German dude with L5/S1 DDD

[Unsichtbaer]

Hi all,

I am a 38 years old male, father of two, married.

I've been struggling with chronic back pain for three years now. Long story short, I've been diagnosed with DDD L5/S1. I am in pain most of the times, however, it's hardly ever so bad that I need meds. It's a nagging, ever-present pain, which only rarely is debilitating, but ever-present.

While a neurosurgeon suggested fusion, I've been to Stenum, which is actually just a 30 minutes drive from my home, and they suggest ADR with m6-L.

I've been doing a lot of research, pros and cons. I've talked to patients of Stenum, most of which were very happy with their outcome, but also some who say they have not improved or even become worse.

I've seen that very terrifying blog at https://m6artificialdisc.wordpress.com, which makes me very uncomfortable about getting the ADR, and also a lot of bad talk about specifically Mr Ritter-Lang, who would be surgeon.

I am here to get your opinions and hope some of you share their experiences with either the m6-L, or even Stenum and Mr Ritter-Lang.

[Harrison]

Welcome, thanks for posting. Yes, years ago, there were serious problems with Stenum:

https://www.adrsupport.org/forums/forumdisplay.php?f=51

Not sure how or if they were resolved!

I hope we can help. You have many good options. How are your pain levels? How are you managing that?

[Unsichtbaer]

Thank you so much for your quick response!

I am not really sure what you mean by pain levels. I can say that I have bad days and better days. It's like phases, and sometimes I can live it it and other times it makes me wish I could have surgery tomorrow.

When the pain gets very bad. I lay down, that helps me a lot. Luckily, laying gives me quick relief.

You're speaking about many good options - could you elaborate? As of now, I only see either ADR or fusion - both of which involve high risks.

[annapurna]

Not trying to second guess Rich AKA Harrison, but I suspect he meant that you have many other surgical clinics to choose from within your country. The proximity of Stenum shouldn't be the driving reason to work with them

As your pain level is currently controllable, I'll offer the advice I've given frequently: Take this time to investigate. Talk with more surgeons, take notes, do your own research once you have your notes from the conversations, then return to a few and ask the questions you wish you'd asked the first time. Get the surgeon you feel the most confidence in selected; even if you're not necessarily ready to get surgery at that moment, know what your plan is gives you security to delay until you're ready. Don't wait to begin your investigations as the pain might ramp up quickly, driving you to make decisions when you don't have time to think through them.

[Unsichtbaer]

Thank you very much, Annapurna.

Do you know where in this forum would be the best place to ask people who got an m6-l for their experiences?

[annapurna]

Searching the forums for comments may be your best bet. Generally people who're happy with their ADRs stop posting. For that matter, you're going to be primarily finding posts from people who're having problems, at least in the post-procedure realm.

Ten years ago, I would have said that there was little indication that type of ADR had as measurable effect on outcome as did surgeon placement of the ADR, patient condition prior to surgery, and patient compliance with post-surgery recovery protocol. Last I paid attention to it, the M6L had some bad post-surgery problems noted - primarily with the surgical mesh. Don't know where that ended up since then.

[Unsichtbaer]

Do you by any chance remember any source for the problems with the surgical mesh? I would like to confront Mr Ritter-Lang with it.

Also are you aware of any better alternatives to the m6-L?

[annapurna]

The discussion about the M6 was on this site but it seems like the search function on the site rejects M6 as a search phrase so I don't know that it'll help you. Rich AKA Harrison might be able to assist if you contact him. Otherwise, there was some a lot of discussion along with anecdotal 2nd hand information from a patient who was operated on by Bertagnoli at ProSpine.

I have not kept up with the new ADR models. As I said, up to ten years ago, there never seemed to be convincing evidence that the different models actually gave different levels of performance. That said, the engineer in me says to go for simple, well tested, styles of design. The more complex designs may perform better in the lab but increase the number of failure points in the field. BTW, the M6L is a complex design due to the mesh, pair of adhesive bonds holding it together, and behavior of the elastomer material. Complexity here is defined by the number of parts which must all work correctly to achieve a functional device, not by the elegance of the design.

[Unsichtbaer]

Which devices would that be in your opinion? I heard about the Cadisk L but it seems to have been pulled off the market due to failures?

[annapurna]

I can't point to a specific device but something like the ball and socket style Prodisc is an example of something that looks complicated, with the ball both allowing rotation and translating as the ADR flexes, but it really a pretty simple system without a lot of parts to fail. Charites are over a quarter century old and still performing well and they're considered "old technology." Being a beta tester or on the cutting edge in surgical technology is okay if you've reached the point of desperation, where bad surgical results don't leave you in any worse shape than you were in already, but you're a long way away from there. I would still stress, though, the importance of the surgeon. I still suspect that you'll do better finding a surgeon who you have good rapport with and trust, then discussing which ADRs they offer, instead of selecting an ADR then finding a surgeon who'll use it.