New to ADR- Seeking Information
 

Good Morning Everyone,

I am new here and looking for information. I have been dealing with constant back pain for over 8 years. I am trying to find information regarding ADR and fusion combined. My L4-S1 are degenerating, the disc space between L5-S1 is basically gone at this point. I have had Dr's in my area offer either a multi-level fusion or to do a One level fusion with the possibility of having to undergo another surgery within 5 years.

I have been doing research, and searching for other Dr's who offer ADR- Which seems to be VERY hard to find in the Florida area. If anyone is around this area, or knows an amazing Surgeon who performs ADR combined with fusion PLEASE help!

I greatly appreciate responses, Thank you!

Tiffany

Dear Tiffany,

For this type of surgery, you may have to travel. One of the best I've heard of in the United States is Jack Zigler of the Texas Back Institute in Plano, TX. I'm also not sure how much insurance will cover if any. Although the FDA has approved certain ADR's at one level, I don't believe they've approved them if they're adjacent to a fusion. You might be able to get the fusion covered, which is more expensive, and pay for the ADR off label. There are a number of surgeons in Europe who can help you if you're willing to pay and have no expectation of insurance reimbursement. The best ones I've heard of on here are Dr. Pablo Clavel in Barcelona, Mr. Dare in the U.K. and Dr Bierstedt in Germany. To go overseas, you are looking at $40k and that's without the flights. Most packages include hotel, hospital, surgery, etc. If you're willing to get a fusion, the hybrid approach may be most cost effective. Even if insurance doesn't pay for ADR, you are covered for most of surgeon costs (certainly for the fusion), anesthesia, hospital, etc if all done in one surgery.

I hope this helps.

Gene

Tiffany,

I ditto everything Gene posted and add something.

Most major insurance carriers will cover the off label ADR procedure known as a "hybrid"; which in your case would be a fusion at L5/S1 and a ProDisc-L at L4/5. That is possibly your only hope for insurance coverage with ADR in the US. If that's what I'd do, Dr Zigler at TBI in Plano, TX is the only one I'd let do it.

Before going with your surgeon's recommendation, I would encourage you to spend a few dozen hours (no I'm not exaggerating) researching your various options, the outcomes others have had with each of those options; the procedure involved, the implant(s) involved, the surgeon, etc... Not just on this site, but every site that you can find. There are no mulligans in lumbar spine surgery and bad outcomes tend to be tragically bad. You have to get it right the first time.

While we've seen glowing reports of numerous US surgeons on this site, I don't recall that any of them were in Florida. Anyone?

BTW: In my non-medical opinion, Jack Zigler does meet your description of "amazing" for ADR surgery.

Good luck, Jeff

Hi there. I'm in the same boat as you. Where in FL are u? As far as ADR goes I'd only trust Dr Rolando Garcia Jr he works out of Aventura Hospital in Miami. He started doing ADR surgeries since 2000. First in FL and I believe the Southeastern US to do it. He also helped on the design of the Active-L disc. From my research his bedside manner isn't the best but he came highly recomended by a Dr who I have the upmost respect for. He flat out told me he'd trust his spine to Dr Garcia. With that said if traveling is an option I second what the others have stated.

Jacksonville, FL
 

Hi,

If you are near Jacksonville, FL. Dr. Gregory Keller at JOI-Jacksonville Orthopedic Institute has probably done the most in the city. He has been involved in the FDA trials for the ProDisc since the beginning. When I saw him about a year and a half ago, he wanted me to wait a while as he was planning on participating in the 2 level lumbar trials.

I obviously did not wait, but it may be an option for you. He is an Orthopedic surgeon and has a good reputation in the area.

Dr. Garcia-Benchochea-spelling? Is a neurosurgeon that has done some ADR's, not that many. He is a very skilled neurosurgeon and developed some the techniques and tools for minimally invasive fusions.

St. Vincents Brain-Neuro Institute has some experience, more with cervicals.

That's about it that I know of for northern Fl.

Laurie

Thanks
 

Thanks everyone for the advice! I have been doing hours upon hours of research, the Dr's in other countries have come up numerous times. I am not too worried about insurance covering the ADR- I will find means if I am eligible for the procedure. I have seen two Dr's here in FL and both of them do not do ADR.

I am meeting with Dr. D' Ariano in May, and fingers crossed for good news. Nothing but great reviews on him.

I finally got my second MRI report back, For a 23 year old it looks like my back belongs in an 80 y/o's persons body.

I am located North of Orlando. I've been to Miami and heard of Dr's down there as well. The Dr I am meeting with in May works in Tampa, Orlando and Lake Worth area.

Best of luck Tiffany. Do the doctors have any idea why you're in such bad condition?

Please keep us posted.

Dr. Rolando Garcia, Aventura Florida, was part of the FDA clinical trial process for ADR / TDR from my limited recall. Dr. Garcia possibly did work in the Aesculap active-L TDR FDA Clinical Trial. He may have written some articles with Dr. Yue of Yale about ADR / TDR.

You asked about a hybrid surgery: adr L4-L5, fusion L5-S1. You need to ask the surgeon about that question.

Insurance coverage for a hybrid lumbar surgery may require some work, ie. paperwork and an appeal, work by the surgeon also.


------------
slackwater_sf

Tiffany, were you in a car accident, or any trauma to the spine?

Tiffany,

I am glad you found this board. There are a lot of people here who can offer some excellent advice. I am not familiar with any surgeons in FL who do hybrids. Would going overseas be a possibility for you. I know of several posters who have traveled to Europe and had successful surgeries, myself included.