Making the Leap - who to choose?

[LauraB]

NJGene: Thank you - I hope that works. I was going to consider upgrading my seat for the flight home, but could only afford one (maybe). I will definitely try that approach. Otherwise I'll do what my crazy old aunt did...lie down in the aisle (ha ha).

[Cheryl0331]

Originally Posted by Dema

Hi Laura, per my signature, I have issues at similar level, except mine are at C3-C6, and today I had an appointment with a local surgeon who recommended fusion at C4-C5 & C5-C6. But I really do not want to do fusion. I had sent my images (MRI, CT...) to Drs. Beratgnoli & Clavel and will share what they will recommend. I also sent my CD's to Dr. Peter Hamlyn in UK, I found his name in one of the previous posts in this group, and he does use the M6. None have responded back yet, and I will share their views as soon as they do.
Thanks & prayers that you will be guided to the best option and speedy recovery
Dema

If ADR did not work, then you can always fuse later. However, if you fuse, you can not reverse that. I have a three level fusion and now have adjacent level ddd because of the stress. You have the option that I was not aware of whrn I had my surgery. Take advantage of it!

[LauraB]

Cheryl, that is exactly why I prefer to try this alternative. However, I hope that it will nnnneeeevvvveeerrr come to that point. I'm extremely active and don't want to give up my lifestyle when I finally have the chance to enjoy it.
I pray that I made the right decision - and I wake up at night thinking about it. Financially it will be very difficult, but I'll just readjust - that's life!

[mary2013]

Hi Laura, Congratulations on making a decision. It is a very difficult process but I am sure it is all going to turn out great! I decided on Clavel and had my surgery last week. It was an outstanding experience with an absolutely phenomenal and humble man! I know that he will be on holiday and they have stopped surgeries until late August which once again would not have fit your timeline . . . so the universe must be talking to you. I have just posted my experience it talks about the decision making process if you are interested. I think the most important thing is to know why you choose. For me, they are all top-notch surgeons. They are the best in the world. They all have successes and complications whether or not they have been broadcast on this blog. So for me, it was primarily the disc. It will have to live in my body for the next 50 years.

Lastly, I was terrified and as it turns out what I probably needed to do was to tell myself more frequently that I am an excellent decision maker. You have done your research, you are an excellent decision maker . . . just trust yourself and the world around you.

[Harrison]

A minor quibble or point to make: keeled designs (of artificial discs) significantly and permanently alter the mechanical strength of the spinal vertebrae. Subsequent revisions of disc replacements:

- are risky, tricky, invasive;
- require VERY skilled, experienced surgeons.

The number of surgeons doing these revisions -- successfully -- is limited. Those that have done the most warn of the brittleness of the vertebral bodies from keel-cuts (kurfs, for you carpenters).

When you add unmanaged disease (DDD), poor diet et al to the patient mix, you can start to appreciate the hazards of re-operations!

We are not Leggos, people! Or Weebles for that matter... ("...Weebles wobble, but they don't fall down...")

[LauraB]

Harrison: That makes absolute sense. I believe you mentioned (in an earlier post) that you felt that the Pro Disc C Nova was less invasive than the M6 with regard to the keel design. Although I have bulging discs at two upper levels (and a fusion), I do have DDD at C6/7. I am trusting the surgeons judgement for the best fit. Dr. Bertagnoli uses this device while the others have only suggested the M6. I agree that the experience in ADR placement is significant to the long-term outcome, and that is why I considered this direction.

Again, please pardon my ignorance in the dynamics of engineering, but would the keels (when properly placed and imbedded to the bone) adhere for permanent placement and reduce the risk of migration. Do the keels have the same effect as screws in plates (fusion)? I am aware that these questions should be directed to the surgeon, but as I see every one has an interest in their particular device of choice. I'm just looking for some unbiased opinions. I also wonder about the future of arthritis and the effect of osteoporosis on these devices, as well. Any thoughts??

[mary2013]

Laura . . . I think the only "unbiased opinions" on the keels would possibly be based on some percentage numbers representing revision history based on slippage.

Harrison, Is that available?

Two cents: My brother is not an expert but he has his PhD in Chemical Engineering and Masters and Bachelors in Mechanical Engineering. I asked him to review the M6 and prodisc designs for me and give me his opinion. For M6, he liked the keels, the function, the materials but did not like the number of parts. For the Prodisc, he liked the number of parts, but did not like the function or the materials - the metals specifically. Obviously, he is not a doctor so not sure if this is worth anything to you.

[LauraB]

Thank you Mary for asking your brother. Your 2 cents is definitely worth much more than that! I feel that our tendency was toward the ProDisc as well because of its more simplified design. I can understand Harrison's point that if revisions need to be made, it is difficult for even the most experienced surgeon. What is the choice? Hopefully, not fusion.

[RP_OutWest]

This is LauraB's big day. Let's all send her positive thought for a good outcome and a speedy recovery.

-RP

[LauraB]

Thank you RP - I'm 6 hours our of surgery. All is GREAT!!!!! Dr. Bierstedt was concerned that he might not be able to use the M6 at the lower C6/7 level because it was too far gone, but he DID IT! I am so very, very happy. I have had a few days of fantastic touring with only a little pain - being that I was very careful what I did. We flew into Frankfurt on Monday (arriving Tuesday afternoon), got a rental car, and drove to Rothenburg ob der Tauber (like walking through a toy village), then to Munich to see Marienplatz and the BMW museum (for my husband). We ended up driving south to Fussen to see Neuschwanstein Castle, and drove back toward the hospital by Saturday.

Dr. Bierstedt met me Sunday morning with the anestheiologist and went over the surgery in details. Although he did inform me that I might need a "cage" at the C6-7 level, he was very honest and about forthright about everything. I am so happy that my path led me in this direction. My surgery lasted four hours and I have two fantastic looking M6's sandwiching my neanderthal fusion from 06.

I have been disconnected from the IV (temporarily) and avoiding pain-meds, but will probably need to sleep. I feel good today - no horrific migraines, arm pain, or tingling. I only feel muscle ache - similar to a vigorous workout - I prefer that pain. I am looking forward to getting better everyday and going into battle to pursue ADR options in the US.

Thank you to all for EVERYTHING! I couldn't be happier and better at this moment - could be some residual pain meds - but if I could I would do a happy dance right now. Prost (?) from Germany.

Laura