will never be the same
Finally a doc that understand mechanics of the spine. The first few gens of the artificial discs had too much movement, every time a patient moved, the ADR would move first before all other discs causing facets to wear out. Plus like he said, if you have DDD, weather you do fusion or ADR, you will be in pain from other discs going bad
I had an injury at work,ended up months later having a fusion,it went great except for tingling and numbness in my left hand,mostly in the last three fingers,one doc said it as a pinched ulnar nerve in my left elbow,I had surgery for bones spurs in my right shoulder and the same doc says the tingling in my left hand was from the injury in my neck ..so he wants me to go back to the doc that did my fusion..on the papers I got he thinks I may possibly have polyneuropathy....so I am waiting on my Workmen's Comp case worker to set me up an app.,she took her time on getting me help in the first place when I got hurt at work,and I think it may have caused more damaged..waiting around (I reported it in November of 2013..,nobody would help,so I went to HR at work and immediately he got ma an app,but didn't have surgery until Feb of 2014)
I hsve been teaching disc replacement surgery for more than a decade. I have been a lead investigator in many clinical trials for total disc replacement. This a poor example of a surgeon, attempting to educate the pubic on a technique that requires talent and experience This is a step backwards in patient education and clinical trials,
With all do respect DR Janssen,I do perform this surgery. I do believe it is an addition to spine surgery. However, I don't believe the indications are as broad as we are told by surgeons who have financial connection to these companies. I am not a poor example of a surgeon. I have four original patents which are extremely hard to do these days.One of them laminar plating system, the only system in the world for osteoporotic spine. always been top of my class. double major in Berkeley.Did my spine training at harvard. However,I understand and accept how controversial this topic is.
ard a
I find his info.. to be to the point. And very helpful. Maybe u should take some lessons..
So since you disagree, what is your suggestion regarding these 2 choices of surgery?
Thanks for uploading this video.I am a 30 year old male.Injured in 2010, It took them over 2 and 1/2 years to approve surgery.I went with the disc-fusion on the L5S1.I went through the recovery stages & 7months out the pain was worse then before.They found that the L4,5 was now bad & 3months from that, the 3,4 went bad as well.I am now looking at more surgery & asking what well work best? I also was told by the NCS both legs are permanently damaged.It hurts to do anything&everything.Input PLZ
Schizoinsomnia how are you doing? Did you find answers? Really wish you are doing better.
I had to listen to it a few times to understand it but if I did you are saying that disk replacement works best in patients that had a traumatic type of episode that “punctured” their “tire”, correct? And the other tires are fine and will continue to be fine, correct?
I wish I could like this 100 times. You're the first video I've found to answer some of my questions. I've been in several car accidents. My neck is the opposite of a healthy one in xray views. I could tell you all the exact places per the reports, but what for? I'm suppose to have neck fusion but I'm not convinced in doing it for the exact reasons you stated. So I've put it off and tried to live with it without treatment. My concern is my right arm pain for work purposes. I thought well of ProDisc until I started researching further. Dr. Light made it seem so perfect. But I think it will be years b4 they work out some of the probs. So now I'm not sure if PT is the way to go, or McKenzie method, or chiro, or what the hell.
I had a double fusion in my neck after a bad car accident C5 and C6 and all the pain in my arms armpits and chest is gone and I've never had any issues arise from that surgery!
@@grahamesmith9139 How long have you had the neck surgery? Still no pain? I too heard bad things happen after spinal fusion so I'd rather do stretches but lower back pain never subsides I now feel light groin pain after 1 year 4 months
This video is 11 years old, have things changed at all with the disc replacement procedure?
this makes sense, what you are saying......nine years on and now with year 2020, have they advanced somewhat with safer method for disc replacement to lumbar area so that reversal can be an achieved ...?
the problem is scar tissue. For a disc replacement it has to go through the belly and past the iliac blood vessels. The risk is tearing these vessels during a revision. That’s why most doctors would just do a fusion if the disc replacement fails.
Hi Dr.I want to know how long the recovery is for a disc replacement. I'm sixty years old jumped off a military truck and injured my back. No surgery just pain meds and rest. My back has hirt off and on since. Good days bad days. In 2010 I was in a car accident which eventually caused me to have to have a hip replacement had that five years ago. My last x-ray showed that I have four bulging disc, Cauda Equina Syndrome, sciatica L2, L3, L4, L5 degenerative getting worse as the numbers get bigger. I'm to see a surgeon soon, but I definitely don't want to have a surgery that would take me a year to recover. Are there specifically new implants that are better than the first original implants and what is your suggestion, constantly lose bladder and bowel functions
Talk to text did not work out well for me lol
I had a 3 level fusion in 1996 . Can I use the artificial disc ?
any update for 2016 ?
thank you, informative. title should be changed because those of us that get fusion have the disk replaced with spacers and bone. The device you show looks like something I saw recently, Mobi-C . My neurosurgeon said I was too old for that. He wants to fuse 2/3 and 4/5 to relieve the pain,pinsand needles, numbness in my right shoulder and arm. I m going crazy, I have to decide soon.
How old are you? M6-C can be used in patients up to 75 yo in the current FDA study recruiting now. However needing surgery on more than a single level is an exclusion criterion. If you replaced a cervical disc rather than fused could it be at only a single level? There's the rub.
We DESPERATELY need to update the design of these replacements. The inside of a natural disc is like silicon rubber, and the outside is like a much tougher, fibrous plastic. Why don't we have a disc designed with two layers like the natural one?
Thanks, man.
@@DavidSain1 M-6 has a major design flaw where by the the core tends to displace because it is not well contrained (the woven mesh in M-6L is not strong enough to keep the core centered if you experience any instability in the segment). This was well mitigated by a different disc manufactured in France: LP-ESP. I just got one three months ago and riding my mountain bike like there is no tomorrow. Good luck!
Artur Curyllo where did you get this procedure done?
Do your research before you allow them to cut you, especially if it's your back , I had a cervical (neck) operation that took 3 1/2 hours!!!
I've had multiple surgeries and would change plans if I'd know better.
Ismael Al-Hakeem Rasul did something go wrong with your procedure?
@@lisandrovalentinmoralesjr1960 what happened to you and @ismael ? How are you guys doing?
Greetings Dr. Asli (per video verbal intro).
* Question: Rather than utilizing a mechanical fixed disc replacement, why isn't a more realistic design used ? For example, a molded prosthetic resembling the same consistency of an actual disc made from a synthetic compound ? It would offer the same flexibility while also the same movement control of a natural disc. For example there currently is a material, "hydrogel" that has a gelatinous consistency. It is comprised of tiny glass pieces of fiber woven together into a fabric, binded together by hydrogel (contact lens material). This material yields a material that is both as flexible as jello and as durable as metal. Jian Ping Gong, professor at Hokkaido University can attest to the benefits of this existing innovation, and further explain detailed specifications associated with this hydrogel composition. This Hydrogel composite is certainly a game changer and must be seriously considered for disc replacement procedures as soon as possible. Even though the current mechanical disc mfg's will lobby hard against its acceptance, regardless influential proponents such as yourself Dr. Asli will be very instrumental toward advancing the improvement of disc surgery.
axiomed L is about to be approved by fda has gel nucleus
Thanks Doctor for sharing such an excellent information !
Excellent, thanks
There are newer and more advanced prosthesis that are 💯 % reliable and durable.
Great video. Been Reading a hole lot about spine surgery. Had a surgery l5 s1 for herniated disc
No fusion or artficial disc. Just remove a partian of the disc the pressed against the nerv. I am plain handicapped after this.
I live in sweden so sorry for My english. This dr feels like a good guy, My dr want even see me after the surgery. Feels like when you get these surgerys your stuck in a loop. Its sucks but Thats life sometimes.
Happy new year byw
daddyp 4 years later, how is your back doing today? is it got any better since the L5-S1 surgery? reason i'm asking, i need to do the same procedure in my L5-S1. cheers.
Did the doctor mess up? How did it handicap you
It is Sept, 2022 wondering g how much improvement hS been done with the disc replacement?
I'm facing fusion in the lower lumbar
Ok looks like it will be surgery in the future 5 discus L2 through S1
This will be done at the VA Salt Lake and I am trying all kinds of therapy to prolong it.
Therefore.....
Right. I have 1 femur longer from traction , 2 herniated l,4l5 , s1. And my fascia around my low back muscles have been destroyed. Finding a surgeon won't be easy.
Excellent video but is over 10 years old. Is there an update somewhere that may indicate if recommendation for disc replacements in the lumbar spine has changed or not? Is it still not recommended or has the technology and knowledge improved to the point where it may now be a recommended procedure? It is very important and any information would be greatly appreciated. Thank You
Wow thank you for sharing your knowledge. Most doctors don’t even give any information just ask if your coming for surgery or not.
HELP HELP i got 3 times herniated surgery bud it come back efter 4-6 mont. the 4th surgery was fusion with scew and some bone cage. it help 60% but i have no stability can even take my shoes on. is possible to remove the fusion and make new M6L Lumbar surgey in replace????????
Thank you so much that’s really help me to understand. I am 51 years old my docter said I need two level fusion I need a second opinion do you think it will work for me or will the fusion be a problem later in life that I would need another surgery
I hope you did not do the spinal fusion. Please do not do a spinal fusion. I would definitely look into the artificial disc replacement. Please do not do a spinal fusion. I saw your comment was six months old .
George Harley Rider oh my why? I did already
@@lidiav6667 how's your spinal fusion?
@@lidiav6667 How are you doing nowadays?
@@armandogonzalez0814 I wanna know too
This video is 10 years old! and way behind the current research. I also don't find his metaphors to be accurate. Do plenty of research and talk to people who have done both.
thank you very much to explain all so well. i have torax lumbar degenerative scoliosis and i am not sure about the fixation operation. pain is always there but worse is not beeing able to keep myself up , walking and simple homework. when is it time for doing such a severe operation?
Good video to proof my speculation. I got my spine fused because of trauma but my family members almost all have degenerative disc problem and they warn me about revisit surgery in the future
I have had 2 surgeries at the L3- L4 level. Both were microdecompressions.
The 2nd surgery was about 2 months ago, but I'm experiencing a lot of numbness in my feet, and its getting worse. Yesterday my physician told me that disk replacement is not an option for me because I have mild case of spondylosthesis at that level, plus disk replacement doesn't work well at L3-L4.
But I am a candidate for disk replacement at the levels above and below.
What do you think?
ok so what do you think for the lumber surgery - fusion or replacement
plz tell me - i have herniated disc in l4 l5 s1
ABDALLA AHMED MAHER this comment is weird. Did you think he was psychic 🤣
ABDALLA AHMED MAHER dude don't get a fusion. It's a old method that's fatal. I have a fusion on my l5 and s1 its not a good look. Get a dics replacement u will still be motion and mobility. That's everything 🙅🏼♂️🙏🏻♥️🦋
@@devinramdihal8149 what does the fusion stop you from doing?
The Spinal Kinetics M6L (Lumbar) has tension rotation properties to simulate a real human disc. Avoiding more facet amplified rotation Degeneration. The US still has not approved it yet. However, Europe’s CE medical listing exists for over ten years now. Just says FDA is slow.
Interesting...I'm 59 and 10 weeks in to multilevel cervical fusion from probably a auto accident where I had neck injury but went away in few weeks. Accident 16 years prior to surgery! Is fusion on someone my age the correct procedure...To late but still would like to know???
Some doctor operate without any assessment or even a conversation which is unconscionable. Thanks for your explanation.
What if you have injury on cervical and lower lumbar disk due to an accident. I'm in treatment but it's been several months and it feels like about the same. I'm sleeping better but the pain is constant when I sit or lay down for a while. I just had an MRI done so I may have to do something else about this
Hello doctor,
I have a damaged disk in my neck and I’ve seen a doctor who wants to do disk replacement, and my second opinion doctor is offering fusion just wondering which would be a better option for 40 years old.
Thanks
DONT GET IT FUSED, GET ARTIFICIAL DISC....MOBI-C FOR CERVICAL...FOR LUMBAR YOU'RE SCREWED
Hi doc, Is surgery the only way for cervical disc bulging or any other treatment is there. Please let me know.
So what kind of procedure for DDD of cervical c 3,4,5,6,7. due to trauma and aging. Walking weird off and on. Pinch nerve with certain movement in which my body goes numb. Problem turning head to the right, feel like disk goes out of alignment, then it straighten itself out when it feels like it. Fusion or replacement, or do nothing?
Would these opinions hold true for surgery in the cervical area also? In 2021, how have things changed regarding ACDF vs. ADR?
Springs and shocks.
Shocks and struts, lol! But, he is VERY GOOD DOCTOR!
I already had a 3 leval fusion of 4,5,6,7disk.. now my spine above the fusion is going to be fused as well.. my question is does this operation involve the brain stem?
Thank you for this clear explanation of disk replacement and fusion. The difference between ddd or traumatic injury to disk .
Would degenerative disk disease be hereditary factor from 🧬 ? If so how would patient proceed to preserve the healthy disks in spinal colum?
This video is extremely outdated. M6-L disc by Spinal Kinetics trumps everything this doc believes to knkw about artificial lumbar discs. Too bad FDA doesn't allow it in the US and you have to pay $40k out of pocket in Germany to get it installed. I am currently looking at that option. [EDIT: I ended up going with the LP-ESP disc instead of M-6L; I have seen several failures of M-6 and those scared me; Several good surgeons in Europe swear by the LP-ESP disc and prefer the design over M-6).
Artur Curyllo; I am suffering from three cervical discs. what is the best clinic in Germany?
Adel Cervical is no problem in the US up to two levels, but for three you may need to go outside. Try Dr Cavel in Barcelona, Ritter-Lang or Biren Desai in Germany. Prof Rischke in Zurich is great, but rather expensive. All of these are great.
Artur Curyllo Thanks for your quick reply. I just suffer from the pain in my neck that does not go away. There are currently no hand tingling. I want to follow up with a trusted good doctor to avoid future surgery and improve this constant neck pain.
Adel Depending on the extent of the damage to the discs you may get away with a microdiscectomy in the neck. Stay careful afterwards amd you might be fine...but if your symtoms return after a microdiscectomy you might be better off with replacing the discs to artificial ones. I am not a doctor and cannot give medical advice but this is the trend I see.
Artur Curyllo What 2 levels are the acceptable 2 levels that you mentioned for the U.S. in your opinion?Please & thank you.
ty doctor very informative, im strugling with that decision right now. not sure witch one to decide i have L3-L4 herniated, laminechtomy is no longer an option. i had that done 10 years ago.
For a 57 year old patient with moderate to severe cervical spinal stenosis at C3-5 which surgery would you recommend?
Any updates in 2020? Is there any change or advancement regarding the artificial disc replacement vs fusion debate?
You are real outstanding doctor who explain very clearly more than I went through 3 doctors . Thank you for this video and other video you also explain should we do fusion or not
Indeed great video and easy to understand..I has question, I had my back surgery due to degenerative disc between L5 and S1, and my spine surgeon had to put a inter laminar device which is a hard silicone block called INTRAspine manufactured by cousin brother. Before the surgery, the doctor giving some options either to do spine fusion, or INTRAspine, but also rejected for disk replacement for same reason you pointed out. So how do you categorized the interlaminar (there are few in the market, such as coflex ? I mean what is the patient experience after few years.
Thanks for this video.
How do you like the M6-C, please, dear doctor? I Like the shock absorption profile mimicking nature's own.
My main concern--other than being nervous about any artificial implant--is that metal so differs in properties from bone. Even with osseointegration, if a cervical metal disc is dislodged in oh, a car accident, e.g., couldn't it endanger the spinal cord quite a lot?
Good question. It is actually REALLY difficult to move the artificial disc between the vertebrae once it is there, even before the bone integration with the disc end plates. There is a lot of pressure between the vertebrae to crush a really hard nut (about 1000 lbs in the male lumbar spine; cervical has less lressure, but still enough to hold the disc tight). If you get into an accident so bad that the spinal cord is at risk of getting pinched, it will most likely be from a displaced vertebral body more than an artificial disc displacement. This is what I hqve vathered after a good year of research. I just got my LP-ESP in Germany at L5/S1 qnd love it! Playing sports like there is no tomorrow.
Did you get it with Dr. Desai? I also need the L5-S1 and as of now he seems like the best doctor and also the best disc. wow playing sports like no tomorrow that sounds good! I hope I will be a candidate, I do have moderate facet arthropathy at L4-5 and L5-S1. Did you feel like you got suspension in that disc? right now I feel like a old car that the shock absorbers have gone on. I would love to ride my horse again!
@@treelore5100 I went to Dr Schmitz in Dusseldorf. Same price as Desai (about $23k for one level) but Schmitz is a very talented and commited neurosurgeon. Both are good but Schmitz operates out of a private clinic so you are not risking the infection you might at a public hospital where Desai works. Each is good so I would send in your images to both. Feel free to email me for more information at curylloartur@yahoo.com. I am going to Tennessee to ride my dirtbike the week of Nov 26. I am 14 weeks out. I was riding my mountain bike at 5 weeks. You will be riding your horse again. Too bad most insurance doesn't want to cover this procedure abroad, but it was still best money ever spent.
:-) thank you! I copied your email address down so if you need to delete this you can (if you want). I may well email you some questions as I get nearer. Getting my MRI today. Next will be working on getting a bone density test. I had a look at Schmitz website and that private clinic sure looks like an upgrade! I am surprised he can keep the cost the same. I am going to think you had a good selection of hotels as it's in the city? I would think they will have very good high speed internet. He also looks to be a good age not too young or too old. I got happy tears reading you saying I will ride my horse again! as you know this is emotional and life changing if all goes well. I just went on facebook and joined the group just waiting for my application to be approved.
@@arturcuryllo5832CRAZY!! I had Schmitz twice, 2 level lumbar 1 level cervical!! 💪
Can you do a video on the coflex device and can it be used in conjunction with a replacement to help with restriction?
Had a car accident 2018 C5 C6 doctor replaced it with a fusion I'm 40 years old
Thank you very much I really needed this information..
What about Coflex for lumbar degenerative discs?
I traveled to Barcelona Spine Center in 2016 and had the Spinal Kinetics M6L lumbar implant and paid $26k and returned in 2018 for a double level cervical ESP discs and paid $35k. VERY happy.
Awesome!!
How was your experience? Did they tell you the useful time of the prosthesis?
Thank you Doctor you have explained very well
i think he forgot talk about m6 disc replacement
Is disc replacement is better than fusion?
Hi
I am 34 and broke a bone in my lower back at the age of 11, after having kids i started experiencing lower back pain due to grade 2 spondylolisthesis at L5/S1 and have seen numerous doctors.
Some say a fusion and some disk replacement, i am very confused and would like to get another opinion, please can you help?
Nadia
Nadia van der Merwe Basson what did you end up doing after all? How are you feeling?
please an updated version of this video doctor
What do you think of the Freedom Lumbar Disc?
Do you take on out of state patients I am 26 and don’t want to have a three level lumbar intervertebral fusion of L4/L5/S1 if I can avoid it
How are you doing now?
I like how he uses gods name 🙏