[NJ Gene]

Dave,

As you can tell by my name, I live in New Jersey. I live right across the river from NYC in Fort Lee. I realize that these board are all about ADR. I've considered it myself. However, I've had two levels of fusion in my neck (C3/C4 in 1998 and C4/C5 in 2010, it's important to note that C4/C5 was herniated in 1998, but the surgeons felt at the time it was only essential to operate on C3/C4 since the herniation was pressing against my spinal cord). I have over 95% mobility in my neck after both fusions, so I wouldn't rule it out. Just make sure you get a very good spine surgeon or neurosurgeon. ADR can be good for some people, where it's a choice between a wheel chair or living a normal life.

Before I answer your questions below, I will mention that I have some excellent names of spine surgeons in the NYC area that I've used and know of. Whether you get ADR or fusion in the U.S., it's much more likely to be covered by insurance than if you go overseas. Anything other than ADR will almost certainly be covered in the U.S. Btw, I am 48, so I'm close in age to your wife.


These are generated by folks connected to Dr. Clavel and Dr. Ritter-Lang in Europe. Whats up with that??? Clavel and Ritter-Lang use primarily the M6. I feel that they have biased opinions. They're not going to endorse something that can be done in the U.S. and take away business from them. Currently the M6 is unapproved by the FDA (probably to a large extent for political reasons) and cannot be used in the U.S. (even though it's produced in California).

3) Should we attempt to go to Europe and do a 2-level M6? Can we even hope to get BCBSIL reimbursement? A year and a half ago, I would have said yes. Now I say "No". There is no accountability if you have surgery in Europe. If there is a problem, you are stuck with it. No U.S. surgeon except perhaps one (Carl Lauryssen in California) would see you at home for follow-up. Furthermore, they want your money up front. As far as insurance reimbursement, if your policy has an international rider, you have a chance of some reimbursement, but you have to go not planning on it. For whatever it's worth, as a C.P.A., I can tell you that virtually all expenses relating to going overseas would be tax deductible to the extent they exceed 10% of your adjusted gross income.

4) Are there any resources available from LDR or Spinal Kynetics that can help us with insurance? Do you guys have any NAMES/NUMBERS of people to talk to? [COLOR="rgb(65, 105, 225)"]Not that I know of for overseas. Perhaps others can answer this better than me.

5) Even though two of the doctors said we haven't a moment to wait and need to get this done right away, are there benefits to waiting in terms of insurance reimbursement policies or maybe approval of the M6? I truly don't believe that it's going to be approved soon enough in the U.S. to make it worth waiting for.

[COLOR="rgb(65, 105, 225)"]If you are absolutely set on ADR and are willing to pay out of pocket some, there are some good surgeons in the U.S. However, I don't think ADR is essential. Read on these boards about Vicki_In_Florida and all the problems she's encountered with the M6. Feel free to send me a private message (PM). I will give you my contact information and perhaps we can talk

Good luck!!

Gene