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 ADR (disc prosthesis) 17 year worldwide experience |
Severe disc-degeneration: treatment with artificial disc-replacement (ADR)
Are you having difficulties accepting that you must 'learn to live` with your back- and leg pain? Have your working and social activities become limited? Have you already had a hernia operation without long term relieve? Perhaps your problem is nevertheless soluble with an Artificial Total Disc Replacement surgery.
To determine whether you need ADR, a perfect diagnosis remains the first crucial step. Your complaints and restrictions in daily life will determine whether a treatment is significant for you. There are several treatment modalities available at our clinic. |
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What is the cause of your pain?
Disc-degeneration can cause severe changeable intermittent low back-pain (with or without leg pain) that can restrict your daily life activities. Many patients with degenerative disc disease have had hernias (slipped disc) previously. Disc-generation is not always visible on an X-ray, but it is on an MRI. The question is, whether the deviations on the X-ray and the MRI are also the cause of your pain: patients without back pain can show considerable spine "degeneration". Others are suffering from severe back pain, whereas their X-ray appears quite normal. In other words, what you see is not always what you get, and X-ray or MRI findings unfortunately are not automatically the explanation of the cause of ones complaints.
However, if the MRI and X-ray’s strongly indicate that the degenerated disc is the source of your pain, then the solution is nearby. > read more
Treatment
When it has been thoroughly determined that a damaged disc is the cause of the constant back- and leg pain, then its only appears logical to think of a "renewal" or a "repair" of the painful damaged disc. The principle is always the same: the old remains of the disc have to be removed until the disc space is mostly emptied. The annular outer ring has to be preserved as much as possible. To prevent a collapse of the spine and to preserve the proper altitude disc height, it is necessary to replace the old disc (with bone, cage or a prosthesis artificial disc). A total artificial disc replacement (disc prosthesis) could be a useful substitute for one (or more) painful disc(s). |
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Animation ADR |
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Pictures ADR |
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The artificial disc replacement operation is carried out via the abdomen. During this operation the whole disc is removed, entering the disc through the annulus, which is preserved as much as possible. The disc will then be replaced with a mobile artificial disc. The prosthesis is nestled between the vertebrae, is immediately stable and conserves a more or less normal motion of the spinal segment. > read more |
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When are you a candidate for an artificial disc replacement?
A disc prosthesis is especially suitable for patients between 20 to 65 years with a clear symptomatic disc degeneration with constant back pain, also after previous hernia surgery. Possible preceding discographic pain provocation test (see diagnosis) should confirm whether the degenerated disc is really the cause of the pain.
A typical patient example:- Security employee, 38 year male
- Has already had a hernia operation at L4/L5 with temporary improvement only
- No indication for a new hernia operation or another decompression
- More than 6 years severe constant lower back pain
- Intermittent leg pain, but back pain dominates
- Pain scores back= 2 leg ri=9 leg le = 9 (0=bad; 10=pain free)
- Standing and sitting is very painful
- Can't work without pain
- Suffers from painful restrictions in activities daily life (ADL)
- Pain treatment doesn't help enough
- No nerve entrapment symptoms
- No indications for mental problems
- Doctor said: accept the pain
What is the diagnosis and treatment option for this patient?
Do you want to know if you're a candidate for a disc prosthesis yourself? Please fill in this questionnaire and attach your most recent spine X-Rays (scanned) and written MRI report. After receipt of the form and reports, doctor Zeegers, artificial disc specialist since 1989, will study your data and contact you within two weeks to discuss your treatment options.
What are the advantages of an artificial disc replacement?
Fusions are the standard treatment for unbearable chronic back pain. We believe that fusion (or spondylodesis) is only justified as second line of defense when the alternatives like abrasion (the sclerotic bone of the adjacent vertebra is abraded) or an artificial disc are ruled out. There are several reasons why we prefer the disc prosthesis over spondylodesis:- The disc prosthesis should keep the spinal segment mobile
- The natural alignment and disc height is repaired
- Good surgery results in > 85%
- Patient satisfaction perfect in 50% after artificial disc replacement (patient satisfaction only perfect in 5% of the patients after fusion)
- Degeneration of adjacent elements is hopefully prevented
- Walking without support is possible directly after the artificial disc-implantation surgery
- Fast recovery and fast pain reduction
- Fast rehabilitation with return to work within 2-6 weeks
- Every back operation has the risk of ongoing pain, but the risk of re-operation after a disc prosthesis operation is 50% less than with a fusion operation
- Much more perfect patients with ADR going back to heavy labour and heavy sports activities (this is seldom the case in fusion). source: Round Tables In Spine Surgery, Volume 1 o Number 4 o 2006, B. Conix, R. Hes, Middelheim, Antwerpen
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What is an Artificial Disc?
Doctor Zeegers nowadays uses the Active L disc prosthesis in the lumbar spine (lower back) and the Mobi C prosthesis in the neck.
The current generation disc prosthesis still contains two metal support plates with a plasmapore coating for optimal stability. In between the plates there is a mobile, protected, high quality polyethylene core. The current design of the new generation Active L disc prosthesis guarantees optimal protection of the polyethylene core. The more or less anatomical shape of the Active L implant assures a symmetrical positioning in the lumbar spine. This guarantees that the plastic core is not overloaded. The constant pressure between the vertebrae reassures that the prosthesis remains stable. The shape of the prosthesis and the bioactive rough surface of the metal plates guarantee extra primary fixation. |
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Lumbar spine prosthesis |
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Neck prosthesis |
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The history of the current generation artificial disc prostheses started in 1984 at the Charité hospital in Berlin. The implantation of an artificial disc is a demanding technique with a continuous evolution. The technique and the implants have been constantly improved. > read more |
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Drs. Zeegers, Disc Prosthesis Specialist |
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Who operates?
Drs. Willem Zeegers, Dutch orthopaedic spine surgeon, performs artificial disc replacement operations (ADR) at the Alpha Klinik since 2000. He already started with this motion preservation technique in 1989. Nowadays he has over 17 years world wide experience (> 1700 disc replacements, single and multi level procedures). It has been proven that experienced surgeons have better outcomes with artificial disc replacement (Orthopedics today: 2004;24:1). Due to constant improvements in surgical techniques and implants, success rates have reached approximately 85% or better. > read more
Are you considering a second opinion from Drs. Zeegers? Please complete this questionnaire and send, e-mail or attach your most recent spine X-ray along with a written MRI report to us. After receipt of the form and reports Drs. Zeegers will contact you within two weeks to discuss your history and your treatment options. This advice is free.
Further information on ADR and Drs. Zeegers also available at: www.wzeegers.com
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Brian's story after 1 level ADR |
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Patient experiences
Over the 17 years in which doctor Zeegers performed implantations
of artificial disc prosthesis, many patients who were treated described their experiences.
How their life was impaired by severe back pain and
how their life changed after the artificial disc prosthesis surgery
by doctor Zeegers.
>Read their stories. |
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Contact Helen Braun |
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Contact Helen Braun after 2 level ADR surgery
Helen Braun, from the UK, is also a former patient of Drs. Zeegers.
In may 2005 she had an ADR operation on level L4-5 and L5-S1.
If you have any questions about her experiences before and after this surgery,
please contact her:
hlesleybraun@gmail.com |
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contact Jodie Vaughn |
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Contact Jodie Vaughn after 3 level, Active L ADR surgery
Jodie Vaughn from Jonesboro, Arkansas, is also a former patient of Drs. Zeegers.
In august this year she had an Active L ADR operation on levels L5-S1, L4-L5 and L3-L4.
If you have any questions about her experiences before and after this surgery,
please contact her:
vaughnjodie@gmail.com |
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Mr. Zeegers and Mr. Perroni |
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Questions about the Mobi C prosthesis? Contact Mr Perroni after 1 level, Mobi C surgery
Mr. Perroni from Arkansas had a Mobi C ADR operation on level C5-6 in april 2007. If you have any questions about his experiences before and after this surgery, please contact:
sperroni1@hotmail.com
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Are there dangers to the disc prosthesis surgery?
In hands of an experienced artificial disc surgeon with the most modern implants: almost none.
The most attentive dangers of disc surgery are: insufficient relieve of pain (10-15%), deep vein thrombosis (1%), continuing irradiating pain (5%), facet joint degeneration in the long term (unknown %), bad positioning and subsidence mostly caused by poor bone quality (women> 45 year). read more
Why go to Munich for a disc prosthesis operation?
- In the specialized Alpha Klinik you get a detailed diagnosis of your back problems.
- Within one day, you’ll get a precise diagnosis and a suggested treatment option.
- Large experience of the surgeon, Drs. Zeegers, required for a successful disc prosthesis operation.
- A success percentage of over 85% for the disc prosthesis type Active L.
- Specialized training centre for a fast and optimal recovery. read more
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The post-operative treatment and rehabilitation process
Patients can leave the wake-up recovery room about two hours after surgery. In spite the post-operative pain they are free to walk immediately after surgery. Food intake is dependent on the bowel activity, usually being careful the first postoperative day only. We try to prevent thrombosis with low molecular weight heparin injections, starting direct before surgery, until discharge. Even if there are no symptoms of thrombosis, during the first days after surgery always a Doppler-sonography-test is performed to visualize the bloodstream in the veins at the legs and pelvis. After a lumbar artificial-disc implantation procedure returning to the hotel is possible in 2-4 days. After a cervical artificial disc the hospitalization can be even much shorter. Wearing a soft belt for the next 6 weeks is recommended during daytime. Driving a car or riding a bicycle is permitted as soon as the incision in the belly has healed. If a nice primary positioning has been confirmed by a standing x-ray, we have the experience that the implant can withstand all exposures like fast walking, falling or jumping, based on sufficient bone quality.
Do you have any more questions concerning your back pain and this treatment method? See our Frequently Asked Questions
General pre-operative instructions
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