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International Assistance Any topics relating to traveling or communicating with international treatment locations are here.


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  #1  
Old 01-21-2014, 11:18 AM
bwink23 bwink23 is offline
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Default Quote comparison from Dr. Clavel

OK, so i got my quote from Dr. Clavel for a hybrid/fusion lumbar procedure of l5/s1(fusion) and ADR(L4/l5). Quoted at 34049 Euros. If i opt for a double ADR for the cervical at c5/c6 and c6/7, the quote goes up to 46049 Euros...or a whopping 62,700 U.S. bucks . Essentially the cost increase would be another 12,000 Euros to do the neck(2 ADRs) the same day.
This is their "all-inclusive package" with transportation and hotel stay for one week after the 5-day hospital stay. It also includes a 1-year insurance management for any complications due to surgery that might arise.
Do these numbers line up with the types of surgeries any of you have had?? That's a a lot of dough to fork over, but is it a substantial savings to do both surgeries at the same time as opposed to doing them on separate dates?
__________________
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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  #2  
Old 01-21-2014, 01:49 PM
FranklySir FranklySir is offline
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Bwink,

Here are the numbers I paid separately. Cervical 29500 EU plus 1000 Eu for the insurance. Lumbar 31500 EU give or take a little with insurance.

Hope this helps.

Frank
__________________
Lumbar issues 18 yrs
herniations lumbar L3-5 multiple Epis etc etc
Annular tears L3-5 cauda equina
Cervical herniation symptoms 2011
C5-7 M6C by Dr Clavel on June 5 2013
L3-5 M6L by Dr. Clavel on 12.18.13
Living life instead of living the condition
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  #3  
Old 01-25-2014, 11:09 PM
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Harrison Harrison is offline
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Default Surprising numbers...

...because Europe is thought to be so much less expensive. Dunno why you are getting these numbers. Some hi-volume clinics in the US are less expensive.

Pls note also the number of Clavels' patients that have less-than-perfect outcomes (which is true for any high-volume doc), though he is STILL telling patients that he has no complications in his patients post-operatively.

This is nonsense.
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  #4  
Old 01-26-2014, 03:03 AM
Stonewall_Boris Stonewall_Boris is offline
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Bwink,

Given Harrison's comment, and I assume you are American, why do you persue a operation over seas when you have available to you the doctors of the US?

Harrison,
I'm not American, I'm Canadian. So my descion making process is different than that of a USA citizen. Based on my research I was not going to have back surgery in Canada.

My wife and I would have to pay for my surgery out of pocket and it would cost a lot by our standards. I wanted the best bang for my buck. I did send my mri's to 3 US doctors and 3 European doctors. All being said I was convinced that surgery in Europe was my best option. As per cost, I got a dollar cost for my back operation from Europe. If I needed more time, if there was a complication that was covered in the quoted cost. If I went to the US, if I had any complication the cost could grow substantially.

You bring up a very good question Harrison. Why do US citizens go overseas when they have compitant doctors at home?
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  #5  
Old 01-26-2014, 08:06 PM
bwink23 bwink23 is offline
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Hey Stone....

The considerable work i need done is very difficult to get covered here. U.S. covers a single-level ADR for cervical and lumbar. I am a multi-level patient for both areas. An ADR doc here told me i would have to run appeals for the lumbar, and do a hybrid fusion/ADR on the cervical cuz insurance wouldn't cover a double-cervical. Double cervicals in the U.S. are rare, and only one device has been FDA-approved for it's use recently. NO DEVICE has been approved for double lumbar, OR a hybrid-construct in the lumbar. Now i know patients have been successful as of late in getting some of these types of procedures covered. But is that risk of non-coverage worth what i'd be getting?

As i've stated before, i'm for anything that can most closely replace my natural disc. The M6 seems to be the one to go with. For the lumbar, the large keels in the Prodisc combined with the fusion procedure that uses screws makes me nervous. Large keel cuts and screws in the same vertebra to me would be risky and could weaken the vertebra. An ADR-doc here in the U.S i talked to said he doesn't like using Prodiscs and is getting away from them. We're getting some more ADR's approved, but the only one i like is the Mobi-C for cervical. Good, but not as good as an M6, IMHO. Prodisc is the dominant lumbar disc here in the United States, and quite frankly i don't like the concept one bit. Too many issues created from the near-perfect positioning that it requires...and the long-term facet degeneration potential.

I have to get my lumbar done. I won't get a Prodisc put in my lumbar spine. Maybe i'm just being paranoid, but l4/l5 disc is a critical disc and is very active. The thought of putting a prodisc there makes me apprehensive. I'm certain i want an M6, especially in my lower back. My neck is a different matter. I COULD live with Mobi-C's from the United States to save a buck. Although not the M6, I believe it's the next best thing available right now for the cervical spine. The cost to have cervical done the same day as my lumbar with Dr. Clavel is about $16,500 U.S. dollars. My insurance covers at 70% out of network, which could be about $5,300 out of pocket for me for cervical....is that worth the cost of having 2 M6's in my neck as opposed to 2 Mobi-Cs??

A lot of tough questions. What you have put in your body, you have to live with for the rest of your life. I don't know if there is a right answer to any of the problems and concerns we face.
__________________
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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  #6  
Old 01-26-2014, 09:07 PM
FranklySir FranklySir is offline
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Angry

Harrison,

I dont think you actually answered Bwinks question but rather suggest something with no numbers to back it up.

No doctor anywhere on the planet will be perfect. What sucess rate is based on is also grey.

Aren't you breaking your own rules here.

Bwink has to make a decision based on what is available here which is nothing as to what needs to be done and will not be covered anyway or most likely. The Euro's have more experience and access to a better implant IMHO. Our bodies aren't perfect nor will anyones recovery.

Cost for most is very difficult and some decisions need to be cost based.

I thought this forum was for information not bashing.
Clavel was straight with me and explained a small number of issues that have transpired over time and spent alot of time doing so.

Painting this surgeon with a broad brush because, I BELIEVE, your experience with another stealing this site is wrong.

I live right near Phila with all the teaching hospitals and I still got the GOLD STANDARD line and the Payton Manning line.

You say "High volume" above. Very misleading and not a help here. The man specializes in this surgery so his numbers will be high by default. Should I complain about the Ferrari dealer messing up my Ferrari because they mostly work on Ferraris

Your comment above gives people pause is not called for. If you want a bashing post hten create one for yourself.

Feel free to kick me off but This is uncalled for since you truly cannot name one surgeon mentioned here that hasnt had problems but claims close to full sucess which is impossible without having the benchmark for what is included in that measure. Feel free to PM me and I would be more than happy to have a real conversation without exposing others and possibly dashing their hopes.

My opinion you owe Bwink an apology for possibly creating doubt. Stick to the facts and provide numbers to back the claim please.

And, lastly I am upset since this site, with all the good people on here including YOU helped me make an informed decision to contact and then make my own judgement. Who cares where someone goes as long as they get fixed to the highest standard possible.

Be well and peace of mind in all decisions.
Respectfully,
Frank
__________________
Lumbar issues 18 yrs
herniations lumbar L3-5 multiple Epis etc etc
Annular tears L3-5 cauda equina
Cervical herniation symptoms 2011
C5-7 M6C by Dr Clavel on June 5 2013
L3-5 M6L by Dr. Clavel on 12.18.13
Living life instead of living the condition
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  #7  
Old 01-26-2014, 09:17 PM
FranklySir FranklySir is offline
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Posts: 177
Smile

Bwink,

Don't feel the need to explain yourself. Get informed including this site. speak to others that are willing to share good and bad. Make your decision with feedback from the person who will need to fix you.

Call Yolanda and have a skype call with Clavel. Ask Clavel directly about people that had issues and get the info from his mouth then you can make a good choice. Contact other surgeons and do the same.

Harrison's point I believe is of frustration that our Docs here will not get the practice needed to help more people here if we keep leaving the country.
He is right and I give him that. Not my back or neck though. I want those that have the most experience.

In the end we all need to be comfortable with our choices and need the emotional support after the fact.

Remember we are losing a part of our bodies which is no different than losing a limb. My next post was going to be about this issue and sense of loss.

I wish you clarity and pain freedom.

Frank
__________________
Lumbar issues 18 yrs
herniations lumbar L3-5 multiple Epis etc etc
Annular tears L3-5 cauda equina
Cervical herniation symptoms 2011
C5-7 M6C by Dr Clavel on June 5 2013
L3-5 M6L by Dr. Clavel on 12.18.13
Living life instead of living the condition
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  #8  
Old 01-26-2014, 10:10 PM
Stonewall_Boris Stonewall_Boris is offline
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Posts: 547
Default quite Frankly Sir

I didn't go with Clavel but Harrison's comment cut through me as well. I thought he made a harsh comment on something he never personally experienced. Given the number of patients that had surgery over seas on this forum with successful results I have no idea on what he was trying to say, other than what you point out as to his frustration that patients are going over seas for their operation.

Harrison, if you boot Frank, feel free to boot me as well!
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  #9  
Old 01-26-2014, 10:15 PM
Stonewall_Boris Stonewall_Boris is offline
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Bwink,

I think you've done tons of research, go with your gut instinct! The one thing I did before making my descion was to "turn off" everything.
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  #10  
Old 01-26-2014, 10:16 PM
bwink23 bwink23 is offline
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Posts: 262
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FranklySir,

Excellent posts. Harrison's points probably would have been better served under it's own thread. No offense taken. I just read and move on. You're right, there is no "100% success rate" wherever you go. I believe his issues are how Clavel is promoting himself as having no complications.

Defining "complications" between clinical terms and patient outcome terms....are 2 very different things. A surgeon can carry a "90% fusion rate" in regards to fusions and be considered a success, despite the patient not getting any pain relief from it. I imagine that ADR surgeons promote themselves in the same manner. A textbook implanted ADR may not resolve a patient's pain, but would be a clinical 100% success if there is nothing to contradict it.

I don't need Harrison's help in second guessing, i'm doing that fine by myself!! It's all about COST vs. RISK. I believe many patients make their decisions solely based on cost, and i don't want to be that way. My insurance, at a 70% out of pocket reimbursement for overseas work, gives me an avenue to pursue what i think is a BETTER option. I would bet my house on the facts that:

1. All INFORMED patients would use an M6 in the U.S if it was fully covered.
2. ALL patients would go overseas to get it if they were fully covered for it there and not in the United States. WHY?? Money, not necessarily surgical experience.


When it gets down to brass tacks, it's about the bottom dollar. Many patients who do know about the M6, still get the Prodisc on virtue of coverage. That's fine. They will even use their "trusted" surgeon despite a limited track record with ADR's....That's fine too....COST vs. RISK. Everyone's different with different circumstances to deal with. That's why we read other poster's scenarios, to try to get a better picture of what you can do for yourself, evaluate your specific COST vs. RISK profile.
__________________
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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