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  #1  
Old 07-14-2022, 12:56 PM
Gadsden Gadsden is offline
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Join Date: Jul 2022
Posts: 2
Default 4 Level Cervical decision

Hello all,

I’ve been lurking the site for quite a while. I’m now having to make a decision very soon on a 4 level procedure, so I've decided to sign up with hope to gain some feedback and/or any suggestions to help with my decision. I've done exhaustive research, but I feel like I'm going in circles at this point.

I have consulted with 3 local surgeons, with 2 suggesting 4 level fusion(3-7) and 1 suggesting 2 level fusion(4-6), ADR in Michigan is well behind the curve. I have also consulted with Dr Rasouli who said unequivocally that I don’t want the multi level fusion and he suggested a limited fusion at 3-4 because of slippage with 3 replacements below 4-7. I have also sent my imaging to Bertagnoli and Desai. Bertagnoli has had my imaging since early June with no response, and Tim Vicknair hasn’t replied to my follow up emails. Desai’s liason has told me that he’s on vacation until the end of July. Also considering contacting Lanman or Bray in the US, and maybe Clavel.

My preference would strongly be to stay in the US, and I do like Rasouli a lot, but I’m frustrated with the limited amount of devices available here. However, I’m also becoming very turned off by the lack of response from Bertagnoli for 5 weeks. Patiently waiting to see if I hear from Desai at the end of the month.

Any suggestions on what the best available device would be for multiple levels in the States? They all have concerning features from my perspective. I know placement is key, and by all accounts Rasouli has impeccable placement.

The only reason I’d even consider Europe is device availability, also doesn’t hurt that the Euro has fallen to parity with the Dollar either. However, the long flights and length of stay seem daunting to me. Not to mention the difficulty of follow ups.

Also, what are the odds that I would need blood during or after the procedure? This is also a major concern for me in the current medical climate.


Thanks in advance!
__________________
42y/o Male
2015 Serious MVA
2020 Forced to become caregiver (Physically exacerbated)
Jan 2021 increasing neck, shoulder, upper back pain/tension
Sept 2021 sudden arm weakness, followed by significant atrophy (Biceps/Deltoid)
Dec 2021 EMG levels "normal"
-----------------------------------------------------------
Multi-level DDD C3-C7
Broad based disc spur complex multiple levels
Foraminal narrowing/encroachment multiple levels
C5-6 worst level

Bulging disc L5-S1
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  #2  
Old 07-25-2022, 09:04 AM
Harrison's Avatar
Harrison Harrison is offline
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Join Date: Oct 2004
Posts: 6,976
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Sorry for the late reply. Have you made any more progress with your research? I would put a call in to Dr. Scott Blumenthal at Texas Back. If he cannot help you, he will refer you to other docs in the US or overseas.

There's nothing wrong with a hybrid procedure, BTW. Many have had fusion and ADR for cervical corrections.
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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
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  #3  
Old 07-25-2022, 10:25 AM
Gadsden Gadsden is offline
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Join Date: Jul 2022
Posts: 2
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Thanks for the reply Harrison. I've still been in kind of a holding pattern. I did contact Lanman's office, but he's 2 months out just for consultations. I was considering contacting Blumenthal this week actually, to see what his availability is.

I also seen that Centinel Spine just got the FDA PMA for the Prodisc Nova, SK, and Vivo on 7/13. They're supposed to be available in Q4, which begins in 5 weeks. So that rules out Bertagnoli for me, since the Nova is his preferred device.

I did see that Spine Innovations sold out to Spineway last week too, so hopefully there's some movement on ESP's in the States soon. I had read in March that they were trying for approval this year as well.



https://centinelspine.press/2022/07/...ement-devices/


https://www.globenewswire.com/news-r...protheses.html
__________________
42y/o Male
2015 Serious MVA
2020 Forced to become caregiver (Physically exacerbated)
Jan 2021 increasing neck, shoulder, upper back pain/tension
Sept 2021 sudden arm weakness, followed by significant atrophy (Biceps/Deltoid)
Dec 2021 EMG levels "normal"
-----------------------------------------------------------
Multi-level DDD C3-C7
Broad based disc spur complex multiple levels
Foraminal narrowing/encroachment multiple levels
C5-6 worst level

Bulging disc L5-S1

Last edited by Gadsden; 07-26-2022 at 09:13 AM. Reason: misstated begining of Q4
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