Hello,

I came across this site while running a search and I must say that it truly is a gem. Very informative and it has some very active forums. Very happy I found this support group.

I recently was a candidate for single level ADR but found to be ineligible because my discogram was confirmed to be positive for 2 levels. Thus the only surgical option I was given was a fusion, which I "DO NOT WANT". I'm still in my 20's with small children I do not want to have to be back in the shop in another 10-12 years (or less) for followup work as I feel according to the various studies and testimonies ADR gives me my best chance to resume some semblance of a normal life.

At any rate my injury is in the domain of WC and my employer has asked about the possiblity of settlement and my attorney is asking for my feelings on a number to bring to the mediation.

It was explained to me by the attorney that it has been his experience that WC insurance companies are very unlikely to pay for any experiment surgeries, i.e. ADR, but I "DO NOT WANT A FUSION".

I know multi-level ADR hasn't been approved in the United States and we can't be sure of any time line as to when it maybe be approved. But I'm willing to suffer a bit longer if I can structure enough money into the settlement to pay for the cost of surgery when it because available. *sigh*

Its a very complicated situation probably just like the rest of your all's own situations. My attorney's estimator came of with a figure of 90k USD for a 2-level ADR surgery. For anyone who has had or is prospecting the idea of a 2-level ADR (L5-S1, L4-L5) does this sound reasonable???

Thank you in advance for any advice!

Feel free to contact me via email if you or uneasy about publicly discussing numbers

ezekiel@ec.rr.com

ezekiel,

Welcome to the club/forum and I hope you find all the info you need make the right decision for your life and your family.

My 1 level was around 40K before the insurance kicked in. I know the disc it self went for 6,000. The rest was hospital and doctor fees.

It is well known that the cost in Germany is much more reasonable and you get a more experienced doctor for your money. May be something to look into.

Good Luck

Probably 1/2 that amount and all-inclusive if done in Germany.

-Jeff

Hi Ezeikiel,
the first of all let's get down to basic fact is that ADR is not experimental worldwide, at the moment it is just the USA that has been on the go for two to three years.

ADR has been in Europe since 1989, and has been extremely successful. I would think that you could go across to Europe and get a 2 level done by the world's most experienced surgeons for well under $90,000 and have change to come back and buy yourself a new truck may be.

I live in the UK but there are plenty of your fellow countrymen that have been to Europe and had 2 level ADR -- -- -- just keep looking at people's personal signatures at the bottom of their postings.

Welcome to the site
Best,
Alastair http://adrsupport.org/groupee_common...icon_smile.gif

Ezekiel,

The AlphaKlinik, where I had my single-level L5/S1 ADR with Dr. Zeegers is currently charging 19,000 euros for a single-level ADR. From what I've heard, additional levels do not necessarily double the cost, so, if you went there, you'd be looking at around 38,000 euros MAX. Given the current exchange rates, that would be somewhere in the neighborhood of 46,000 US dollars. I would imagine that Dr. Bertagnoli would be charging something in the same neighborhood. I've currently paid for two ADR's out-of-pocket and, despite the fact that I have continued pain issues, feel that it was the best decision I could have made. I am still able to work (albeit with some pain med's). I paid myself back for my investment with my first three month's back at work (an that doesn't count the tax deductions). If worker's comp will give a generous settlement, that might really help too.

Before you make any drastic decisions, you might want to be evaluated by a good ADR doc and make sure ADR will help you before you settle with WC in anticipation of going overseas for ADR.

Best,
Laura

The incremental cost for adding levels at the AlphaKlinik or Pro-Spine is 3-4k Euros.

My 2-level ADR 3.5 years ago at the AlphaKlinik was 22k Euros.

Mark

ezekiel -- welcome!

Roughly $34k a level in the US (on average), including the (Charite') disc and professional services.

PS: Put your email in your profile, not in the message. That way, the spambots won't get you....

Ezekiel,

The costs are all over the map. My surgery (single level) was billed at about $105,000. Cedars Sinai hospital (charged about 90k out of the 105k total) only received about $30,000 as that was the contracted rate with my insurance company. And the surgeons will get anywhere from $8k to $15k depending on who pays what on top of the $30k. So the negotiated cost of my surgery will be roughly $40k-$45k.

Cedars does NOT negotiate rates with individuals. So even though an insurance company will only have to pay them $30k, if you are on your own you would have to pay them the full rate of $90k (nice huh?). My surgeons also did a similar thing, although we made a financial agreement as a safety measure in case the insurance company wouldn't cough up.

So, as you see the prices can be very high or reasonable depending on which hospital you go to, if they are negotiable, which surgeon you go to and if they are negotiable as well. It never hurts to ask for a discount...

Dan

Wow! Thank you all for you quick responses. I wasn't thinking I would hear anything back so quickly!

I'm also blown away by the cost of ADR stateside versus going overseas. Whenever FDA gets around approving multi-level ADR according to above and what I have found/heard elsewhere 90k USD probably won't be enough because my current insurance doesn't cover single level ADR and all expenses will be out of pocket having to come from a structured WC settlement; if and when that ever comes to. The surgeons performing the procedure will be qualified but I feel pretty comfortable in saying that compared to european ortho-surgeons that can't compare.

Maybe 34k USD (only a guess) to go abroad to Munich to have a 2 level ADR seems to be the ticket. Especially if I can have it now and not have to wait for the FDA to get their thumbs out of their ...

I suppose the pro of having it done stateside is that if for some reason I had complications I wouldn't have to travel abroad but then again I'm sure Dr. Zeegers has some colleagues stateside he would feel more than comfortable referring someone to in the event I was unable to travel overseas?

It just seems like a no brainer to get it done NOW, and not delay any longer like I thought I was going to have to do because of the FDA. Am I missing something? Is there a huge drawback to traveling to lets say Germany and having the procedure done there versus waiting another 2-3 years for multi-level ADR here in the States?

Thanks again.

If you can wait for two to three years, for your surgery then do so. Surgery really is for those who cannot wait because they are in too much pain.
Best,
Alastair http://adrsupport.org/groupee_common...icon_smile.gif

But, Alastair - if one waits too long isn't there the danger of irreversible facet joint deterioration or then needing a prosthetic facet joint as well?

I mean, that's what I'm understanding anyway. Realizing that surgery is one of the final resorts - but debilitating pain isn't always the final motivator, is it? Or am I wrong?

And, I've also talked to many that didn't realize the pain they were in until it was gone. Don't you think the body "masks" that pain with endorphines and just a high pain threshold in many cases?

Just wondering about all these things.

And, good luck to you Ezekiel - in what ever path you take. Be sure to "over kill" your settlement in case there are other issues as well. So, are you going for a partial disability (i.e. % of total body disability) settlement?

Ezekiel

In my opinion, one problem in waiting may come with your nerves. If you have nerve impingement like I did waiting may cause more damage and scaring to the nerves and nerves have minds of their own. I�m still waiting for them to regenerate, heal, stop hearting, this may take much longer then I thought.

I waited 10 months and for most this is a very short amount of time. Some have waited many years. Yes I was in a lot of pain but did not know how much until it was gone.

Also it comes down to what you can live with or without. I was unable to work, play or socialize and those that know me around here that was like being in prison.

Ezekiel, Where would you put yourself on this pain/play profile scale?

I hope I haven't waited too long for this surgery.

2 years ago I got a quote from Dr.B's office for 2 level ADR and possibly 3 levels and it was quite reasonable by US standards I think... As I recall it was something like 30,000 Euros and Vertebroplasty was even figured in if I needed it.

One thing I honestly believe is that while we have our really good quality US surgeons here and we do have multilevel surgery patients with execellent results, still one cannot beat experience when it comes to something as important as your spine ~ that's just my take on it...

You CAN have multilevel ADR here in the states, many of us have done so. The problem is, most insurance companies aren't paying no matter if it is one level or multiple. I had surgery in September, I had fusion at L5/S1 and then Charite ADR at the two levels above it in NYC.
The cost of the whole thing was about 70K. MY insurance paid 50K (because the fusion was approved) and I had to come up with 20K which was the fee for the two discs and the surgeon's fee to put them in.

I think it might be a little cheaper in other parts of the country, but I was in NYC in Manhattan, kind of an upscale place. I think other people have had similar surgeries for less.

My daily pain is no less than 5/10 and ramps up to 8/10 or worse throughout the day. Its the biting, burning, gnawing, scraping kind of pain that intensifies to piercing, stabbing, thrusting pain as it escalates through the day with activity (i.e. walking). I have been dealing with my back injury since 2001 and I am beyond the point of waiting. I have been waiting and hanging on for a quite a while and I'm just tired.

I'm tired of hoping that one day the pain will subside to tolerable levels. I'm tired of taking muscle relaxers, painkillers, transdermal patches, injections, etc. I'm tired of hoping that the FDA will approve multi-level ADR. I'm tired of hoping my employer's WC insurance company will agree to ADR and not continue to push spinal fusion. I'm tired of missing out on things that I would like to be doing with my two young children and wife. I'm tired of hoping the next conservative treatment will help me. I'm tired of dealing with the pain each day. I'm just tired.

Again, one factor is bone density. We can get the best US surgeons but if the non-sampled L4-5 or L5-S1 regions are "spongy", we're screwed if the surgeon doesn't have Dr. B's vertebraplasty cement. Wonder when/if this w/be down the pike. (Realizing that osteoporosis is one facet - bad joke - of healthy bones), e.g.

http://www.adrsupport.org/private-cgi-bin/ultimatebb.cg...t_topic;f=4;t=000002

At your age, I don't know how Workers Compensation can value your case and put a price on medical to settle. If this is even in discussion, you must have one open and shut claim. I thought I had a shot at one level through WC and then I too became a 2-level candidate. Right down to the day before my surgery, they argued against the procedure (they were not paying for anyway) with my doctor. Pricewise I got free discs and I paid 30k cash for hospital in the trail. 58 degrees this morning and I am heading out to fill a leafbag. Yippee. Wishing you all the best, you are in the right place.