Artificial Disc Replacement Anonymous

Hello From The New Mechanical Me In Germany !!!

Since we keep getting requests from friends for more detailed information about my surgery (most not familiar with or have even heard of arthroplasty/artificial disc replacement) I have decided to write a summary I can share along with my progress report 7 days post-op:

On Monday, November 30, Dr. Rudolph Bertagnoli performed a two-level lumbar ADR (artificial disc replacement) surgery to fix my severely deteriorated lumbar discs (I’ve suffered with pain from lumbar disc issues for 15 years—and have been bedridden from painful lumbar events for the past 8 months).

I am happy to report the surgery was a complete success, with post-op Xray confirming correct placement of both Pro-DiscL devices. This surgery was anterior approach through a 4-inch vertical incision to the left of and below my belly button, moving all muscles and organs aside to access my spine from the front. YIKES! This is why it is such a serious surgery. It was amazing to awaken with zero of the original back pain I’ve had since 1995--and to be able to walk with none of the old back pain one day after the surgery. There will be new/different pain as I heal--muscles that must adjust to the new spacing from the new discs; facet joints of the spine that will be forced to work after years of limited motion. Over time these issues will resolve. Since I'm not yet walking much to activate those muscles and facets, so far this week the only pain is from my very angry organs that did NOT appreciate being shoved around, and now must heal! However, the tenderness and swelling is already diminishing, and I am off almost all pain drugs except Ibuprofen--cool, huh?

Dr. Bertagnoli reported that he found absolutely no disc material left between the vertebrae at the lowest level (L5-S-1) and the next disc almost entirely gone. This means that my vertebrae were literally crushed together, rubbing bone on bone. Since there are many pain sensors in that area, no wonder the excruciating pain. It was clear the only solution at this point was installation of two new mechanical discs.

Dr. B also found my vertebrae very porous at these levels (low bone density from lack of weight-bearing exercise over recent years as back pain precluded it). We also chose Bertagnoli for his pioneering technique using vertebroplasty in conjunction with ADR to handle poor bone density. He injects a ceramic cement into the porous areas of the spinal vertebrae, returning their strength to almost normal--so they can withstand the force of the new mechanical discs being literally pounded into them (and minimize risk of fracture of the vertebrae, a risk even normally strong bones have with such a procedure).

So, now I must be very careful, slowing increasing my walking (weight-bearing) exercise over the next months--to allow my body to once again rebuild the natural bone density in these areas. The body is an amazing healing machine. Bone is dynamic, being produced, broken down, and reproduced over and over. So there is real hope I can rebuild the density. I also have a back brace to wear for the next 12 weeks as I carefully resume normal movement. The brace protects me from myself, limiting twisting and torsion, reminding me not to make stupid moves while the discs seat in the bone. By the end of February I hope to have resumed normal daily activities--but still plan to be very careful until the end of 2010. I don’t want to compromise any of Dr. Bertagnoli’s incredible work.

So the miracle has happened--Dr. Bertagnoli has literally given my life back. I am truly blessed to have access to surgery by the finest spine surgeon in the world.

I was released from St. Elizabeth’s hospital Monday, December 7 (seventh day post-op). We appreciated the fact that the doctors and nurses committed to a very a high standard of care. They base hospital release dates on the condition of the patient—erring on the side of more time vs. less. We were actually reluctant to leave the very profession and kind nursing staff. We felt rather bereft when we found ourselves alone back in our lovely Theresientor Hotel! The town square is now filled with Christmas decorations and all kinds of booths for the holiday season. I hope to be able to take a few strolls at least before returning to Palo Alto on December 16.

We just looked up Straubing on Wikipedia and were fascinated to learn it has been a settlement since Neolithic times--that's a long time!!! It was occupied and ruled by the Roman Empire for 400 years. Apparently there are some small museums with artifacts from various eras--I would love to get a glimpse, but not certain my back will be well enough for such excursions. If not, I will do my best to force David to do some touring for me!

David has already had time to do some long walks around town, and along the Danube river nearby. Everyone here has been so very gracious and friendly--more than we even hoped. We have a driver (Peter Hoch) who is connected to the Pro-Spine surgery group. Peter speaks English very well, and has been arranged like our personal chauffeur to pick us up from the Munich airport, drive us to our hotel in Straubing (1 hour away) and settle us in; take us to and from various appts; and will eventually return us to the airport to head home. It's wonderful not to have to research, figure out and negotiate all of this when mobility is still so difficult for me--really takes the stress out of traveling in a foreign country.

We have a few days to try out a few more wonderful restaurants and take some short walks before my final Pro-Spine appointment. We return to San Francisco on December 16th and will have much to celebrate and be grateful for this holiday season.

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