Waiting... and research

So after the cortisone shot has had time to kick in a bit, I'm feeling a little better.  I still get woken up in the middle of the night when I accidentally roll onto my side which seems to cause something to press into the nerves and I'm usually sore in the mornings unless I happen to sleep perfectly on my back without shifting in my sleep, which almost never happens.  But with ice and medication, I'm usually at a tolerable level by mid afternoon if I just lay down all morning while I work.  Sitting is still a mixed bag.  Sometimes it seems I can sit for maybe up to an hour, and other times, less.  I think it depends on where the disc fragment happens to be at as I think it moves around a bit.  The waiting and waiting seems endless at times.  It has been nearly a month since I re-herniated my disc and I'm anxious to get back on the road to recovery, which will probably require more surgery and a long recovery.

I'm just convinced that my disc is shot.  The latest MRI shows that it is darkening more and more, which means that it is drying out and degenerating.  Over time, the disc will most likely loose height and cause the vertebrate to get too close to each other and will eventually pinch the nerves going down my leg.  This is what is known as degenerative disc disease (DDD).  Right now my disc height is still ok, but over time, will most likely cause me problems again.  This is in addition to the risks of continuing to re-herniate disc fragments due to the large tear in the back of my disc which has refused to heal properly, which has already happened.  My disc has proven 3 times now (internal tear, first herniation, and second herniation post surgery) that it does not want to heal properly on its own and I think it's time to accept that and move towards getting it out of my body so I don't have to keep facing these issues over and over like I'm starting to now.

I'm hoping to get the ball rolling towards artificial disc replacement (ADR) at my next appt. with my surgeon on Thursday.  I know it will probably take at least a month and maybe even more to get all the arrangements, consultations, etc. made and that is assuming that everyone agrees and there aren't any more curveballs like finding out for some reason I'm not a candidate.  From all the research I've done on my own, I think I should be a good candidate (single disc level, good health, no bone weakening issues, no other back problems besides the disc), but that is just my University of Google medical degree talking.  After the surgery, they usually say it takes at least 6 weeks for the bone to fuse to the disc to ensure it stays in place and another 6 weeks before the bone is solid, and can take 9 months for nerves to completely settle down since they may be slightly stretched due to the change in disc height that can occur when the artificial disc is implanted.

So in the meantime, I've been doing more and more research to make sure that this would be the best option for me.  A lot of people ask me, "Why can't you get something done here?"  Well, they do perform some disc replacement operations in the US, although it hasn't been done here that long.  Unfortunately, most of the discs they use here are ball and socket designs such as the Maverick, or a slight variation with a plastic core like the ProDisc.  These artificial discs do not provide any shock absorption at all, which is one of the main functions of your discs.  Without any shock absorption, the other discs are forced to take the extra force and can lead to faster degeneration of the other disc levels (this is also a risk of spinal fusion surgeries).  Also, the ball and socket type discs do not provide any resistance when twisting like a normal disc does.  This can lead to problems with the facet joints since they can get overextended and damaged by the unnatural range of motion and lack of resistance.  My surgeon said that he has had a number of patients with the Maverick ball and socket disc and most have done very well.  The simple design of the Maverick is attractive in its simplicity, but since I am so young and want to keep the rest of my back as healthy as possible for as long as possible, the obvious known design issues make this not a good option for me.  Also, the two parts of the disc are not mechanically joined together by any means other than the natural pressure of spinal bones which makes me a bit nervous.

The disc I'm looking at is called the Spinal Kinetics M6-L developed by the Spinal Kinetics company based in the US.  It has a polymer core and woven fiber annulus that provide shock absorption, graded resistance when twisting, and movement in all 6 planes of motion.  My surgeon agreed that it most closely mimics the natural spinal disc closer than any other artificial disc in existence.  More than 10,000 of them have been implanted as of March of this year, the vast majority of which have been in Europe.  There are no obvious design flaws that have been called out other than the unknown performance of the polymers in the lumbar spine over the life of the patient.  No significant flaws were found during testing where they simulated heavy loads far beyond what the disc would experience in the human body while being immersed in a solution which mimics the environment in the body.  I haven't been able to find a single report of a failure of the materials yet in all my hours and hours of research of the M6, however, they have not had many years to prove themselves, so there are no guarantees on what will happen over time.

I have been continuing to follow a blog of a 25 year old guy who had an M6-L implanted.  He has kept a very informative blog including all of his research and consultations with his various doctors about their opinions and experience on the different discs.  I have a link to it on the right and would suggest anyone considering an ADR, to read his blog and pay close attention to the links he has to the M6 testing data.  His results so far have been much much better than the results I had with a discectomy (even before I reherniated).  I do realize however, that this does not guarantee I would have the same results if I had an ADR.

I have also been doing lots of reading of a few online communities devoted specifically to ADR surgeries where I can read personal experiences of hundreds of people who have had different discs with different doctors.  My research has almost become like a second job and I usually spend several hours a night searching and reading as much as I can.  I think at some point though, you can do too much research, and you are left to realize that there are no sure things.  But I guess I get comfort out of knowing as much as I can ahead of time so that I at least feel like I'm making the best possible decision based on all the information available since this will most likely affect me for the rest of my life.