Quote comparison from Dr. Clavel

[bwink23]

OK, so i got my quote from Dr. Clavel for a hybrid/fusion lumbar procedure of l5/s1(fusion) and ADR(L4/l5). Quoted at 34049 Euros. If i opt for a double ADR for the cervical at c5/c6 and c6/7, the quote goes up to 46049 Euros...or a whopping 62,700 U.S. bucks :uhoh:. Essentially the cost increase would be another 12,000 Euros to do the neck(2 ADRs) the same day.
This is their "all-inclusive package" with transportation and hotel stay for one week after the 5-day hospital stay. It also includes a 1-year insurance management for any complications due to surgery that might arise.
Do these numbers line up with the types of surgeries any of you have had?? That's a a lot of dough to fork over, but is it a substantial savings to do both surgeries at the same time as opposed to doing them on separate dates?

[FranklySir]

Bwink,

Here are the numbers I paid separately. Cervical 29500 EU plus 1000 Eu for the insurance. Lumbar 31500 EU give or take a little with insurance.

Hope this helps.

Frank

[Harrison]

...because Europe is thought to be so much less expensive. Dunno why you are getting these numbers. Some hi-volume clinics in the US are less expensive.

Pls note also the number of Clavels' patients that have less-than-perfect outcomes (which is true for any high-volume doc), though he is STILL telling patients that he has no complications in his patients post-operatively.

This is nonsense. :sulkoff:

[Stonewall_Boris]

Bwink,

Given Harrison's comment, and I assume you are American, why do you persue a operation over seas when you have available to you the doctors of the US?

Harrison,
I'm not American, I'm Canadian. So my descion making process is different than that of a USA citizen. Based on my research I was not going to have back surgery in Canada.

My wife and I would have to pay for my surgery out of pocket and it would cost a lot by our standards. I wanted the best bang for my buck. I did send my mri's to 3 US doctors and 3 European doctors. All being said I was convinced that surgery in Europe was my best option. As per cost, I got a dollar cost for my back operation from Europe. If I needed more time, if there was a complication that was covered in the quoted cost. If I went to the US, if I had any complication the cost could grow substantially.

You bring up a very good question Harrison. Why do US citizens go overseas when they have compitant doctors at home?

[bwink23]

Hey Stone....

The considerable work i need done is very difficult to get covered here. U.S. covers a single-level ADR for cervical and lumbar. I am a multi-level patient for both areas. An ADR doc here told me i would have to run appeals for the lumbar, and do a hybrid fusion/ADR on the cervical cuz insurance wouldn't cover a double-cervical. Double cervicals in the U.S. are rare, and only one device has been FDA-approved for it's use recently. NO DEVICE has been approved for double lumbar, OR a hybrid-construct in the lumbar. Now i know patients have been successful as of late in getting some of these types of procedures covered. But is that risk of non-coverage worth what i'd be getting?

As i've stated before, i'm for anything that can most closely replace my natural disc. The M6 seems to be the one to go with. For the lumbar, the large keels in the Prodisc combined with the fusion procedure that uses screws makes me nervous. Large keel cuts and screws in the same vertebra to me would be risky and could weaken the vertebra. An ADR-doc here in the U.S i talked to said he doesn't like using Prodiscs and is getting away from them. We're getting some more ADR's approved, but the only one i like is the Mobi-C for cervical. Good, but not as good as an M6, IMHO. Prodisc is the dominant lumbar disc here in the United States, and quite frankly i don't like the concept one bit. Too many issues created from the near-perfect positioning that it requires...and the long-term facet degeneration potential.

I have to get my lumbar done. I won't get a Prodisc put in my lumbar spine. Maybe i'm just being paranoid, but l4/l5 disc is a critical disc and is very active. The thought of putting a prodisc there makes me apprehensive. I'm certain i want an M6, especially in my lower back. My neck is a different matter. I COULD live with Mobi-C's from the United States to save a buck. Although not the M6, I believe it's the next best thing available right now for the cervical spine. The cost to have cervical done the same day as my lumbar with Dr. Clavel is about $16,500 U.S. dollars. My insurance covers at 70% out of network, which could be about $5,300 out of pocket for me for cervical....is that worth the cost of having 2 M6's in my neck as opposed to 2 Mobi-Cs??

A lot of tough questions. What you have put in your body, you have to live with for the rest of your life. I don't know if there is a right answer to any of the problems and concerns we face.

[FranklySir]

Harrison,

I dont think you actually answered Bwinks question but rather suggest something with no numbers to back it up.

No doctor anywhere on the planet will be perfect. What sucess rate is based on is also grey.

Aren't you breaking your own rules here.

Bwink has to make a decision based on what is available here which is nothing as to what needs to be done and will not be covered anyway or most likely. The Euro's have more experience and access to a better implant IMHO. Our bodies aren't perfect nor will anyones recovery.

Cost for most is very difficult and some decisions need to be cost based.

I thought this forum was for information not bashing.
Clavel was straight with me and explained a small number of issues that have transpired over time and spent alot of time doing so.

Painting this surgeon with a broad brush because, I BELIEVE, your experience with another stealing this site is wrong.

I live right near Phila with all the teaching hospitals and I still got the GOLD STANDARD line and the Payton Manning line.

You say "High volume" above. Very misleading and not a help here. The man specializes in this surgery so his numbers will be high by default. Should I complain about the Ferrari dealer messing up my Ferrari because they mostly work on Ferraris

Your comment above gives people pause is not called for. If you want a bashing post hten create one for yourself.

Feel free to kick me off but This is uncalled for since you truly cannot name one surgeon mentioned here that hasnt had problems but claims close to full sucess which is impossible without having the benchmark for what is included in that measure. Feel free to PM me and I would be more than happy to have a real conversation without exposing others and possibly dashing their hopes.

My opinion you owe Bwink an apology for possibly creating doubt. Stick to the facts and provide numbers to back the claim please.

And, lastly I am upset since this site, with all the good people on here including YOU helped me make an informed decision to contact and then make my own judgement. Who cares where someone goes as long as they get fixed to the highest standard possible.

Be well and peace of mind in all decisions.
Respectfully,
Frank

[FranklySir]

Bwink,

Don't feel the need to explain yourself. Get informed including this site. speak to others that are willing to share good and bad. Make your decision with feedback from the person who will need to fix you.

Call Yolanda and have a skype call with Clavel. Ask Clavel directly about people that had issues and get the info from his mouth then you can make a good choice. Contact other surgeons and do the same.

Harrison's point I believe is of frustration that our Docs here will not get the practice needed to help more people here if we keep leaving the country.
He is right and I give him that. Not my back or neck though. I want those that have the most experience.

In the end we all need to be comfortable with our choices and need the emotional support after the fact.

Remember we are losing a part of our bodies which is no different than losing a limb. My next post was going to be about this issue and sense of loss.

I wish you clarity and pain freedom.

Frank

[Stonewall_Boris]

I didn't go with Clavel but Harrison's comment cut through me as well. I thought he made a harsh comment on something he never personally experienced. Given the number of patients that had surgery over seas on this forum with successful results I have no idea on what he was trying to say, other than what you point out as to his frustration that patients are going over seas for their operation.

Harrison, if you boot Frank, feel free to boot me as well!

[Stonewall_Boris]

Bwink,

I think you've done tons of research, go with your gut instinct! The one thing I did before making my descion was to "turn off" everything.

[bwink23]

FranklySir,

Excellent posts. Harrison's points probably would have been better served under it's own thread. No offense taken. I just read and move on. You're right, there is no "100% success rate" wherever you go. I believe his issues are how Clavel is promoting himself as having no complications.

Defining "complications" between clinical terms and patient outcome terms....are 2 very different things. A surgeon can carry a "90% fusion rate" in regards to fusions and be considered a success, despite the patient not getting any pain relief from it. I imagine that ADR surgeons promote themselves in the same manner. A textbook implanted ADR may not resolve a patient's pain, but would be a clinical 100% success if there is nothing to contradict it.

I don't need Harrison's help in second guessing, i'm doing that fine by myself!! It's all about COST vs. RISK. I believe many patients make their decisions solely based on cost, and i don't want to be that way. My insurance, at a 70% out of pocket reimbursement for overseas work, gives me an avenue to pursue what i think is a BETTER option. I would bet my house on the facts that:

1. All INFORMED patients would use an M6 in the U.S if it was fully covered.
2. ALL patients would go overseas to get it if they were fully covered for it there and not in the United States. WHY?? Money, not necessarily surgical experience.


When it gets down to brass tacks, it's about the bottom dollar. Many patients who do know about the M6, still get the Prodisc on virtue of coverage. That's fine. They will even use their "trusted" surgeon despite a limited track record with ADR's....That's fine too....COST vs. RISK. Everyone's different with different circumstances to deal with. That's why we read other poster's scenarios, to try to get a better picture of what you can do for yourself, evaluate your specific COST vs. RISK profile.

[FranklySir]

Thanks for the backup Stone!

This is why my screen name is Franklysir (i don't give a darn)

No need to boot me or Stone.

If you feel this conversation is not appropriate for public viewing then I will retract it. I don't see the value of being negative and arguing or being argumentative on here brings nothing to the table.

More importantly Bwink needs to make an informed choice and should be directed to get answers from the source. Clavel is a dedicated, professional and very personable man. He is more concerned with helping people then updating his website.

I will be contacting him to speak about this subject since i don't feel good about a fine man's reputation possibly being tainted without having all the facts.

Feel good Stone!
Oh and i answered your survey "why go to Europe"

[FranklySir]

Bwink,

Thank you. It just cut me the wrong way especially since I have been to Clavel twice within six months.

Im glad you know to read between clinical results vs actual or what the typical person thinks about as success.

My concern really was your question was not answered. I hope my feedback helps your venture. I am awaiting my first claim outcome for the cervical before submitting my Lumbar. Should know this week.

Frank

[bwink23]

Stone,

"Turn off" everything is good advice...got to pick up the ball and run sometime. I'm at a point in the decision process that if i take a different avenue(like staying in the U.S. and getting a Prodisc), i would always wonder if i cheated my body for the sake of a few dollars( or thousands)...i can always make more money, but health decisions are permanent.

[bwink23]

FranklySir,

Good luck on getting your claim reimbursement. I also have BCBS, keep me posted on your results. Were you given itemized billing before your departure?? Yolanda said i would get it in an email 10-15 days after i leave...but i talked to another poster who said they got it before they left.

[jss]

Bwink,

A couple of observations/speculations...

The cost of my double ADR with Clavel four years ago was $29.6k, $9000 of which was for the two M6-C's. It looks like the cost of the implants are almost all of your cost increase by adding cervical to the package surgery. While it doesn't sound like it, he might be giving you a bargain by adding the cervical now?

$67k ... For that kind of price, I'd look at some other possible surgeons too . You are having a lot done, but that does sound more like a US price. Perhaps Clavel has gotten busy enough that he's rationing his time with price? I suppose that's a good problem to have. Wish I had that problem.

Good luck, Jeff

[LauraB]

Has anyone looked at a US medical bill lately (especially for an inpatient stay)? How are we even comparing cost?

Bwink,

I was turned down for ADR surgery here in the U.S. I was told that I didn't do enough non-invasive pre-presurgical treatment; BS! I had given them a 5 year report of my extensive pre-surgical failed protocol - didn't matter. In the end, the FDA rules and insurance standards rule over best practice and logical care - who cares about you (right?).

US surgeons are limited to restricted procedures. You MUST be your own advocate. It is the body you are going to live with in the end. $67K may seem a lot for European medical cost; but not compared to what you will pay here. I agree with you about the M6 - I didn't want any other device (and that was after my OWN extensive research and inquiry). AND, as we have spoken through "PM," you stand a good chance of receiving insurance reimbursement because it is an accepted form of corrective surgery and medically approved for 12+ years (in respect to the M6) and 20+ for ADR alone in EUROPE.

In my opinion, I believe you had made a confident, well thought, and educated decision about having your surgery overseas. The only downside was finding a competent neurologist to do follow-ups upon my return in the event I experienced any problems. Found one - so that entity was eliminated.
My 2-level cervical was 28000 euros or roughly $37,000 US. Lumbar, I would imagine, would be slightly more expensive due to its intricacies. If you're concerned about the price - by all means inquire with a few other experienced surgeons (run it by Dr. Bierstedt - at this time he does not charge a consultation fee). You're focus is getting your body back and performing in the way it was meant to be...that's priceless! The cost (less what you will be refunded by your insurance company - optimism) will be less than the purchase of a car - and will last you much longer.

You're on the right road - My best wishes for you.
Laura

[FranklySir]

Bwink,

Yup, you have to shut out the noise once you have enough info. Good point Stone. Snake eating the tail if you don't and no decision will be made.

The itemized billing is a little slow depending on how busy the hospital is. I would ask Yolanda when you arrive to see if you can get it before you leave but most likely you won't.

Well considering I just spent 86-88K for both lumbar and cervical doubles when done seperately 67K sounds like a bargain especially when you add in first class both ways (deifnately on the return nonstop if possible). The good thing about getting both you will save $ but will pay in extra pain BUT one recovery. Your neck should be very good before you leave the hospital and giving you minimal if any pain. Your throat probably will be more sore though since the traic tube will be in alot longer but again your hospital stay will be 5-6 days. Clavel won't kick you out unless you are ready so dont worry and they won't charge you more.

I can't see even with flights anyone in the US doing four levels for that kind of $.

Wishing you peace of mind and spirit. Small mountain to climb but the other side is quite awesome. I'll be praying for a very uneventful surgery for you wherever you go.

All the best,
Frank

[bwink23]

Thanks to all the responders...couldn't ask for a better support group than what i've found here. I hope for further progress in your recoveries, and will keep everyone posted when i make the transition to the bionic man.

[TPatti]

I feel bad that I have had so little time to be on the site lately. I plan on posting my 6 month report in the next few days but wanted to comment here: 1)Laura sums up most of what I would add, 2) My US doc(Dr. Cappuccino) had 2 options for me-a) he could perform hybris wit fusion and 2 kineflex discs thru AIMIS in Cyprus, or b) he would be my follow-up doc of record if I choose to go to Europe for 3 M6's. I think his options for me say a lot, neither one was surgery in the US. He said he would not even consider the prodisc for multi-level.
Harrison, I cannot thank you enough for starting this site which helped me find the help I needed, but why have you been so against European surgeons? My US doc even made it clear that my best choices were not available in our country. Within 3 minutes of seeing me for the first time he said, "you know if you can, you ned to go to Europe." Believe me, I am not happy about this, going to Germany to pay for a surgery out of pocket and the disc is made in the US!!!!

[pittpete]

Kineflex Artificial Disc System to Treat Degenerative Disc Disease (DDD) - Full Text View - ClinicalTrials.gov (http://clinicaltrials.gov/show/NCT00292292)

[davidstagno2110]

I went to Dr Pablo Clavel at the Barcelona Spine Center and it was the most horrible experience you can get. He used these M6 discs and I had a failure a year later. Dr Clavel decided to leave me with these M6 discs inside my spine and even threatened to sue me because I spoke out. If you want to learn more about the story:
www.artificialdiscreplacementadr.com