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  #1  
Old 07-27-2014, 12:47 PM
Throttlejockey Throttlejockey is offline
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Join Date: Jun 2014
Posts: 52
Default New Here - Need Help with 2-level ADR C5/6 and C6/7

Dear All,

After years of neck and arm pain, my wife was recently diagnosed with cervical spinal stenosis and myelopathy. My wife is 47 years old, with a fairly active life style. We also have a Son who is 3 years old and a daughter of 7. She has had symptoms off and on since the early 1990's, and even had X-Rays done in 1998 by a Chiropractor that indicated she had issues in the C5/6 and C6/7 levels.

We have seen four different doctors here in Chicago and have four different opinions. The first doctor from Illinois Bone and Joint suggested we move forward with 2-level ACDF asap, did not mention ADR (we did not know about ADR at that point either).

The second doctor from Rush said that we should hold off, continue treatment, and try to put off the surgery as long as possible. That doing nothing was better due to the slow development of her disease and the risk associated with surgery.

The third doctor from Rush (big shot) did not offer ADR, even though I knew he was involved with Medtronic on the Prestige and Bryan. Then after I prompted, he backtracked and suggested a 2-level with the Bryan Disc (not FDA approved and Medtronic is not marketing right now??) or a hybrid with the Prestige on top and a fuse on the bottom at the C6/7. He also hedged on needing to do it right away and suggested PT (even though his nurse said we are probably going to have to do surgery).

The last surgeon suggested she was a good candidate for the 2-Level ADR using the Mobi-C device and that we should not postpone the decision at all as he did not want to see the condition deteriorate. However, after we went to see him the second time, he admitted that he has never done a 2-level Mobi-C and has only done a handful of 1-level Mobi-C's under supervision at TBI in Plano, and the rest of his experience is on the Prestige.

Now we are at a crossroads as to what to do. I am sending her stuff down to TBI to see if we can get into see Dr. Hisey who was on the Mobi-C clinical study. But now I am getting cold feet for the following reasons:

1) Can we get the 2-level ADR with the Mobi-C reimbursed by BCBSIL? The current policy is to only cover 1-level. Can anyone help with the process?

2) Is the Mobi-C the right solution? I have seen no posts on this forum, or any forums for that matter regarding outcomes with Mobi-C. Why is that??? If anyone is reading this and can direct me to outcomes on the Mobi-C (that are not from LDR marketing/sales departments) please do. Also, a couple of "anti Mobi-C" micro sites have popped up recently on the web saying that the lack of cushioning and the unconstrained design of the Mobi-C makes it a poor choice. These are generated by folks connected to Dr. Clavel and Dr. Ritter-Lang in Europe. Whats up with that???

3) Should we attempt to go to Europe and do a 2-level M6? Can we even hope to get BCBSIL reimbursement?

4) Are there any resources available from LDR or Spinal Kynetics that can help us with insurance? Do you guys have any NAMES/NUMBERS of people to talk to?

5) Even though two of the doctors said we haven't a moment to wait and need to get this done right away, are there benefits to waiting in terms of insurance reimbursement policies or maybe approval of the M6?

I know this was a long email. But we are really nervous about the whole thing and need help.

Thanks!

Dave
__________________
- Wife has been diagnosed with Severe Spinal Stenosis Right and Left Sides, Degenerative Disk Disease at C5/6 and C6/7, Large Osteophyte Complexes at a both levels, with C6/7 on R/H Side, and C5/6 both R/H and L/H Sides. Also Reverse Lordosis.
- Performed 2-Level ADR with M6-C by Dr. Clavel, Barcelona Spine Center on 10/15/14.
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  #2  
Old 07-27-2014, 02:10 PM
NJ Gene NJ Gene is offline
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Join Date: Feb 2013
Posts: 376
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Dave,

As you can tell by my name, I live in New Jersey. I live right across the river from NYC in Fort Lee. I realize that these board are all about ADR. I've considered it myself. However, I've had two levels of fusion in my neck (C3/C4 in 1998 and C4/C5 in 2010, it's important to note that C4/C5 was herniated in 1998, but the surgeons felt at the time it was only essential to operate on C3/C4 since the herniation was pressing against my spinal cord). I have over 95% mobility in my neck after both fusions, so I wouldn't rule it out. Just make sure you get a very good spine surgeon or neurosurgeon. ADR can be good for some people, where it's a choice between a wheel chair or living a normal life.

Before I answer your questions below, I will mention that I have some excellent names of spine surgeons in the NYC area that I've used and know of. Whether you get ADR or fusion in the U.S., it's much more likely to be covered by insurance than if you go overseas. Anything other than ADR will almost certainly be covered in the U.S. Btw, I am 48, so I'm close in age to your wife.


These are generated by folks connected to Dr. Clavel and Dr. Ritter-Lang in Europe. Whats up with that??? Clavel and Ritter-Lang use primarily the M6. I feel that they have biased opinions. They're not going to endorse something that can be done in the U.S. and take away business from them. Currently the M6 is unapproved by the FDA (probably to a large extent for political reasons) and cannot be used in the U.S. (even though it's produced in California).

3) Should we attempt to go to Europe and do a 2-level M6? Can we even hope to get BCBSIL reimbursement? A year and a half ago, I would have said yes. Now I say "No". There is no accountability if you have surgery in Europe. If there is a problem, you are stuck with it. No U.S. surgeon except perhaps one (Carl Lauryssen in California) would see you at home for follow-up. Furthermore, they want your money up front. As far as insurance reimbursement, if your policy has an international rider, you have a chance of some reimbursement, but you have to go not planning on it. For whatever it's worth, as a C.P.A., I can tell you that virtually all expenses relating to going overseas would be tax deductible to the extent they exceed 10% of your adjusted gross income.

4) Are there any resources available from LDR or Spinal Kynetics that can help us with insurance? Do you guys have any NAMES/NUMBERS of people to talk to? [COLOR="rgb(65, 105, 225)"]Not that I know of for overseas. Perhaps others can answer this better than me.

5) Even though two of the doctors said we haven't a moment to wait and need to get this done right away, are there benefits to waiting in terms of insurance reimbursement policies or maybe approval of the M6? I truly don't believe that it's going to be approved soon enough in the U.S. to make it worth waiting for.

[COLOR="rgb(65, 105, 225)"]If you are absolutely set on ADR and are willing to pay out of pocket some, there are some good surgeons in the U.S. However, I don't think ADR is essential. Read on these boards about Vicki_In_Florida and all the problems she's encountered with the M6. Feel free to send me a private message (PM). I will give you my contact information and perhaps we can talk

Good luck!!

Gene
__________________
Car Accident 2002 - Small Herniated Disc C3/C4
1998 Larger Herniation and Cervical Fusion C3/C4
2005 Herniation C4/C5 - 40 epidural steroid injections from Oct 2005, - Oct, 2007
2008 - Foraminotomy at C6/C7 on left side
Feb, 2010 - Cervical Fusion C4/C5
Dec, 2010 - Lumbar Fusion L3/L5
2013 - Bulge on C5/C6; herniation C6/C7 right side
Mar 26, 2013 - Foraminotomy at C6/C7 on right side
May 5, 2015 - ADR with Dr Blumenthal of TBI for C5/C6 using Mobi-C
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  #3  
Old 07-27-2014, 02:54 PM
FranklySir FranklySir is offline
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Join Date: Jun 2013
Posts: 177
Default TJ. Careful what you read

Gene, Ill give you this at least you are consitent in displaying your path. Hows that 16 years worth of injections and multiple surgeries working for you. Talk about biased!
All good until you hit the second paragraph with your own bias

Throttle,

Gene does have a couple valid points but doesn't really provide support. Notice he wants a PM to talk around the support mechanism. Does this all the time and see for yourself. I dont care for his opinion nor the way he handles himself. You might find this rough but someone needs to say it and I dont care what he thinks of me.

I dont agree with it and think it wrong like there is another agenda. He leaves out that the numbers are overwhelming in success but because those people move on with there lives (because of this kind of post) there is only bad. Ask yourself what will the FDA do for you. Its nonsense. Do you want to get fixed (whatever way you choose) or sue someone. Would you not see hundreds of cases of failures here or abroad as opposed to the continuation here and abroad. Be realistic. Chance of failure is there with any surgery, implant, procedure or fusion. Finding the right answer for your specific needs is the key.

In the end there are no quick answers. You will have to research and see which procedure is right for you. Myelopethy is nothing to play with especially if you have mucsle loss or loss of feeling or spacial awareness. Fusion isn't necessarily a horrible thing. You might not be the right candidate for ADR anyway. Insurance most likely wont pan out for overseas but you might get lucky.

People should not push you in any direction without facts to support a claim. Facts are not one person or even five having an issue with any surgery. It is horrible for Vicki but the fact is that there are not rampid instances of this. Pointing out one case is ludicrous when we all know many people in Families and friends HECK Look at Genes Bio that needed multiple surgeries. Negative push and its wrong.

The best thing is to send all your info to multiple surgeons in US and Europe. GO to outcome posts and look for yourself. None of this nor any surgery is a game. It must be suited to you and for your specific curcumstance.

Wish you peace of mind in finding your specific solution. Most here will support whatever choice you make because thats what its for!!

F
__________________
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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  #4  
Old 07-27-2014, 02:57 PM
drewrad drewrad is offline
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Join Date: Jan 2014
Posts: 629
Default

Sorry you're going through this. It's cool to see you take up your wife's case. Most people here are digging into research themselves.

As far as ADR versus fusion, everyone is different. Look at the entire neck. Some people can withstand one or more fusions. Others cannot. If the adjacent discs are healthy enough and can withstand a fusion, then it may be a decent way to go. If the adjacent discs are also next to worn out, then ADR may be more suitable, as more strain will be applied to those adjacent levels as now more are being asked of them.

In the US fusion is termed 'the gold standard', but not in Europe. In Europe it is considered directionally retrograde(not in all cases as I'm a hybrid).

I had multilevel lumbar degeneration. My discs were all shot, torn and compromised. Regardless, due to my sacral slope being too steep, an L5/S1 fusion was chosen at that level with two M6s placed above it. So far I'm happy with the decision since there is a strong base at the pelvic floor to support the new motion above, and in turn, a better introduction of vertebrae to vertebrae on my higher up discs, a more correct angle of introduction. Basically my L2/3 is more centered now as a result of the work on the lower three underneath.
__________________
Weightlifter since 12 years old, now mid-40's and figuring out this wasn't such a good idea.

Chronic back pain started in 2010 while shrugging weights that a 40 yr. old shouldn't even try.

MRI in 2012 showing L4/L5, L5/S1 herniations and L2/L3 bulge.

L5/S1 taking on new shape, chronic sciatica, etc.

DEXA bone scan performed 5/7/14 showing mild osteopenia.

Surgery performed July 9th, 2014, Dr Clavel, hybrid three level lumbar.
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  #5  
Old 07-27-2014, 03:29 PM
annapurna annapurna is offline
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Join Date: Dec 2004
Posts: 1,668
Default

To comment exclusively about waiting vs. getting surgery immediately: We've always been an advocate of getting your ducks in a row about which surgeon and what surgical repair you want as soon as you can then waiting until your personal condition reaches the point where you decide for yourself that it's time for surgery. Assessment of risks and a personalized cost/benefit analysis is just that, personalized, and you can seek advice to help make that decision but you need to make it for yourself.

What we've failed to point out and want to expand on here is the effect of the treatment type. The surgeons who offered fusion suggested waiting; the ones who offered ADR suggested immediate surgery. It make sense based on what the surgery needs for success. On the scale of intervention, non-surgical techniques pretty much need to be pursued immediately upon diagnosis because they can't heal all that much, work very slowly and need everything other than the one thing they're addressing to be in as good a shape as possible or else they'll have very limited effect. Fusion, on the far opposite hand, can "fix" extremely damaged structures but can't ever get you back to 100%. That's why it makes sense to hold out until you're sure it's time for surgery. ADR falls between the two. If the structures in your spine are too degenerated, it can't work. It can get you closer to 100% than fusion if it does work.

I don't know if this helps but it does give you some idea of why you'll get the "surgery right now" and "hold off as long as possible" answers as you talk with docs.
__________________
Laura - L5S1 Charitee
C5/6 and 6/7 Prodisc C
Facet problems L4-S1
General joint hypermobility

Jim - C4/5, C5/6, L4/5 disk bulges and facet damage, L4/5 disk tears, currently using regenerative medicine to address

"There are many Annapurnas in the lives of men" Maurice Herzog
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  #6  
Old 07-27-2014, 03:35 PM
NJ Gene NJ Gene is offline
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Join Date: Feb 2013
Posts: 376
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Dear Dave,

I do have to admit when I am wrong at least to some extent. I do include many of my biases in here. There is a member by the name Lillyth who had 6 levels of the M6 put in here by Dr. Clavel. She is living a relatively normal life now. Had she listened to U.S. doctors, she would probably be in a wheelchair.

As Frank suggested, get multiple opinions from both U.S. surgeons and European ones. If you do go to Europe, consider what I said about the medical tax deductions. Believe it or not, that was a large part of what I wanted to discuss in a PM being a C.P.A. I also wanted to mention that my U.S. surgeon would look at your MRI films at no cost to give one opinion without you having to travel. I also believe that Frank and others will agree that if you go to Europe, stay away from Dr Ritter-Lang. There is an entire thread in here called nightmare in Stenum.

Lately I am focused on the negative, given the isolated incident of Vicki_In_Florida. However, it's you and your wife's job to read through these boards and form your own opinion along with those of the doctors you see.

Frank, thank you for being blunt, it helps me out when my opinions get lopsided. One thing I want to point out though is that it's not necessarily about suing to use a surgeon in Europe, it's that many patients on these who've had surgery in Europe have had difficulty finding doctors in the U.S. for follow-up care afterwards. Dave, whichever way you want to go, you can PM me for support.

Best of luck!!
Gene
__________________
Car Accident 2002 - Small Herniated Disc C3/C4
1998 Larger Herniation and Cervical Fusion C3/C4
2005 Herniation C4/C5 - 40 epidural steroid injections from Oct 2005, - Oct, 2007
2008 - Foraminotomy at C6/C7 on left side
Feb, 2010 - Cervical Fusion C4/C5
Dec, 2010 - Lumbar Fusion L3/L5
2013 - Bulge on C5/C6; herniation C6/C7 right side
Mar 26, 2013 - Foraminotomy at C6/C7 on right side
May 5, 2015 - ADR with Dr Blumenthal of TBI for C5/C6 using Mobi-C
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  #7  
Old 07-27-2014, 06:17 PM
FranklySir FranklySir is offline
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Join Date: Jun 2013
Posts: 177
Default

Gene,

Thank you for taking that constructively! Cudos to you for having an open mind and tracking back.

Dave,

1) Can we get the 2-level ADR with the Mobi-C reimbursed by BCBSIL? The current policy is to only cover 1-level. Can anyone help with the process?

Any two level is tuff to get reimbursed

2) Is the Mobi-C the right solution? I have seen no posts on this forum, or any forums for that matter regarding outcomes with Mobi-C. Why is that??? If anyone is reading this and can direct me to outcomes on the Mobi-C (that are not from LDR marketing/sales departments) please do. Also, a couple of "anti Mobi-C" micro sites have popped up recently on the web saying that the lack of cushioning and the unconstrained design of the Mobi-C makes it a poor choice. These are generated by folks connected to Dr. Clavel and Dr. Ritter-Lang in Europe. Whats up with that???

Clavel just to note is not with RL. Every surgeon has their preference for many reasons. I can say here for me at least that I would not want a NON constrained device. I believe they work but you would need to be in top condition muscle wise IMHO which most are not due to length of wait and putting off surgery as is typical.

3) Should we attempt to go to Europe and do a 2-level M6? Can we even hope to get BCBSIL reimbursement?

Yes there is hope for reimbursement. I did for my neck two level 100% less expenses but it was an emergency. Both surgeons here US agreed I was a (Great) candidate but did not do ADR. Major muscle loss, speech and swallowing problems, both arms affected. Im awaiting the Lumbar. Emergency as well Cauda Equina. Two major tears finalizing herniations while working out rehabbing for the neck. Still awaiting on the Lumbar outcome.

4) Are there any resources available from LDR or Spinal Kynetics that can help us with insurance? Do you guys have any NAMES/NUMBERS of people to talk to?

SK is no help with insurance. Again here, ADR may not be the best thing for your wife.

5) Even though two of the doctors said we haven't a moment to wait and need to get this done right away, are there benefits to waiting in terms of insurance reimbursement policies or maybe approval of the M6?

This happens all the time with the right away and wait opinions. The benefit might be that it would calm down giving you time to make a sound choice. M6 is a long way out in US. As time passes if her condition gets worse or collapses more ADR is out at some point. "(Annapurna)" Be cautious of muscle loss, swallowing issues and spacial awareness. A good indicator of really bad stuff (my experience) was that out of the blue I couldn't whistle then the swallowing and speech thing kicked in with more muscle loss and twitching.

If both surgeons and two of the EU surgeons all agree it might make sense to contact BCBSWW to see if you are covered. They might green light it as another on this forum did get the go ahead from BCBS for a two level..

Hope this helps. Keep digging for answers.

F
__________________
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 07-28-2014, 12:02 PM
Kelly4ADR's Avatar
Kelly4ADR Kelly4ADR is offline
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Join Date: Jan 2014
Posts: 259
Default Insurance

Dave,

I have some information for you about insurance reimbursement for two level cervical ADR. I have Aetna who also states in their clinical policy bulliten that they only cover one level. I have been appealing the decision as I need a two level. My surgeon (his staff, rather) and a company called MCRA has Been helping me with the appeals. We are waiting on the final decision from an external reviewer which should be any day now. If Aetna's denial is overturned and surgery is approved, I will be moving forward with the mobi-c at c5-6 and 6-7.

If Aetna's denial is upheld, I can opt to have them pay for 1 level and my husband and I will pay for the second out of pocket. A quote from my surgeon if done this way would be a little over 16k. This also opens up prosthetic choices since Aetna will only be paying for one, but chances are I will still go with the mobi-c.

There are other insurances now who are covering two level cervical. United healthcare, and Cigna that I know of. The mobi-c has been FDA approved for two level for almost a year, so it won't be long before other insurances change their policies to include it.

If you need more info on the appeals process let me know, it's been my area of expertise for the last 6 months.
__________________
2004 MRI -cervical bone spur causing pain
2011 MRI -5 bulging discs at C3-7: Recommended C5-6 and C6-7 for a two level fusion, I said no thanks.
2014 MRI -progressive compression C5-7.
MRI 6/5/14- Ruptured L4-5, bulge at L2-3 and L5-S1 Dr recommends discectomy of L4-5 but won't do surgery until cervical is stable
8/2014- 8 months/3 rounds of appeals, Aetna denies 2 level cervical ADR
2 level ADR w/ mobi-c C5-7 Jan 7, 2015
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  #9  
Old 07-28-2014, 12:09 PM
JEVE19 JEVE19 is offline
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Join Date: Feb 2006
Posts: 359
Default Every back is different

Every back is different and you can find different outcomes for all procedures.
Just to clarify, Zeeger's said that I'm not the first nor the last to have an M6 removed.
At the same time, there has also been Charite's removed, Prodisc removed, etc...
There are video's posted on Youtube where you can watch surgery of discs being removed!
I watched one where the disc broke and the doctor showed it being removed.
There is no "golden" disc.
Some people have had Charite's for 20 years and it worked fine, other's not so fine?
Same thing with fusion. Some have a fusion, it works great. Some have a fusion, and it doesn't turn out so great.
Why is that?
Is it the doctor?
Is it their experience?
Is it our body?
I've had several doctor's tell me that ANY foreign object put into your body can lead to rejection. I've been told that my bone spurs are probably caused by the fact that my body does not like the disc. Again, that is a doctor's opinion.
Wouldn't that mean that my body would then grow bone spurs because it's not going to like the fusion either? I asked that question and was told "not necessarily" LOL
So you see, there is no one right answer.

All I can say is....if you read through the surgical outcomes, most people will say "I wish I had done this sooner".

When your real God given discs are degenerating, they hurt!
It affects your life in every way.
You are willing to try something because you can't "live" with the pain.

The question is....which something should you try?
Which doctor's opinion do you listen to?
Can you afford an overseas surgery?
Will you have a doctor willing to help you when you come back to the US?
Remember, that this is the doctor's "business" and they are in it to make money.
Some care and make money but still...it's a business.
They can each sell you on why they want to do a certain procedure.
Which doctor do you listen to?
It's maddening and frustrating.
Feels like you have to become a doctor yourself to make a decision.
I did all kinds of research. Waited years before having my surgery.
At the time, EVERYONE was doing great with the M6.
Now look, just barely past the 2 year mark and mine has to be removed.
That's not the norm, but I'm also not the first.
Well, obviously if I had known this was going to happen, I would have saved $34,000 and
just stayed in the US and had a fusion. Whose to say that wouldn't have had some problems too?

My point is only you can decide what to do.
There are all kinds of different outcomes for every disc/fusion/etc.
All you know is that you're in pain, you have to do something and what should you do.

Make yourself a list of questions.
Ask the doctor's all the same questions.
I do have to say that the overseas doctor's are much more willing to be frank about their feelings. The US doctor's always have to consider "lawyers" in their life.
Zeeger's made me laugh because he said "the local doctor you're going to doesn't know s**t about bones"! Boeree was the same way. Came right out and told me why he thought certain discs were "rubbish". I guess they can talk more freely because they can! No FDA guidelines to follow. I love that about them though and it made me feel good to hear them talk to openly because the US docs didn't seem to be as frank.

All I can say is...would I get another lumbar disc?
NO

Would I get a cervical disc?
YES

My opinion is if I can keep my cervical motion, I would like to try.
If it doesn't work out, cervical revision isn't as risky as the lumbar is.
Still not an outcome you want, but it can be done.

The lumbar is not a great place for revision surgery.
I didn't read about that part before my surgery because I was so convinced that it was my cure I never really thought about the revision aspect.
Now that I've read and had MANY consults, I'm very scared about having this disc removed.
Knowing that, I'd be more willing to say L4-L5 is right in front of your two main arteries.
You don't really want a revision at this level. The L5-S1 is just a bit below the arteries which is why Zeeger's says he has done this many times. (I didn't ask how the outcomes were though..I'm scared to hear the answer).
After all these recent consults, I'm not sure I'd recommend a lumbar disc.
EVERY doctor told me that the cervical's do much better with ADR than the lumbar.
I'd be willing to give the cervical's a chance.

Sorry for the long post but I'm trying to give a good perspective since I'm living with the good, bad and ugly right now.

Do lots of homework, make a list of a zillion questions, pay for Zeeger's consult, ask MANY doctor's for their opinion then pray.
We can only control certain aspects of the decision and the outcome is up to God.
That's how I look at it.

I read a funny on Facebook that said:
I know when God closes one door, another door opens but man, those hallways are a b**ch!
LOL
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L5-S1 Lumbar M6 by Nick Boeree
10-14-2011
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  #10  
Old 02-03-2015, 03:42 PM
donnzih donnzih is offline
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Join Date: Jan 2015
Posts: 1
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Hi! I'm new to the forum. I live in the Chicago suburbs. The Ortho surgeon I have seen here recommended I have surgery (ACDF) on c5-c7. It is scheduled for next Tuesday, February 10th. This is all happening quickly. I've been researching and found this forum. It's very comforting to read other peoples experiences. To not feel so alone and scared. In all my research I found a doc in Chicago at Rush who has performed multilevel cervical ADR. I'm seeing him on Thursday. Not sure what to expect. I feel that I have somewhat educated myself in the last two weeks on ADR. I get nervous around doctors, and I clam up. Not good! I'm making a list of points I want to cover and questions.
Throttle jockey, I'm wondering what doctors you saw in Chicago. It would be great to get your input.
Also, wondering if anyone recently had multilevel cervical ADR and has Cigna insurance. Ugh!
Thank you so so much!
Donna
__________________
*10/14-Severe pain in neck, shoulder and right arm and hand.
*10/14-X-ray shows DDD from C4 through C7.
*11/14-MRI shows C4-C5 & C5-C6 desiccated discs. Bone spurs from C3-T1. Broad based disc protrusion at C6-C7 & C7-T1. Foraminal stenosis at C5-C6 & C6-C7.
*12/14-Epidural cortisone injection @ C6-C7. No relief.
*01/21/15-Ortho surgeon recommends C5-C6 & C6-C7 ACDF. Scheduled February 10th.
*Feb. 5th-Appt with Ortho surgeon at Rush in Chicago to discuss ADR.
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