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Position of a M6 L ADR in neutral position.
Topic Started: 6 Jan 2012, 04:20 PM (1,554 Views)
Kirst77
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Hi I was wondering if anyone could tell me the correct position of a M6 L artifical disc when laying down on back? Any pictures would be great :D .

Although I went to see my surgeon who fitted my disc and he said it was all fine, I still went ahead and ordered a copy of the x-rays as I have moved to a different area and am waiting to see a new doctor, hence why I have a 'back file' with all the copies of x-rays, reports and mri's.

I received the copy today and it just doesn't look right. Firstly the disc is placed more to the front of the disc space, it is right at end at the front and a gap at the end. My understanding was that ADR's should be centerly placed, but I probably got this wrong.
Another thing which looks wrong is the gap between the two end plates of the ADR. At the left side of the xray (the back of spine) it looks as if the two plates are either touching or nearly touching. Whereas the right side of pitures (the front) the gap between the two looks far too large. All the pictures that come up in a search on the web shows the gap as equal on both sides (unless xray is took leaning backwards). I know the internet throws up many different things and perhaps I am clutching at straws because of the pain I am in, thats why I turn to you guys with heaps of experience and viewpoints which will be unbiased. I would download the picture on to here but I am unsure as to how that is done.

Many thanks in advance.


Here's my lateral view:- (Picture added 8/1/12)
1994 Back injury
2000-09 Pain clinic
2009 Mr Boeree
2011 ADR M6-L & decompression @L4/5
2012 Multi level facet degeneration, dehydrated disc, hyper extension due to adr, ossification of anterior longitudinal ligament, bugles throughout lumbar area, loss of disc height, stenosis, kyphosis.
2013 onwards ADR Frozen in wedge position ends touching
Nottingham pain clinic
Zommorph, Capsaicin, Versatis plasters
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Alastair
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Alastair
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From what you say it is very difficult to give an opinion. Where they show prosthesis on the Internet it generally is more or less the position that they want it to be shown or out of a person's body. Everybody wants to look really good.

What looks too large from the view at the front could be your spine tilting which appears to make the plates look too wide when in actual fact they are close together at the back (posterior). It could be anterior positioning or all sorts.
best,
Alastair :D
Attached to this post:
Attachments: Kirsty_lateral.jpg (13.53 KB)
Founder of this board 24th February 2007
Slow and Steady Wins This Race
Over 23 Years experience and research into spine surgery and over 2500 surgeries discussed and recorded

ADR L5/S1 Surgery with Dr Zeegers 26th July 2002 in Munich
8 facet joint ablations 28 – 8 – 12 with Dr Baranidharan and Jake Timothy in Leeds Diagnosed Forestiers disease
Your Best Asset Is Your Health
I live in West Yorkshire aged 81 now

Knowledge is power
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naintaid
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couldnt find how to upload my pictures.



























discetomy feb 2005
discetomy june 2005
mri 3 of
cat scan
facet joint injections .aug 2007
adr active l disc 2 level .l4l5 and l5 s1 .sept 2010.
2 blood transfusion after adr surgery
feeling more positive.

4 years post op and everything is fine,really pleased with outcome.
go back every 2 years for check up and x ray.
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Alastair
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Alastair
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Kirst -- -left you an e mail
Founder of this board 24th February 2007
Slow and Steady Wins This Race
Over 23 Years experience and research into spine surgery and over 2500 surgeries discussed and recorded

ADR L5/S1 Surgery with Dr Zeegers 26th July 2002 in Munich
8 facet joint ablations 28 – 8 – 12 with Dr Baranidharan and Jake Timothy in Leeds Diagnosed Forestiers disease
Your Best Asset Is Your Health
I live in West Yorkshire aged 81 now

Knowledge is power
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Alastair
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Alastair
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Click on this link for what they should look like

http://www.stenumortho.com//back-pain-and-...rosthetics.html

I will help as per e mail if required
Best
Alastair :D
Founder of this board 24th February 2007
Slow and Steady Wins This Race
Over 23 Years experience and research into spine surgery and over 2500 surgeries discussed and recorded

ADR L5/S1 Surgery with Dr Zeegers 26th July 2002 in Munich
8 facet joint ablations 28 – 8 – 12 with Dr Baranidharan and Jake Timothy in Leeds Diagnosed Forestiers disease
Your Best Asset Is Your Health
I live in West Yorkshire aged 81 now

Knowledge is power
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Lynda
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Kirst, even though you say your images were taken in neutral, the position of your spine/pelvis could make it look like you've described, .... ie if you're hyperlordotic...and if your pelvis was tilted forward it would look differently. It could be you are worrying unecessarily about the postioning as your surgeon has told you they are good.

The following images are from the Spinal Kinetics site (Manufacturers of M6)

http://www.spinalkinetics.com/patients/m6-...al-lumbar-disc/

M6 lumbar spine - Extension
May 2008 onwards - Lumbar facet injections - First post-op ones four years post surgery, have lost count of the number I've had since then but they do help. Pre-op they didn't make much difference- Mr Shackleford, Warrington
Feb 2008 - Cervical TDR, (Activ C's) C5/6 & C6/7- Mr Shackleford, Warrington
May 2006 - Craniotomy and resection frontal lobe brain tumour - The Walton Centre for Neurology and Neurosurgery
Feb 2004 - Lumbar TDR, (ProDisc's) L4/5 & L5/S1 - Mr Shackleford, Warrington
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Lynda
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M6 Lumbar Spine - Neutral
Attached to this post:
Attachments: M6_Extension.jpg (14.17 KB)
May 2008 onwards - Lumbar facet injections - First post-op ones four years post surgery, have lost count of the number I've had since then but they do help. Pre-op they didn't make much difference- Mr Shackleford, Warrington
Feb 2008 - Cervical TDR, (Activ C's) C5/6 & C6/7- Mr Shackleford, Warrington
May 2006 - Craniotomy and resection frontal lobe brain tumour - The Walton Centre for Neurology and Neurosurgery
Feb 2004 - Lumbar TDR, (ProDisc's) L4/5 & L5/S1 - Mr Shackleford, Warrington
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Lynda
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M6 Lumbar Spine Flexion
Attached to this post:
Attachments: M6_Neutral.jpg (17.54 KB)
May 2008 onwards - Lumbar facet injections - First post-op ones four years post surgery, have lost count of the number I've had since then but they do help. Pre-op they didn't make much difference- Mr Shackleford, Warrington
Feb 2008 - Cervical TDR, (Activ C's) C5/6 & C6/7- Mr Shackleford, Warrington
May 2006 - Craniotomy and resection frontal lobe brain tumour - The Walton Centre for Neurology and Neurosurgery
Feb 2004 - Lumbar TDR, (ProDisc's) L4/5 & L5/S1 - Mr Shackleford, Warrington
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Kirst77
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Many thanks for your replies I appreciate them so much.

Alastair sorry for my slow reply to your messages but I only received them a short time ago, I have now replied and attached some files for you to look at.

Lynda, thanks for the links of which I will have a look at, many thanks.

The one thing what I don't want to do is make a fool out of myself! Maybe it's my mind working over times and trying to find answers to the question of why I am in so much pain. I know I should trust the doctors and I do to a certain extent but I have been treated so wrong my many that it's very hard to believe everything especially as I am in pain most of the time.

Take care & I hope people get a good nights sleep.


Here's my A/P view of my M6 x-rays (Picture added 8/1/12)
Attached to this post:
Attachments: M6_flexion.jpg (13.57 KB)
1994 Back injury
2000-09 Pain clinic
2009 Mr Boeree
2011 ADR M6-L & decompression @L4/5
2012 Multi level facet degeneration, dehydrated disc, hyper extension due to adr, ossification of anterior longitudinal ligament, bugles throughout lumbar area, loss of disc height, stenosis, kyphosis.
2013 onwards ADR Frozen in wedge position ends touching
Nottingham pain clinic
Zommorph, Capsaicin, Versatis plasters
Offline Profile Quote Post Goto Top
 
Lynda
Advanced Member
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Oh Kirst, please dont worry, you won't make a fool of yourself at all, I fully understand, (and am sure others do too) you have on-going pain and are seeking answers as to why. I am sure anyone in your situation would do the same, its just that you seem to keep hitting a brick wall through no fault of your own.

It so frustrating that you are not getting the answers from the surgeons despite all your efforts.

Best wishes to you

Lynda

xxx

PS This may help demonstrate positioning although its not specifically M6's

Normal and abnormal imaging findings in lumbar disc replacement
Attached to this post:
Attachments: Kirsty_AP.jpg (12.34 KB)
May 2008 onwards - Lumbar facet injections - First post-op ones four years post surgery, have lost count of the number I've had since then but they do help. Pre-op they didn't make much difference- Mr Shackleford, Warrington
Feb 2008 - Cervical TDR, (Activ C's) C5/6 & C6/7- Mr Shackleford, Warrington
May 2006 - Craniotomy and resection frontal lobe brain tumour - The Walton Centre for Neurology and Neurosurgery
Feb 2004 - Lumbar TDR, (ProDisc's) L4/5 & L5/S1 - Mr Shackleford, Warrington
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Alastair
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Alastair
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Well folks,
I'm here staggering off to bed and I'm hoping that I've got everybody sorted out having looked at the pictures in detail. The discs do look a little bit anterior, but it could be hyperlordosis which might be causing the problem. It's a job for the experts really, but it's a difficult surgery to do and difficult to position because the great vessels of the body are on either side of the spine when the surgery is being done so to get the anterior/posterior position perfect is not always easy.
Everyone sleep tight please
Alastair :D
Founder of this board 24th February 2007
Slow and Steady Wins This Race
Over 23 Years experience and research into spine surgery and over 2500 surgeries discussed and recorded

ADR L5/S1 Surgery with Dr Zeegers 26th July 2002 in Munich
8 facet joint ablations 28 – 8 – 12 with Dr Baranidharan and Jake Timothy in Leeds Diagnosed Forestiers disease
Your Best Asset Is Your Health
I live in West Yorkshire aged 81 now

Knowledge is power
Offline Profile Quote Post Goto Top
 
Kirst77
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Many thanks for the replies and all the help. Alastair I am sorry if I have kept you up as that is that last thing you need! Lynda thank you for the pictures they are a great help thank you.

Take care.
1994 Back injury
2000-09 Pain clinic
2009 Mr Boeree
2011 ADR M6-L & decompression @L4/5
2012 Multi level facet degeneration, dehydrated disc, hyper extension due to adr, ossification of anterior longitudinal ligament, bugles throughout lumbar area, loss of disc height, stenosis, kyphosis.
2013 onwards ADR Frozen in wedge position ends touching
Nottingham pain clinic
Zommorph, Capsaicin, Versatis plasters
Offline Profile Quote Post Goto Top
 
Kirst77
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Full Member
[ *  *  * ]
Meant to add Lynda that I have sent a reply to your e-mail, many thanks.
1994 Back injury
2000-09 Pain clinic
2009 Mr Boeree
2011 ADR M6-L & decompression @L4/5
2012 Multi level facet degeneration, dehydrated disc, hyper extension due to adr, ossification of anterior longitudinal ligament, bugles throughout lumbar area, loss of disc height, stenosis, kyphosis.
2013 onwards ADR Frozen in wedge position ends touching
Nottingham pain clinic
Zommorph, Capsaicin, Versatis plasters
Offline Profile Quote Post Goto Top
 
Lynda
Advanced Member
[ *  *  *  *  * ]
Hi Kirsty,

Just to reiterate that any images online from manufacturers / spine centres /surgeons websites are very likely going to be the best images they have rather than sub-optimally placed prosthetics. Even sub-optimally place prosthetics can have good outcomes although a perfectly placed prosthetic will give the best outcome. Your surgeon has said the placement is okay so I assume the positioning is acceptable.

Are you aware that you can get free on-line evaluations from some spine centres? I know ProSpine offer this service and that would be a way of getting another opinion from medics on your images.

Lynda
May 2008 onwards - Lumbar facet injections - First post-op ones four years post surgery, have lost count of the number I've had since then but they do help. Pre-op they didn't make much difference- Mr Shackleford, Warrington
Feb 2008 - Cervical TDR, (Activ C's) C5/6 & C6/7- Mr Shackleford, Warrington
May 2006 - Craniotomy and resection frontal lobe brain tumour - The Walton Centre for Neurology and Neurosurgery
Feb 2004 - Lumbar TDR, (ProDisc's) L4/5 & L5/S1 - Mr Shackleford, Warrington
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Lynda
Advanced Member
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Kirsty, the blog in the following link has some interesting images of the M6, it is written by a private patient of Mr Boeree and is excellently done.

http://healingmyback.blogspot.com/

I have now seen the pictures attached to your earlier posts and can see what you mean about the placement of your M6.......your surgeon has said its okay though so be reassured by his comments.

If you've read the blog above you'll see that the writer has had facet joint injections with good effect and I wonder if such injections would benefit you? Several members here have had them post surgery for residual pain with good results do they may be one option to consider.

Lynda


xx

PS
The picture attached below of an x-ray of M6 at L4/5 and is a little similar to your images Kirsty, I know its not that clear but it may reassure you that the placement is acceptable...(as your surgeon says.) Can I ask if you were on an angle when x-rayed, (ie was the head of the table tilted at all) as that may explain things too, it could perhaps just be the angle it was taken ???
May 2008 onwards - Lumbar facet injections - First post-op ones four years post surgery, have lost count of the number I've had since then but they do help. Pre-op they didn't make much difference- Mr Shackleford, Warrington
Feb 2008 - Cervical TDR, (Activ C's) C5/6 & C6/7- Mr Shackleford, Warrington
May 2006 - Craniotomy and resection frontal lobe brain tumour - The Walton Centre for Neurology and Neurosurgery
Feb 2004 - Lumbar TDR, (ProDisc's) L4/5 & L5/S1 - Mr Shackleford, Warrington
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