Introduction - Mike33
 

Good Evening everyone, as my names says, I am Mike and I am a 37 y/o male from PA. I fell 20 feet off of a roof in college and landed on concrete on my tailbone. From there I had a drop-foot in my right foot and had an old-school right-sided laminectomy with partial discectomy which corrected the nerve pain and drop-foot immediately (even left the hospital the same day). over the past 18+ years I have dealt with flare-ups, muscle spasms, tight hamstrings, and sciatica/numbness in the legs (primarily right). I continued playing hockey and heavy lifting over the years but have backed off substantially due to my back (and an irregular heartbeat that I developed over the years as well - now corrected mostly via cardiac ablation).

As time passes, I seem to be having more and more flare-ups where my lower back completely spasms and gives out. It used to be 1-2x a year, now its 5-6x a year. I had an MRI in 2012 and just last month, both showing DDD in L4-S1 with scar tissue at L4/L5 pressing on the right side of the nerve. I am actually in a spasm now - just last Saturday I leaned to get something out of my car that weighs maybe 1lb, yes 1lb, and boom it seized and it's been floor or bed for 2-3 days, ice-packs, heat, etc. I am almost to where I won't even lean over at the sink any more just to brush my teeth. I am so frustrated and fear that my back will just seize/spasm up again. With my job (cover 26 states) and the flying that I do (2x a week) I cannot afford to do extensive PT, injections (never worked anyway), pain pills, etc.

Brings me to now - I met with a local surgeon and he say pain management or 2-level posterior fusion. I met with Dr. Zigler recently and he suggested a hybrid L4-S1 ALIF and ADR. My insurance is out-of-network so I am probably looking at 30K + for surgery at TBI. Does anyone have experience with hybrid ADR/fusion in the lumbar region? I need my life back and while I expect to be patient with recovery, I cannot miss more than 8 weeks from starting to travel again. I appreciate you all reading this and any potential advice that you can give!

Hi Mike, sorry you are here. I hope we can give you the support you need to get back to full health.

Let me know if you need help with this:

http://www.adrsupport.org/forums/f58...-health-11053/

Thanks, will check in later. :beer:

Hi Mike,

Welcome and I too am sorry you have found yourself here but, you are in good company and there are some great people here who I think can give you some good advice. I don't think I qualify since I'm more cervical and from what I've read the L5/S1 area of the spine is unique because it takes the greatest force. The biggest question always is should you put an ADR down at that level or not? There are members here that have fused and members who have gone with the ADR.

I'm not sure if you know that the Activ L was just FDA approved a few weeks ago in the U.S. It's a disc I would talk to TBI about. I think there are some benefits to using it over the Prodisc.

You might want to reach out to Dr. Clavel in Spain and get his opinion as well as Dr. Zeegers in the Netherlands too. (TBI is one of the best we have in the U.S. so, I'm not suggesting they are inferior.) At least take a look at their websites. I suggest this since you are looking at paying cash anyway. You can read about their successes in the Post Surgery Forum here.

Wishing you wellness,

Cynlite

Thank you both for the replies! I will work on my sig once I'm back in front of my PC. I am looking at Dr. Bertagnoli and Dr. Zeegers as well.

It's weird, the nerve pain isn't bad really, it's the constant muscle spasm and tightness, along with bruising feeling from very lower spine below wait line. SI JOINT is also very tender on right side (and I've heard a pop there too yesterday). I'm just wondering if it's purely muscular or is the spasm being caused by structural issues? Perhaps my SI JOINT is the culprit? Don't wanna get operated on and find out its muscular only!

Mike, I hate to be the bearer of bad news but, I'll put myself out there anyway. If you go through the post surgery forum, you will find stories of many unfortunate patients of Dr. Bertagnoli. He doesn't have a great record of being there for his patients that have had a bad experience after him doing surgery and there are quite a few of them unfortunately. Of course, there are some patients that have done well but, it's sort of 50/50 from what I read. Also, since he helped to engineer the Prodisc, he has a vested interest in using it. Both the Activ L and the M6-L are better discs IMO. These are just my opinions from spending many, many hours reading the forums so, I do recommend that you do your own research. Talk to Dr. Zeegers about the Prodisc. One of the issues with it is that it has a large keel design which is not optimal and has later been perfected on by other manufacturers. (The problem with a large keel is that if it doesn't work out, you can't have it replaced. There is a lot of bone drilling involved. Only fusion and sometimes leaving it in are your only options.) I'm sure Dr. Zeegers will have something to say about it. I don't think he has used that disc in many years and is quite knowledgeable about them. He seems to be a conservative surgeon and an honest man so, I would respect what he has to say. I have been working with him as well.

On your other point about your question about it being a muscular problem, are you seeing a good pain specialist? They can help you to figure this out. I'm using an inversion table which is helping my lower back. I know this is not for everyone though. We are all so unique when it comes to spinal problems. Best to get a pain specialist to guide you. Traction can make things worse for some. Good luck to you!

Thanks Cynlite and no worries, I appreciate the insight. Dr. B does seem to have a hit-and-miss review history from what I've seen so far. Zeegers seems to be more consistent though. Have you heard/read much on Dr. Zigler? He seems very confident and nice, I just didn't have much time with him.

I've been reading a lot here and on the internet but it appears that there's more failures than successes, and this has me stressed!!

I haven't seen a pain management doc - I have a very difficult time with pain meds so I am avoiding them. I would, however, like to have my SI JOINT tested via injection. I know my discs are hurting, but I'd hate to go through a large procedure only to find out that my SI is the main culprit (especially since the neurological pains are minimal).

Mike

Mike,

These are the people that I found that went to TBI. The surgeons include Zigler, Arakal & Blumenthal:

PDIDDY, AMYWOOD0108, MILLERTO, GROVER771, REDTX, CORTEXPHAN, NJGENE

I went through the entire Forum for cervical surgeries but, did not finish reading all the lumbar surgeries.

I found there were more failures in the U.S. and with Bertagnoli in Germany than with several of the surgeons in Europe. Dr. Clavel has a stellar record so, I would read the stories from his patients. Dr. Zeegers also has a good record but, many, many more of the ADRSupport.org members went to Clavel so, it was hard to compare the two surgeons just because of a lack of feedback in the forum.

In my study which was mostly cervical, the failure rate was significantly higher with the Prodisc and Prestige discs. The M6-C and Mobi-C were much better in comparison. Dr. Clavel did an outstanding job with the M6-C for most of his patients. Where he lost ground was in the 3 level surgeries which is what he is recommending for me. The more complex the surgery, the higher the risk for problems IMO. So, this is what I am weighing right now. I spoke to one of Dr. Clavel's patients who had 6 ADR's and she's doing fabulous so, one never knows.

I too have problems with medications in general so, pain meds and muscle relaxers are no exception. I found that the epidurals never gave me any relief so were not great for figuring out my pain generators. They have a 50/50 success rate. I know some of my pain comes from my facets so the RFA procedure was truly a gift. I wouldn't be writing you without it because I otherwise I would be in bed with a 24/7 migraine that is just debilitating.

My pain specialist says all the time for me to stretch. I spend about 30 - 40 minutes a day and sometimes more stretching. This includes using my inversion table. My spine is so screwed up that is causes muscle spasms all the time. I have to just keep working on them. I also use a heating pad quite a bit. In my case, I think the spasms are the body's response to the damage in my spine. I used to just lock up occasionally like you described but, then it got chronic. BTW, SalonPas (green) are great on muscle spasms. I keep them in my purse to stick to places that start hurting when I'm out and about.

I hope some of the lumbar patients will jump in and help you out. If not, it's because they are back to living full lives. I know that some will respond if you send them a PM. Just keep digging through the Forums. There is a massive amount of information here. I've been reading it for five months and still haven't gotten through it all LOL. It's a rabbit hole of information thanks to Harrison who set this up for us many years ago and keeps it running.

wow, Cynlite, thank you very much for the detail! It's means a lot since I'm in the early "it's time to accept that I need surgery" phase. I'm still relatively young and it crushes me that I can't pick up either of my young daughters. I'd like to get back to athletics too but at this point I'd be content on being pain-free (or close) in a laid-back lifestyle.

I have decisions to make - I really like Dr. Z but I'm honestly a bit cautious as he made his recommendation on an MRI, X-ray, and 2 minute physical exam. That being said, he seemed awfully confident that I'd do very well with the hybrid, particularly over a 2-level fusion or ADR as my L5-S1 facets are degenerating too. Going to keep researching but I have a feeling that Dr. Z will be my surgeon (overseas will be too difficult with my family situation).

Have a great evening and thank you again!

If I stay in the country there are only two places I would go, TBI and Dr. Pettine in Colorado. I think TBI has some great surgeons. (NJGene just got back from having surgery there with Dr. Blumenthal. He's a super guy if you want to PM him. He had cervical surgery with the Mobi-C.) Perhaps you could get a second opinion from Dr. B. I would think that TBI will be one of the first to start using the Activ L because they are always at the forefront when it comes to ADR in the U.S. (Europe makes more sense to me right now because I'm a cervical patient with a lot going on in my neck but, I'm still trying to puzzle this out.) The other benefit of staying in the country is that you would have a surgeon here to see you if you have problems. That's a big deal! If I have surgery in Europe, I know that finding a U.S. surgeon to follow me afterwards is going to be a challenge.

You might want to touch base with Colorado Babe. She had lumbar fusion and stem cell injections last year and is doing great. She knows more about Dr. Pettine's work than I do.

I'm sorry you can't pick up your girls :( I hope you can someday soon.

Does anyone know if TBI was in the trials for the Activ L?