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  #81  
Old 12-20-2013, 05:36 PM
dustman9725 dustman9725 is offline
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Default Frustrating frustrating !!

Jeff, yes I would imagine that you would have done your homework for sure. You are very versed on all of options, doctors, topics, etc...

I feel like the cervical sector would be more difficult when removing the prodisc because of an overall smaller space. Funny that it is more dangerous to remove the Prodisc from the lumbar area. But i guess a ton more bone growth occurs in the larger Lumbar sections.

I am finding myself simply pushing this surgery (or the thought of it) off because I am a chicken. I would be so heartbroken if I tried this prodisc removal and it didn't work out and I was paralyzed or lost feeling in my arms or hands, etc... It is such a frustrating 50/50 decision. But I keep also thinking that if I do this now at 35, it will better than at 36 or 40 or even beyond. Ahhh, I just want to scream. My mother is of course trying to prevent me from even considering another surgery...but of course people in our lives do not understand the current pain that we endure every second and how much that pain effects the quality of our life each day. If you are like me, you have learned through about a year of complaining and begging (2010), that people actually start to avoid you and you actually lose friends when you need them most. People create space from us when we are hurting, because they don't know what to say or how to help. So, I have become a master at not even bringing up my pain and hiding it from the outside World. I remember meeting people and within 15 mintues, I was discussing my neck and the pain, the doctor, the technology, etc... And although not terrible, the agony was defining me.

On aonther note...Christina I thought that you were certainly out of the woods. What have your symptoms been? Did you just go for a checkup and this neurosurgeon noticed the misplaced M6 or were you suffering and made an appt? I remember talking with you and you were so happy...that stinks that you are hurting again. We should chat again 702-812-8749. Jeff feel free to call as well.

Thanks guys and everyone.
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Ruptured C5/C6 June 2010. Rushed into Prodisc surgery July 1, 2010. Month after installation, symptoms came back and new more intense pain. Fought all year for help. July 6, 2011 received fusion-revision on top of Prodisc - John's Hopkins. Numbness went away in hands, but pain still remains. Doctor's all say "Life of Pain Management" forever. Trying to endure life through the fog of pain and meds and procedures. New hope is now Neurotransmitter "TENS" unit implanted into neck at C5/C6.
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  #82  
Old 12-20-2013, 10:59 PM
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Harrison Harrison is offline
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When I was considering a ProDisc-C with Dr Zigler in 2008, I quizzed him thoroughly (for a layman) about removing the ProDisc if something went wrong. He explained to me that the patient's situation would have to very bad for him to even consider explanting a ProDisc-L; saying that with lumbar, "we only get one shot". He contrasted the ProDisc-C saying that it comes out relatively easy and that each cervical level can be accessed multiple times. I've since learned that that means that provided that 1) there has not been excessive bone in-growth and that 2)during implantation if the surgeon also implanted a barrier to keep damaged tissue from growing together, that it is easy, relative to lumbar, to remove a ProDisc-C.

All I mean by all of that is that since your fusion wasn't done with BMP, that your disc 'might' not be prohibitively dangerous, or even hard, to remove???

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Jeff,

Helpful post, thank you as always.

Keeled designs are very invasive. I don’t speak with ortho surgeons much anymore, nor do I attend the spine conferences. I attended several years ago, which influenced my biases against keeled designs. I know that “marketing won” and keeled design rule, but they don’t account for the localized or systemic osteoporosis of the patient – which often have absolutely no root cause defined by any of the patients’ doctors.

I believe that the cause of these disease factors are trauma, infection and poor nutrition.

If the patient is healthy, their spine can compensate for minor (whatever that means, subject to interpretation) surgical placement errors.

Subsidence of devices, with or without axis placement errors, are probably the biggest problem. This is my opinion only, but based on observations within this community. If a patient has both problems, that may create the most obvious problems.

I also recall Dr. Zeegers in a SAS conference audience, responding to a panel of surgeons on the podium commenting as to how brittle the spinal vertebrae can be for revision patients – suggesting that keeled devices weaken the spinal bones. That really stuck with me, since the etiology of DDD is still overlooked – and the basic fact that bones that are cut are compromised in different ways. Patients tend to overlook this fact.

Jeff:

- Cervical kinematics are very different than lumbar as we know.
- Can you elaborate on this: barrier to keep damaged tissue from growing together. If this is being done on patients, it’s news to me. Are you referring to bone wax, which is not done in the US?

Good reference to Zeeger's opinion. Dated, but still valid: http://www.adrsupport.org/forums/f48...-testing-9161/ Sadly, his opinion is already outdated, since people in their teens, twenties and thirties have been diagnosed (DEXA et al) with both localized and systemic osteoporosis.

This is just my opinion and observations. Hope it helps.
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"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
Donate www.arthropatient.org/about/donate
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  #83  
Old 12-21-2013, 03:47 AM
dustman9725 dustman9725 is offline
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Default Great Inupt and questions Harrison

Definitely, Thanks Harrison. That sentence about bones being brittle when going through multiple traumas/surgeries would have stuck with me too. And I wonder how a prodisc at the C5/c6 level and then a subsequent Fusion at the same level would, then allow a surgeon to find enough bone to do the removal... They have to drill above the prodisc notches to remove it.

I just don't know, I am so confused. I can see that this Doctor sees Dollar signs too, I just feel it. I mean, any surgeon would...but I can't look past that fact without pondering. Treating me w/ just meds is not his cash cow.

I am definitely going to be grabbing some "extra" opinions. I had a really rough autumn and Winter so far and it has been extremely nasty with the headaches and the numbness in the hands and the overall pain in the shoulders, arm, neck and combined with the sleeplessness. I type this at 12:44 am in Vegas and I know that I will be up untl at least 5am shuffling around and playing musical beds, trying to find a magical-comfortable position.

What did I ever do to deserve...No! It could be much worse. After my 1995 car accident, I could easily be a parapalegic right now.
__________________
Ruptured C5/C6 June 2010. Rushed into Prodisc surgery July 1, 2010. Month after installation, symptoms came back and new more intense pain. Fought all year for help. July 6, 2011 received fusion-revision on top of Prodisc - John's Hopkins. Numbness went away in hands, but pain still remains. Doctor's all say "Life of Pain Management" forever. Trying to endure life through the fog of pain and meds and procedures. New hope is now Neurotransmitter "TENS" unit implanted into neck at C5/C6.
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  #84  
Old 12-21-2013, 09:38 AM
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jss jss is offline
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Harrison,

Great information. A BTW ... I learned about the infectious cause of DDD coming to this site AFTER my double ADR. Had I learned about that cause BEFORE surgery, I would have requested the excised tissue be tested for potential pathogens. I will make that request when C7/T1 finally has to come out.

The barrier to keep damaged tissues from adhering to other structures... I was referring to products like SepraFilm, that are often placed between a damaged and its adjacent tissue to keep the damaged tissue from adhering to the adjacent tissue as it heals. I don't know if Dr Naftalis used this during each of my fusions, but Dr Clavel did use it during the ADR.

Jeff
__________________
C4/5 - ACDF in 2000
C5/6 - ACDF in 2002
C3/4 & C6/7 - M6 ADR, Nov 2009, Barcelona
Conceded defeat to a manifestly disingenuous BCBS-TX in my quest for reimbursement, Jan 2011
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  #85  
Old 12-21-2013, 10:12 AM
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jss jss is offline
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Dustin,

Having two grown 'children' of my own I understand and appreciate your mother's position. I have a good idea of the devastation that would be heaped upon her if you came out of surgery worse than you went in. Certainly her opinion and the potential consequences on her should be considerations as you decide whether or not to proceed with a risky surgery. If the surgery is worth the risk is something that only you can decide. As you're pushing this surgery off because you're understandably 'chicken', it sounds like your answer right now is that it's not worth the risk?

Good luck, Jeff
__________________
C4/5 - ACDF in 2000
C5/6 - ACDF in 2002
C3/4 & C6/7 - M6 ADR, Nov 2009, Barcelona
Conceded defeat to a manifestly disingenuous BCBS-TX in my quest for reimbursement, Jan 2011
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  #86  
Old 12-22-2013, 10:23 PM
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Lucelia Lucelia is offline
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Quote:
Originally Posted by jss View Post
Harrison,

Great information. A BTW ... I learned about the infectious cause of DDD coming to this site AFTER my double ADR. Had I learned about that cause BEFORE surgery, I would have requested the excised tissue be tested for potential pathogens. I will make that request when C7/T1 finally has to come out.

The barrier to keep damaged tissues from adhering to other structures... I was referring to products like SepraFilm, that are often placed between a damaged and its adjacent tissue to keep the damaged tissue from adhering to the adjacent tissue as it heals. I don't know if Dr Naftalis used this during each of my fusions, but Dr Clavel did use it during the ADR.

Jeff
Dear Jeff:

I need to do surgery on the same levels as you and I am debating between having a mixed procedure in the US or having 3 level ADR in Germany or Barcelona. Based on your experience what do you think?

Also, don't understand why some people say ADR is only approved in the U for 1 level and I have seem post by people saying they had 3 level done by Dr. Delamarter. Actually he is one of the surgeons that proposed mixed procedure, ADR + fusion when Dr. Bierstedt clearly said 3 level ADR. Very confused....

Lucelis
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56 year old
C4-5 moderate canal stenosis
C5-6 moderate to severe canal stenosis
C6-7 mild to moderate
Trying to figure it out best option
Also many issues with lumbar
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  #87  
Old 12-23-2013, 11:17 PM
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Harrison Harrison is offline
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Exclamation

Thanks Jeff. I found a financially biased article here on SepraFilm:

Seprafilm® adhesion barrier: (1) a review of preclinical, animal, and human investigational studies

But still, it appears promising. There are some definite contra-indications highlighted in this paper:

http://download.springer.com/static/...059d5&ext=.pdf

Lucelis, your post may get lost. Pls post again in the new member forum, introduce yourself, where we can give you full attention.

Thanks. Ga night.
__________________
"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
Donate www.arthropatient.org/about/donate
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  #88  
Old 12-25-2013, 11:37 PM
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jss jss is offline
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Lucelia,

You will forgive my delayed reply. We've just returned home from a funeral and an extended Christmas holiday in our home town (Wichita Falls, TX). We had an outstanding visit and trust that you had a very Merry Christmas as well!

Condolences on the need for surgery. The best course to take is extremely difficult to determine, usually impossible to know, sometimes even years after surgery.

I've made no secret of my affinity for the M6 and aversion to the ProDisc. Even so, I don't know which you should pursue. I need to start keeping statistics from the surgical outcome forum. It certainly seems that those that go to Europe for an M6 are significantly more likely to do better than those that stay in the US for a ProDisc or fusion; certainly in the short term (four years or less).

I would encourage you to spend long hours reading in the surgical outcomes forum of this site, and of any other spine forums that you can find. You will see patterns begin to emerge. There simply is no substitute for that kind of research. It will not be long before my C7/T1 disc has to come out. Rather than drop another $30k in Europe, if my insurance carrier will cover a Mobi-C, I will very likely do that. I've already begun researching US surgeons for that intervention. Whatever you do, I would implore you to not use a surgeon whose record with the device you select cannot be researched and verified.

I don't understand that either... What does "FDA approved" mean? Multilevel ADR has been done in the US for over a decade, even though it wasn't "approved". Insurance carriers routinely refuse to pay for approved procedures while paying for procedures that haven't been approved. I don't understand it either. I do wonder if US surgeons tend to recommend not the procedure that they believe to be the best for the patient, but rather the one that they believe that the insurance will cover?

Good luck, Jeff
__________________
C4/5 - ACDF in 2000
C5/6 - ACDF in 2002
C3/4 & C6/7 - M6 ADR, Nov 2009, Barcelona
Conceded defeat to a manifestly disingenuous BCBS-TX in my quest for reimbursement, Jan 2011
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  #89  
Old 12-26-2013, 03:20 PM
bwink23 bwink23 is offline
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Quote:
Originally Posted by jss View Post
Lucelia,

You will forgive my delayed reply. We've just returned home from a funeral and an extended Christmas holiday in our home town (Wichita Falls, TX). We had an outstanding visit and trust that you had a very Merry Christmas as well!

Condolences on the need for surgery. The best course to take is extremely difficult to determine, usually impossible to know, sometimes even years after surgery.

I've made no secret of my affinity for the M6 and aversion to the ProDisc. Even so, I don't know which you should pursue. I need to start keeping statistics from the surgical outcome forum. It certainly seems that those that go to Europe for an M6 are significantly more likely to do better than those that stay in the US for a ProDisc or fusion; certainly in the short term (four years or less).

I would encourage you to spend long hours reading in the surgical outcomes forum of this site, and of any other spine forums that you can find. You will see patterns begin to emerge. There simply is no substitute for that kind of research. It will not be long before my C7/T1 disc has to come out. Rather than drop another $30k in Europe, if my insurance carrier will cover a Mobi-C, I will very likely do that. I've already begun researching US surgeons for that intervention. Whatever you do, I would implore you to not use a surgeon whose record with the device you select cannot be researched and verified.

I don't understand that either... What does "FDA approved" mean? Multilevel ADR has been done in the US for over a decade, even though it wasn't "approved". Insurance carriers routinely refuse to pay for approved procedures while paying for procedures that haven't been approved. I don't understand it either. I do wonder if US surgeons tend to recommend not the procedure that they believe to be the best for the patient, but rather the one that they believe that the insurance will cover?

Good luck, Jeff

I got a taste of that when i visited a local doc about my low back...he didn't even bring up ADR to me, and when i asked him about it, he said i wouldn't be a good candidate for it. I told him the other doc i talked to said i was a perfect candidate for it (did a fellowship at Texas Back Institute). He proceeds to say "Well insurance doesn't cover it so we don't even talk about it."


Perfect example right there....not what's BEST for you, but what's best for THEM.
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2013 - MRI and CT scan....DDD L4-S1
left side (where my pain is) interarticularis pars fracture/defect with Spondylolithesis L5 over S1 with 2MM anterior displacement

Feb. 2014 - Hybrid lumbar fusion(l5/S1), ADR(L4/L5)...2-level cervical ADR (C5/C6, C6/C7). Dr. Pablo Clavel of Quiron Hospital in Barcelona, Spain. All M6 implants (PEEK cage and plate from Medtronic at fusion level in lumbar.) SAME DAY OPERATION for both areas of the spine.
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