ADR: Germany v. US

[jan]

I am new here and appreciate all of the great information. After a few days of reading, it seems like there are a number of doctors in the US that are getting to the point of being very experience in ADR. I need 2 level (C4/5 and 5/6) and will probably soon head to Dr. B in Germany. I'm just wondering if there is any doctor (the 2 often mentioned in LA and the doc at Yale) here that may do comparable surgery.

[Dale S]

Jan,
I need a 3 level adr along with 1 fusion. I too was headed for Germany but saw Dr. Regan in L.A. for a 1 on 1 better understanding of everything. Though I'm told I'm better off with Dr. B, I decided to stay in the U.S. with Dr. R.... but my insurance has different ideas.

If I can get my insurance to authorize at least part of my surgery, I'll stay here, if not the cash price at Cedars is beyond my means so I'll be off to Germany too.

Dr. B has more multi-level experience but my personal comfort level is here at home. I suppose it's up to your own comfort level.

Good luck, Dale

[Harrison]

It is a very fair question, although there is almost too much to say on this worthy topic! Much of it has been discussed, and debated, herein.

If folks can find and post the appropriate links, that would be appreciated.

[mmglobal]

This is a different topic for cervical than it is for lumbar. For lumbar, there are 3 tiers of surgeons available. Old guard with many hundreds or even thousands of implantations; Clinical trial investigators, with up to 5 years experience, some pushing over 200 procedures; and newly trained surgeons with procedures numbering in the tens/twentys...

There is no FDA approved cervical ADR available in the US, so there is no third tier. I don't know if any cervical trials are allowing more than one level. I know that some surgeons are getting compassionate use exemptions from the FDA to do 2 and 3-level procedures. It is my understanding, and I could be wrong, that the most experienced cervical ADR doc in the US is numbering around 50 implantations. If anyone has further info on this, please post.

As with lumbar, if you are a plain vanilla easy case, AND you don't present anything unusual... a less experienced surgeon will probably be OK. I still would not be on anyone's learning curve. Some people may consider it to be 10 procedures, others may consider it to be 50. I lean towards 50. However, if you present something unusual, high experience will be very important.

As with everything... age and experience does not always equal competence. Some very experienced surgeons still do shoddy work... but it sure is fast! Do your homework... make informed decisions.

Mark

[jan]

Thanks for the responses. I do wonder what the difference between 50 and a few hundred is, but my gut says it's very significant. It seems that in ADR, proper placement is everything.

I'd love to hear from those who had to choose between Germany and the US, and chose the US for other than monetary reasons.

[Wayne]

Jan:

I chose Germany. Not for monetary reasons, but for practical ones. As Mark says, "do your homework". This is your decision, and no one can make it for you. Unfortunately, there is so much information the potential for becoming even more confused is high. However, assuming you are not an idiot, the more information you gather, the better equipped you will be to make the decision that is right for you.

Money was not a consideration at all for me (I�m not independently wealthy). In my condition I would have sold everything I owned to get the procedure from whomever I felt would give me the highest possibility of a successful outcome. When you get to the point that you have no life, you have nothing to lose and the thought of rebuilding my life was more attractive to me than continuing on a downward spiral of pain and physical limitations.

I am partial to Dr. Zeegers because of the research I did and now that I am going on 9 months post-op, I can say with all the confidence in the world, that it was the right choice for me.

As Mark indicated, the choices are difficult when it comes to which doctor to go with. However, in my mind, it�s not a matter of what continent they reside on. I would only go with the doctor that I felt gave me the highest possibility of a successful outcome, regardless of the complexity of my condition. This is not as "simple" a procedure as it is made out to be by those who promote it. Anything can go wrong once you have surrendered to a surgeon. You will want the peace of mind that comes with knowing you have selected the best possible physician for the job after all is said and done.

One note on post-op recovery. Take it easy and slow. You may be in a great deal of pain at first but it will slowly ebb away. When you start feeling like you can do cartwheels. Don�t. Gentle, pain free stretching as many times a day as you can discipline yourself to do is very important. In fact, it may be the most important element of post-op recovery I have experienced. It may also be a lifetime commitment. Who�s to say that it shouldn�t be even if you had a perfect spine. If you listen, you will learn a great deal about my body in the days after your procedure.

Good luck,

[Juli]

I went and saw Dr. Zeegars and also went and saw Dr. Bitan in NYC to get two opinions from two experienced doctors. My only concern about going to Germany was post surgical support. However, after seeing Dr. Zeegars and Dr. Bitan, I felt Dr. Bitan's diagnosis was the better of the two. Fortunately, as Dr. Bitan is French, he has a little more experience than most U.S. doctors in the ADR arena, so I am confortable in his level of experience. I believe he has done around 200 surgeries, although how many of them are multi-level, I don't know.

I would suggest that you get a surgeon who has at least hit triple digits with ADR surgeries and that you still get two opinions from experienced surgeons prior to making your final selection. I have yet to really have two opinions that fully matched.

[natasha]

Jan, It is hard to make a decision on which surgeon's hands to put your spine into. I need 2level lubar adr. 2 months ago I had a consultation with DR.Blumenthal at Texas Back,
and then my films were sent to DR.Zeegers.
DR.BLumenthal thinks it would be better for me to have 1 level and 1 fusion, D.Zeegers thinks that I am a good candidate for a 2lever adr. I would prefer to have it done in Germany but what concerns me is a post -oprative recovery outside of the hospital and a long flight back home. I hope the Light will cone through and I will know what to do.
Good luck
natasha

[Alastair]

After your surgery at the Alpha clinic and Dr Zeegers -- -- which is different to Dr Bertagnoli you have two weeks in Germany after your surgery. You should take time to go into the gymnasium discuss with the physical therapists your future exercises and progress, they give you a book of exercises to do which you bring home in addition to the exercises in the gymnasium.

I have no idea what you get after surgery in the USA but if you get problems with your recovery, you can always e-mail or speak to Dr Zeegers on the phone about your problems which are usually dealt with fairly quickly and conclusively
best,
Alastair

[jan]

It is difficult to consider being so far from home when you are most vulnerable and in pain. I'm wondering just how much pain the average 2 level cervical patient is in. Anyone? How long do Dr. B's patients stay post surgery? Just how bad is the flight home?