[jgvesely]

Hi Dave,

I had ADR on L4/L5 and L5/S1 5 and 1/2 weeks ago with Dr. Clavel. I also have neck issues and Dr. Clavel has said that he thinks I would benifit from ADR at C3/C4 and C6/C7.

Regarding your decision making process, prior to getting my lumbar surgery, I consulted with a couple American doctors and Dr. Clavel. I think the general rule of thumb is that American doctors tend to be A LOT more cautious when it comes to ADR when compared with European doctors. I think there are many reasons for this. One is that ADR has been around for a long time (I think since the 1980's) in Europe where as it is relatively new here. (I think one level surgeries were FDA approved around 2004). Many doctors in the US have very little or no experience with ADR (Texas Back Institute is, of course, an exception). Also, I have heard there are restrictive insurance issues especially when it comes to getting more than one level done. In Europe, where they generally have socialized medicine, they are not bound by these insurance considerations. I have read stories on this website where people were told by many US doctors that they were not a candidate for ADR but a European doctor said they were a candidate. They got the surgery done in Europe and experienced success!

Getting back to my experience, I consulted with the Texas Back Institute and they reccomended ADR at L4/L5 and fusion at L5/S1. When I asked the representative (I didn't actually speak to the doctor because I did not go there in person), why fusion was reccomended, I was not given any real answer. I was relieved when Dr. Clavel recommended ADR on both levels as, based on the research I have done, that was definitely my preference.

Anyway, the gist of what I want to say is that if Dr. Clavel reccomends ADR, I would trust him even if American surgeons say otherwise. I believe Dr. Clavel has done over 1500 cervical ADRs, many of them multi-level. He has the experience, I believe he is a gifted and thorough surgeon, he is a very nice person and believe he has a lot of integrity.

One last thing I want to say is that I will consult with TBI for my neck surgery. I think they are the most experienced in the US with ADR and I have heard that people have good results with them. My cervical surgery may be partially covered by insurance if I go to a US doc and of course money is a definite consideration.

But getting back to you, I highly recommend Dr. Clavel and for me, the one year insurance was included in the package which really added to my peace of mind in knowing I was covered should a complication occur.

All the best,
Juliette