Hello....another ProDisc c
 

story. I had the adr surgery on 09/30/2009 after 8 spinal edpidurals, 2 different attempts at pt, one call McKenzie (specifically for herniated discs), chiro - one swung my neck around and made my pain worse for a while there.

I could not stop the pain so I opted for the adr at C6/7 this was the worse level, and I begged not to be fused at C5. I am now hoping to have the proDisc revised, or replaced as it may have migrated.

I am in Florida and in misery. I have bcbs, any thoughts? And, thank you.

Hi Christin, sorry for your pains. Please tell us (much) more about the diagnostics you had pre and post-operatively, including the report from the radiologist describing the placement of the artificial disc. When you can, please take the time to add a signature too.

I have many more questions for you about how your spine got to that point of requiring surgery, but I don't want to detract from your motivation to share more information. I am just trying to better understand your condition, which also helps other members here too.

:look:

Wow, thx for fixing your signature! You've been through a lot. I hope we can help.

Hi Harrison,
 

:angel:You have as well. As have we all.
I have a chance to see zeegers, and am in tears this has been my wish for a long time.

Now
 

I know what is causing all this relentless pain since 09/30/09, my c6/7 prodisc is too far forward and the c5/6 is narrow and also will need an adr. I do not have the insurance prepayment okay to go overseas (big shock), and am going to beg and plead a US surgeon to fix this, I cannot imagine a 2 level fusion and a bone graph, that was the last US surgeon's suggestion.

I am currently in Tampa and I am running out of time....any suggestions, thoughts, or information is greatly appreciated.

Sincerely,

Christine

Woh, wait a minute: your disc replacement has subsided? How did you learn about this? Who did the surgery? Why did it subside? Can you tell us more information from your post-op visits and radiologist reports?

How was the diagnosis confirmed that your Prodisc-C had migrated forward? The only way that I know would be an A/P and Lateral Xray confirmation that was compared with the same X-rays when the disc was placed. What you would see at that point would be the CoCr plate of the disc sticking out in front of the spine. It is possible (and unfortunately a potential weakness of the keeled design) as the product is held in place by bony ingrowth to the superior and inferior aspect of the plate. The advantage of this is no screws, however the disadvantage appears to be that the device can "slide" in the keel space if one was jarred enough prior to it completely healing into place.

Rgardless, if you have x-ray confirmation, then I would agree that you may be looking at a revision. I recently had my Prodisc-C done at UCH Carrolwood with Dr. Billys (Florida Orthopaedic). I had several physician reviews of my MRI and all confirmed my C6-C7 herniation. However, I had three local Tampa Bay based opinions and 2 of three said ACF over ADR. I did some research with some local spine reps and was lead to Dr. Billys. He suggested ADR over ACF, based largely on my age and activity level. He has been nothing but professional and great to deal with. I am 3 weeks post-op today and am now in physical therapy 3x per week. I want to do everything that I can to avoid future issues and realize that this may seem like more of an agressive path this early, however as a medical device rep (non-spinal related) and former surgical rep, I tend to side with agressive therapy choices.

Since you make a comment about the Tampa area, I would suggest a visit to Dr. Billys (unless he is the one who did your original case and you want to look elsewhere). A local spine sales rep suggested to me that there is also a high volume ADR operator in Orlando, although I do not know the name off hand, maybe someone on this board can help. After a few visits with Dr. Billys, I felt comfortable with his knowlege and experience as an enroller in several ADR studies (even offering to assist with getting me into the Discover study, or a new disc on disc study). He has also spoken on ADRs and ADR/ACF combonation procedures (which may also be an option based on your symptoms, assuming you want BCBS to financially support the procedure) at regional spine meetings.

Regardless, I wish you all the best of luck with alleviating your pain and finding a suitable solution for you... Feel free to PM me if you wish.

Dr. Zigler
 

I was able to get to Dallas, TX and meet with Dr. Zigler, thank God. He viewed all my mri's, xray's, ct scan, as well as ordered more tests to see what was going on.

I had a facet block and a discogram, my C5 and C4 are both bad and have to be replaced. I am thanking God I did not go through a revision on the Pro Disc at C6 as Dr. Zigler let me know it is not too far forward and the alignment is ok. I cannot believe how close I came to making a mistake.

Now, I am waiting for Empire Blue Cross Blue Shield to approve whatever Dr. Zigler orders and hope I will be able to have my surgery with him and get my life back.

Christina,

Everything I've read about Dr Zigler suggests that if he says that the ProDisc-C is correctly placed, then it is correctly placed. As one of the lead investigators in the Systhes ProDisc-C IDE, he possibly has more experience with and knowledge of the ProDisc than any other surgeon in the US.

Did the discogram suggest that C4/5 and C5/6 were also generating pain? Or had they just started showing DDD? Were the facet blocks done because Dr Zigler believes that they are pain generators? Or were they diagnostic?

I suppose that Dr Zigler is going to your insurance company with a surgical prescription of multilevel ADR? If so, is he planning to use two more ProDisc's? NeoDisc?

Good luck, Jeff

Please post your xray pics...

You should also post this in the surgical outcomes section of the forum to help keep people informed.

discogram report
 

Hi Jeff,
Dr. Zigler's office submitted a surgery plan to replace the C5, the facet block was a diagnostic test but I still felt the pain so the discogram was done. That one was kinda awful.
I am so skinny now and miserable, I want to be on the other side of this. I know they are going with the prodisc because it has been fda approved in the us, he wanted to use the mobi c, but I don't think I can last another 6 months.
He and his office have been great, I am just praying for it to be over.
Thanks for always checking on me,
Christine

To: Jack Zigler, MD
From: Renaud Rodrigue, MD
Date: 07/14/2011

PROCEDURE: Three level cervical discogram at C4-5, C5-6, and C7-T1.
LEVEL ARCHITECTURE VOLUME/RESISTANCE PAIN

C4-5 Mild degen; leak 0.4cc - reduced Concordant neck pain; VAS 8/10

C5-6 Mild/degen; leak 0.5cc - reduced Concordant neck pain; VAS 10/10

C7-T1 Normal 0.4cc – normal No pain; VAS 0/10

IMPRESSION:
The C4-5 disc was mildly degenerative. Contrast leaked thru annular defects and into the epidural space. Resistance was reduced. Pressurization caused concordant neck pain VAS 8/10.

The C5-6 disc was mildly degenerative. Contrast leaked thru annular defects and into the epidural space. Resistance was reduced. Pressurization caused concordant neck pain VAS 10/10.

The C7-T1 disc was architecturally normal. Contrast was contained within the nucleus. Resistance was normal. Pressurization was painless. 0/10.

Discographers note: this is a very stoic patient. Her reports were consistent and reproducible on the one level that I tested twice-i.e., C4-5. There was no pain whatsoever with pressurization at C7-T1.

TEXAS BACK INSTITUTE FOR SURGERY
Cervical Discogram Report
Referring Physician: Zigler

LEVEL ARCHITECTURE VOLUME RESISTANCE PAIN
C 2-3 _Normal _0.1 cc _Normal _No Pain
_Abnormal _0.2 cc _Reduced _Concordant
_Degenerative _0.3 cc _Increased _Discordant
_Flat _0.50cc _/10
_Leaky _ .75cc

LEVEL ARCHITECTURE VOLUME RESISTANCE PAIN
C 3-4 _Normal _0.1 cc _Normal _No Pain
_Abnormal _0.2 cc _Reduced _Concordant
_Degenerative _0.3 cc _Increased _Discordant
_Flat _0.50cc _/10
_Leaky _ .75cc

LEVEL ARCHITECTURE VOLUME RESISTANCE PAIN
C 4-5 _Normal _0.1 cc _Normal _No Pain
_Abnormal _0.2 cc X Reduced _Concordant
_Degenerative X 0.3 cc _Increased _Discordant
_Flat _0.50cc 8/10
_Leaky _ .75cc
MILD
LEVEL ARCHITECTURE VOLUME RESISTANCE PAIN
C 5-6 _Normal _0.1 cc _Normal _No Pain
_Abnormal _0.2 cc X Reduced _Concordant
X Degenerative MILD _ 0.3 cc _Increased _Discordant
_Flat X 0.50cc 10/10
X Leaky _ .75cc

LEVEL ARCHITECTURE VOLUME RESISTANCE PAIN
C 6-7 _Normal _0.1 cc _Normal _No Pain
_Abnormal _0.2 cc _ Reduced _Concordant
_Degenerative X 0.3 cc _Increased _Discordant
_Flat _0.50cc _/10
_Leaky _ .75cc
LEVEL ARCHITECTURE VOLUME RESISTANCE PAIN
C 7-T1 X Normal _0.1 cc X Normal X No Pain - SUBTLE
_Abnormal _0.2 cc _Reduced _Concordant
_Degenerative X 0.3 cc _Increased _Discordant
_Flat _0.50cc _/10
_Leaky _ .75cc

xrays
 

Hello,
the xrays are uploaded onto my profile, I am not certain if the images help.

Boy oh Boy
 

Just when you thought that you had done the right thing and this should have made it better. I have dreamt of an ADR at my c6/7. I am alreayd fused at c3-6 and it sucks!!! I have facet arthrosis now even at the levels that were fused. Fusion can cause ddd from stress above and below. That is what happened in my case anyway. If I could find a doctor that would remove the disc and merelyt let me pay put of pocket for the adr I would do it in a heart beat! But I can;t find anyone here in Oklahoma City.

fuse
 

Dear Cheryl,
I am so very sorry for all that you have had to endure. I remember going to the surgeon and seeing his plan for the adr at C6, (prodisc) and he had drawn a 'peek' cage at C5, I begged him not to do ANY fusion at any level. I know I am terrified of this, and I wish you also had the option for ADR. I liked Dr. Zigler enormasly and will travel back to Dallas for the Surgery, God willing, as it is worth going to the best.
I am praying for the insurance approval and the surgery date today, and every day.
If I can help in any way, please let me know.
Sincerely,
Christine

A Few Thoughts
 

Hi Christine,
I'm new to this forum and I too have some multilevel cervical DDD. I have just a few thoughts while reading through this thread. When you feel up to it, I'm wondering if you'd be willing to post sometime what symptoms you are currently experiencing? Secondly, I see in your signature that you have four levels that are affected - does Dr Zigler feel that this 4th level could not be a pain generator? Since you are facing another very difficult surgery, shouldn't this level be addressed as well? And my last thought is that even though you can't afford to travel overseas, and I know you must be feeling incredibly exhausted by now, it might be helpful to sent your MRI and reports to one of the more experienced surgeons overseas just to get another expert opinion - like with Drs Boeree, Clavel, or Pimenta. There's probably some time left while your waiting for your insurance approval. I just want to make sure you're 100% comfortable with your decision.

Wishing you all the best,

MeggieLynn :)

great...
 

empire blue cross does NOT approve artifical discs at all and won't for several more years.....I have no idea how to fix my neck now...

been there...
 

Hello Christine,

Mine was denied by insurance as well. I am going to Dr. Nick Boeree in England for ADR 2 levels on 8/31. I am using my retirement acct to help me finance it. I don't know if that is an option for you, but I am determined that ADR is the better option for me than insurance approved 2 level fusion. I know you like Dr. Zigler, but there are also many experienced surgeons you can look into overseas that have been doing this surgery for years and it will cost much less than a US MD. That was my conclusion, at least. Just some thoughts for you....

Take Care

Hi there
 

Lizard,
I am working with Dr. Zeegers again in hopes that Blue Cross Blue Shield worldwide will pay for one level at C5. I spoke with my case manager on Friday and he said this should work.
I have a feeling Empire blue cross will just leave me like this and I am NOT going to do a 2 level fusion, I so agree with you.
I am (of course) depleted financially since I have been injured and although have paid most of my medical copays....it's not great.
I pray your surgery goes well, and please let me know if you need anything.
Sincerely,
Christine
727-213-7228

Hi Christine
 

Christine,
Thank you so much for the support. I really appreciate it, and will probably be taking you up on the call soon, as I am very nervous about my upcoming surgery!
I pray insurance pays for your surgery with Dr. Zeegers, and your BCBS Worldwide CM can sway it in your favor. You have been through a lot, and pain relief is not too much to ask!
Take care,
Nancy

Soon...
 

I think I will be okay and soon. Dr. Zeegers is working on my finalized report, and the draft alone was so complete. I cannot wait to have my life back and go to work everyday, the gym at night, and have time with friends and family without crying or feeling miserable.

I cannot imagine what others go through and feel lucky to have the technology and surgeon to fix this mess.
Christine

Prodisc...
 

I am working on getting to Dr. Zeegers to have my existing Prodisc revised to another adr (mobic) or an roi a cage? not sure but have been reading up on this device too. and my c5 will have to have an adr, but a mobic, not the prodisc.

I am absolutely terrified my insurance will mess with me or I will get left like this, I can't imagine living like this for the rest of my life, it so sucks.
I am scared about surgery but more terrified to just waste away in pain like this.

Please keep us updated about this. Also you should post your story in the surgical outcomes section. And please post a pic of your x ray with the prodisc.

Good luck.

Hi Christine
 

Hi Christine,

I was just catching up on your entry. I hope everything works out for you with insurance, and you have surgery soon to get some relief.

The pain we go through is terrible, and with the financial stress, it is at times unbearable. Keep strong and I will be praying for you!

(BTW, I tried to respond to your PMs, not sure if you received them as a msg popped up saying you do not accept PMs).

How are you?

September 27
 

Is the surgery date with Dr. Zeegers, thank God. He is removing the Prodisc and putting in an roi-c cervical cage at c6/7 and mobic adr at c5/6. I have alot of faith in Dr. Zeegers.
The surgery is scarey but what would be worse is to be left in all this misery, this is no life so I feel very fortunate to go to the best and keep Praying.

Christina,

This is GREAT news!

Has BCBS signed off on this? Fingers crossed... Please say yes.

Good luck, Jeff

Best wishes Christina. I have a friend that has a mobi -c and has had for several years. He has had no problem and is extremely athletic (barefooting, skydiving,etc). My surgery is the day after yours, so I'll say prayer for you now as I'm going to get a little distracted with my own stuff! Good Luck!

Jeff & Joey Sue
 

I honestly don't know what I would have done without the wealth of information from this site, I have spent 2 entire years in so much misery from the Prodisc and initial cervical disc problems, I could not have analyzed and figured out what to do and how to try to fix my neck....thank you so much.

Blue Cross Blue Shield has approved the surgery, I am still in shock and the fact that I will be able to go to Dr. Zeegers is more than I had ever hoped for.

Joey Sue, I will keep you in my Prayers as well, I hope you are safe and pain free soon.
Jeff, once again, your kindess and encouragement has meant so much, sincerest thank you.

Christina,

I join you in shock over the insurance approval. Congratulations!

I have only ever read good things about the Mobi-C in Dr Zeegers hands. When are you leaving? How long will you be in Germany?

Please keep us posted, and good luck!

Jeff

Christine, I am SO excited and happy for you! As you know, I'm also working with Zeegers so I'm excited to find someone else who will get relief in 2011. Please keep me posted on your progress either here or on Facebook, and I will also be excited to hear about travel plans and any advice you can share about that when you get back (or before you go if you have time, but you have some packing to do!)

Hooray!!!!!
 

Christine,
I am so happy for you!!!! I have to admit, I am also shocked insurance approved it, but could not be happier for you.

I will be praying for you to have a safe trip to Germany, uneventful surgery and a full recovery with a pain-free future!

I know this must be such a weight off your shoulders. Please keep us updated.

I tried to PM you, but you do not except PMs. Please contact me by PM if you want to talk further!

nice to read, ...
 

Best wishes from California for your path forward..

Good news on BCBS. I am thumbs up+++ on the Blue Cross Blue Shield response for your case.


Revised September 11, 2011
Blue Cross Blue Shield Florida,
Medical Covergage Guidelines :
Total Disc Replacment (TDR) Total Disc Arthroplasty (TDA)

Cervical total disc replacement (TDR) at a single level meets the definition of medical necessity when ALL of the following criteria are met:
...
Lumbar total disc replacement is considered experimental or investigational, as evidence is insufficient to determine whether artificial lumbar discs are beneficial in the short term.

================
MPOV ~
Cervical TDA / TDR two (2) year results are better than ACDF results. Cervical TDR results are better than the historical lumbar results from my limited readings and comparisons.

My neighbor got a Cervical TDR at the suggestion / recommendation of her surgeon (surprised me). She asked me about Cervical TDR and I was conservative. Anyway, my neighbor is expecting another child now.

Lumbar TDA / TDR results are ~better than fusion. The historical Lumbar differences are not as large as the cervical TDR population. Historical lumbar differences are measured by Charite and ProDisc. Maverick v ALIF patient results were very good. I need to go to the source doc on Maverick to see if the rhBMP-2 was the cause of any complications in the ALIF patients causing a skew.

Blue Cross Blue Shield Worldwide
 

reversed the approval and denied the surgery after telling me it was all FDA approved and the plane tickets will not be reimbursed. What an absolute nightmare I am tired of fighting all this, I am tired of having this ruin my life, this is beyond rotten.

Christine, I'm so sorry to hear that. What next?

I'm very upset to hear the bad news, before you give up make sure to use extreme radicalism.

beg
 

for my job back and try to save the $$ to pay for this myself or fuse and live like crap. I am now down to about 118, I am miserable and spend most of my time sleeping because the pain is so bad. why I ever got a prodisc and trusted ANY us surgeon or insurance makes me feel like an idiot. I have lost pretty much everything and have a ton of bills due to the disc being in wrong and another level just being left because the us surgeon wouldn't have gotten paid, so this is what I am left with.....

I
 

am so tired of this, I cannot believe after working and paying insurance my whole life they treat you like a joke.

Christine, I am so, so sorry about this turn of events. I wish I had an easy answer for you. I have been in similar shoes, and know how it feels to be treated this way. Do you have any recourse, since they said it was approved? I know you may not feel in the mood at the moment, but have you considered writing a letter to the president/CEO outlining what has happened, a chronological order of events, asking them to reconsider? Writing to the highest up person can often solve a lot of problems. Just a thought. I will keep you in my thoughts.

Thank you
 

for you kindness, I am beyond consolation.....I know every single person on here knows how this is.
Everything was summarized and sent to a healthcare attorney, I have pretty much zero hope though, I found a ton of others that the insurance companies have denied, although to approve, then say "hey sorry we had bad information from their own company, so we are denying"
ahhh, I am considering just fusing and forgeting it all, Blue cross will probably deny that as well somehow.