L4-S1 ADR decision
 

Hello everyone. I want to say thank you for this site and everybody involved sharing their experiences. This is my first time posting and I’m hoping to get more answers. I’ve had lower back pain for close to a decade that I can recall but like most cavemen I never looked into it. I learned how to be mindful in the gym and moving heavy objects for the most part.

My back pain is typically around a 4 to 5 and it’s constant. Approximately four or five years ago I started having trouble sleeping through the night. I’m guessing I get around three or four total hours of onset to ruptured sleep a night currently. The lack of sleep is most definitely affecting my every day life and is by far the biggest concern as far as my symptoms. I wouldn’t find out until later that I am waking slightly and adjusting as a result of my back tightening up.

After a turbulent day driving some heavy equipment at work my back seized up as it has from time to time over the years. I went into my chiropractor who recommended PRP injections which we did. A few months later I felt maybe 15% better and just went on with life. Around six months ago I switched to a new chiropractor who did x-rays and felt I needed to do more imaging and recommended an MRI because she suspected herniated disc. After we got the imaging and the radiologist report back it was confirmed I have a 5 mm herniation in my L4 L5 with 60% disc space and a 4 mm herniation in my L5 S1 with 30% disc space left. She recommended I see an orthopedic surgeon and I decided to see three. The first two I looked at the imaging and recommended pain management for a few years and then possibly a fusion from L4 to S1. The third recommended total disc replacement with the pro disc L.

After looking into disc replacement online and watching a ton of video on YouTube I decided to move forward with the replacement only to find out that my insurance probably isn’t going to cover two and Best will only cover one if I’m lucky. At this point I’ve looked into ways I could finance everything.

Basically where I’m at now is deciding if I’m going to pay out of pocket for surgery here in the states which could be anywhere between $60-$75,000 I was told or deciding to go go overseas. I’ve read a lot of posts in regards to getting disc replacement in Germany or England and I am intrigued by the M6 versus the pro disc because of the major difference being compression and not wanting adjacent disc failure. I submitted my imaging to Enande with Ritter Lang ( i’m aware there’s been some negative reviews).

Id like to get in contact with some of the surgeons that have been talked about on this site to see what my options could possibly be. Any recommendations on other surgeons and opinions on types of ADR discs are appreciated.

First thought - I'm often the contrarian here on this subject but I'd suggest concentrating on finding a surgeon you like and you feel confident of first instead of thinking of the device. Again and again over the past decades, having the device placed correctly seems to do more for a successful surgery and good long-term outcome than having the best device. This isn't an attack against Ritter-Lang in particular, just a reality that you get what you pay for applies to the surgeon's skill far more than the device itself.

Second - European surgeons tend to be more aggressive in using ADR on borderline cases. To me, it's because they think in terms of someone who's going to get a lot of post-op ongoing care and physical therapy to allow those borderline cases to be successful, but that's an opinion. As an American overseas, you're going to get limited post-op help unless you plan on staying there for months; that means you're going to have to be a little more conservative in whether you're a good candidate for ADR.

Side note about the PRP - it's not a bad idea to investigate them post-op. Laura used it to help post-op healing but, by itself, they're not likely to do more pre-op than buy a little time to deal with the failing disk.

Thank you I appreciate the information more than you know. I’m currently getting ready to send imaging to Dr. Clavel and Dr. Bertognoli. If you have any other surgeons to suggest please let me know. Thank you again

Warning!
 

I would steer clear of Ritter Lang and there are very few accomplished ADR surgeon s in Britain.
Many misleading websites about artificial disc replacement come up then you get into reading and d I d out its fusion they specialize in.

I would consider the higher volume spine centers in the US; and/or the the surgeons in the US that have been performing ADR since 2000. By now, there are hundreds of them, like Texas Back.

A "hybrid" procedure of a fusion and spinal artificial disc are usually reimbursed by insurance in the US, especially at these larger spine clinics.

Exceeding care in California
 

Please contact Dr. Ali Mesiwala in California. He will not BS you. He does except insurance. I have BCBS. He will give it to you straight. If he thinks he can help he will& if you don't need surgery, he will tell you that too.

Hi Diesel, what's the latest? How are you managing your physical activity these days?