Well, I just had my second Skype (and a zillion emails) with Dr. Rischke. We're going to do the surgery in Hamburg at a place he states is rated in the top 10 of 2000 centers in Germany. His rate for a 3-level ADR using the LP-ESP, as well as a posterior dynamic fixation using the best carbon-fiber technology with articulating screws (an important consideration for longevity) is E45,000. The clinic cost & parts is what I'm waiting for, but probably circa E20,000. I definitely appreciate the fact Dr. Rischke writes back reliably, although often via cell phone hence some confusion possible, and that he's conversant and patient via phonecon. I was learning toward Dr. Bertagnoli with a much more expensive plan, but am a little put-off by the Pro-Disc and difficulty in getting any answers from him or the clinic at Bogen. One is forced to deal with Tim Vicknair who, while according to some is a great person, in my experience, has been difficult and very impersonal or even rude and uninvolved. The tentative date is for the last week of March 2018 with a 1-week stay in the hospital and two-week stay in the area. Dr. Rischke asked for this because he too will be in the area until 13 April when he has to leave for a conference in Toronto, Canada.

I feel good about this, or at least as good as my nerves will leave me, and I genuinely like the guy. His explanations were on point and he seems up-to-date with the research and techniques as well!

Tony,what type of dynamic stabilization is being contemplated and why? Dr Bierstadt in Dusseldorf uses the Israeli TOPS system

Dynamic Stabilization by Rischke
 

Hey there:

He's using a different system than what he uses in Switzerland. It's called the CoLigne Ostapek. I haven't had a lot of time to look it up, but it does use articulating screw heads, a major factor when it comes to long-term screw retention, and apparently the highest-tech carbon technology. Their website does allow for translation. Upon re-visit, here's a more specific link about the stabilization system, and finally, information detailing the technology can be found in this detailed product release. I hope this helps!

Hi, I had a positive impression of him. He seems very confident, but since I don't know very much about the coligne screws (or with any other posteriordynamic systems) I have some doubts, like: how many year are they suppose to last, do they really get enough load to offset artrosys at the facet joints? Can they get loose with time? How is screw important is positioning during surgery? If anyone has any insight on those issues that would be great. Is there also any competitor rods for posteriordynamic systems that are used without fusion. Thanks

Post-Op Updates
 

Anyone looking for Post-Op updates should follow my other post:

Lumbar L4-S1 FH Orthopedics - Nathan