ADRSupport Community  

Go Back   ADRSupport Community > General Discussion > New Member Introductions

New Member Introductions If you just joined, please introduce yourself here. Please add a signature describing your spinal history (use the "User CP) and ask us how we can help you get started.


Reply
 
Thread Tools
  #11  
Old 06-28-2022, 10:08 PM
Suzanne1234 Suzanne1234 is offline
Junior Member
 
Join Date: Jun 2022
Posts: 29
Default

From googling, I see that Dr. Bertagnoli seems to say that multiple level ADR is totally fine if placed right....and that facets can be a little bad and thats fine because the ADR can actually relieve pressure on them. This seems to be totally different from what other surgeons say.

Is Dr bertagnoli really that much better than everyone else? Do the people who have had multiple level ADR's with him really seem to do better?

I know the one difference is that he reconstructs ligaments or something, right?

Thank you for reading.
Reply With Quote
  #12  
Old 06-29-2022, 08:59 AM
annapurna annapurna is offline
Senior Member
 
Join Date: Dec 2004
Posts: 1,668
Default

Bertagnoli may use a ligament sparing technique but you still need to remove some of them to access the spinal disks. Depending on the approach used for your fusion, that may be moot because the ligament damage from that surgery may be more than what Bertagnoli might do.

Bertagnoli's one of the best for multi-level and cases on the edge of being acceptable. He's expensive but often the surgeon of last resort for that kind of case. As to whether his patients do better - maybe. I'd say over the years, he's had a few real failures and a number of patients who didn't improve as much as they'd wished but he's also taken patients that would have been fused from skull to ribs and rebuilt their spines with a hybrid set of ADRs and fusions and given them their lives back. He's definitely one to talk with to see what you could do but there's the risk of not being able to create an stable ADR from a fusion.

Laura's much better off now than when she had the bulging disks. On the other hand, the instability has led to vagus nerve irritation and an inability to engage any activity with the hand above the shoulder. Long-distance swimming, for instance, is now off the program after being able to swim 5 miles a day.

I don't know of a ADR & facet replacement for the c-spine, though our data is about 15 years old on that front. I do know of two people using stem cells with guided prolo injections to try to regenerate disks. Facet injections are even more fiddly than that but they might, if you discuss it with them, flood the region and hope some passes through into the facet capsules.

One thing I liked about Hauser at Caring Medical was that he was focused on the effect of instability on the jugular veins. They pass through the neck in a sheath that also holds the vagus nerve. Instead of arguing too much over instability, he had doppler ultrasound check to see how open the jugular veins were under different conditions. More instability means more conditions where one or both can close. Being an engineer, I tend to like numbers and measurements. You can still argue that it's untested theory but it's at least an internally consistent untested theory.

How painful and frequent are your cervical symptoms right now? If you wore a cervical support collar for a week or two to help with the instability you may or may not have, do you think your symptoms right now are intense and frequent enough to tell if it's helping? I'm not suggesting this as a long-term solution but a cheap diagnostic to see if your feelings about instability at C6.7 and C2 are accurate. If they are, you could approach Bertagnoli, and whatever evaluation fee he charges, with some confidence that it's a worthwhile path to take.
__________________
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
Reply With Quote
  #13  
Old 06-30-2022, 10:03 AM
Suzanne1234 Suzanne1234 is offline
Junior Member
 
Join Date: Jun 2022
Posts: 29
Default

How wonderful a response! Thank you. I am confused as to whether your name is annapurna or laura lol

well, i had heard little things here and there that maybe the vagus nerve has some connection with levels further down from C2 also but I could not find anything about it. You gave me some helpful info!

I was assessed long distance for blood flow issues by neurovascular expert dr liu and i was all clear on that front.

i guess i will just let the c6-c7 pain worsen until i can no longer take it and then see what to do. I am sure you are right in that ADR with preexisting fusion is probably even worse than jusr ADR instead of fusion.

Forgiving myself for what I did despite zero symptoms is the biggest hurdle.

If I send images to Dr Bertagnoli, he might say that if I want reversal I had better act now - that is, if fusion has not taken place yet. So that is another mountain to climb.

thanks so much for your time and help btw
Reply With Quote
  #14  
Old 07-02-2022, 04:53 PM
JackBauer JackBauer is offline
Member
 
Join Date: Aug 2018
Posts: 92
Default

When I started on my journey I was very intrigued with Dr. Bertagnoli.

Certainly he is very skilled. However I'd only personally go with an ESP device... More so for lumbar, but I have both... And in the end both cervical and lumbar are ESP.

Anyway - at the time Dr. Bertagnoli did not use ESP at all. Not sure if he does today, but it ruled him out as a doctor for me.

Given your situation I would consider him a top candidate.

I know of one person who had a cervical revision and she went to Dr. Schmitz. One of the benefits there might be that he's an actual neurosurgeon I think, as opposed to a spine surgeon? I really don't know, but something for you to consider perhaps?
__________________
L4-L5 Broad Diffuse Bulge, mildly contacting left L5 nerve root
L5-S1 Broad Central Disc Protrusion mildly impinging left S1 nerve root
"Mild scoliosis of lumbar spine".
Four central disc protrusions in thoracic spine.

C5-C6, C6-C7 bulging, bone spurs. Imaging not looking good. Successful CP-ESP's placed in Oct 2019 by Dr. Desai.

Delayed lumbar surgery to work on bone density. Considering options now, some but minimal bone density improvement. Will only use LP-ESP.
Reply With Quote
  #15  
Old 07-04-2022, 01:20 PM
elorpar elorpar is offline
Member
 
Join Date: Apr 2022
Posts: 32
Default

Quote:
Originally Posted by JackBauer View Post
When I started on my journey I was very intrigued with Dr. Bertagnoli.

Certainly he is very skilled. However I'd only personally go with an ESP device... More so for lumbar, but I have both... And in the end both cervical and lumbar are ESP.

Anyway - at the time Dr. Bertagnoli did not use ESP at all. Not sure if he does today, but it ruled him out as a doctor for me.

Given your situation I would consider him a top candidate.

I know of one person who had a cervical revision and she went to Dr. Schmitz. One of the benefits there might be that he's an actual neurosurgeon I think, as opposed to a spine surgeon? I really don't know, but something for you to consider perhaps?
Same reason for me, that's why I did my cp-esp with dr. clavel. Still with pain but for the moment I would say i feel better with cp-esp than fused.

------------------

Elorpar

2020 Accident at previous c5c6 degenerated level
2020 c5c6 herniated disk compromising spinal cord
2021 C5/6 fused but bone spures not removed
2022 Chronical pain at c5c6, bone spurs removal and c5/c6 fusion reversal to cp-ESP by Dr. Clavel
Reply With Quote
  #16  
Old 07-08-2022, 08:02 PM
Suzanne1234 Suzanne1234 is offline
Junior Member
 
Join Date: Jun 2022
Posts: 29
Default

wow. so you guys actually had a fusion changed to an ADR? elorpar you mention you are stilli in pain. may i ask what kind of pain and where it eminates from? why do you think the ADR did not improve the pain more?

Jack- did the person you know do well with Dr. Schmitz? May I ask why you want only an ESP? I know very little about this so far.

When I had my neck done, I also had L4-L5 fused. It is maybe 19 months since then and the pain is really starting to bother me at the level above the fusion. Wonder if I should try PRP or something. I don't think they inject the disc itself so not sure what they do...

I heard there is a new device going on trial that will replace both disc and facet in lumbar...
Reply With Quote
  #17  
Old 07-09-2022, 11:07 AM
annapurna annapurna is offline
Senior Member
 
Join Date: Dec 2004
Posts: 1,668
Default

I think Cheryl0331 is the person who was revised by Dr. Schmitz, https://www.adrsupport.org/forums/sh...ad.php?t=14123.

There's a clinic in Austin participating in a trial for the combined lumbar ADR and facet joint replacement device; or it least it was in 2021. The trial is out of the Cayman Islands (location stayed with me because Regenexx practices there as well). I can't remember the details but that's hopefully enough keywords to find it on an internet search.

PRP inside the disk isn't going to help much as the disk interior isn't vascularized in that fashion. Stem cell injections and stem cell-like procedures have had some success inside the disk. There's also the idea of PRP or similar all around the disk and surrounding tissue to stabilize and halt further degeneration. Laura and I are both pursuing that for c-spine and I'll be pursuing it for lumbar after a bout of idiocy picking up a heavy weight a few days ago has left me with lower back pain
__________________
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
Reply With Quote
  #18  
Old 07-09-2022, 02:09 PM
JackBauer JackBauer is offline
Member
 
Join Date: Aug 2018
Posts: 92
Default

Quote:
Originally Posted by Suzanne1234 View Post

Jack- did the person you know do well with Dr. Schmitz? May I ask why you want only an ESP? I know very little about this so far.

When I had my neck done, I also had L4-L5 fused. It is maybe 19 months since then and the pain is really starting to bother me at the level above the fusion. Wonder if I should try PRP or something. .
From the lumbar perspective - the ESP to me is the most superior design out there, by far. I don't care for the M6 for it's mesh loop that seems to be allowing the unconstrained core to escape (in some failures?) and the fact it is an unconstrained device that won't significantly limit twisting... And for the damage the 'blade' at the top and bottom of the disc will do to your vertebrae...

I could go on about other discs.

The CP-ESP I don't quite feel as strongly about but still believe it is likely the best out there. I just wouldn't bet my life on it.

The person who had the revision is Cheryl. Last I heard she was doing well.

BTW - the whole reason for choosing an ADR - and importantly IMHO a constrained ADR... Is to reduce likelihood of adjacent segment disease and specifically wear and pain on neighboring facet joints.

My symptoms were FAR less severe than some here, but in the end I'm glad I had both my lumbar and neck done... with ADR's... instead of waiting until it got really bad and then fusion would be a more likely outcome.

I wish you luck in trying to get better.
__________________
L4-L5 Broad Diffuse Bulge, mildly contacting left L5 nerve root
L5-S1 Broad Central Disc Protrusion mildly impinging left S1 nerve root
"Mild scoliosis of lumbar spine".
Four central disc protrusions in thoracic spine.

C5-C6, C6-C7 bulging, bone spurs. Imaging not looking good. Successful CP-ESP's placed in Oct 2019 by Dr. Desai.

Delayed lumbar surgery to work on bone density. Considering options now, some but minimal bone density improvement. Will only use LP-ESP.
Reply With Quote
  #19  
Old 07-11-2022, 07:04 AM
elorpar elorpar is offline
Member
 
Join Date: Apr 2022
Posts: 32
Default

Quote:
Originally Posted by Suzanne1234 View Post
wow. so you guys actually had a fusion changed to an ADR? elorpar you mention you are still in pain. may i ask what kind of pain and where it eminates from? why do you think the ADR did not improve the pain more?

Jack- did the person you know do well with Dr. Schmitz? May I ask why you want only an ESP? I know very little about this so far.

When I had my neck done, I also had L4-L5 fused. It is maybe 19 months since then and the pain is really starting to bother me at the level above the fusion. Wonder if I should try PRP or something. I don't think they inject the disc itself so not sure what they do...

I heard there is a new device going on trial that will replace both disc and facet in lumbar...
I had c5-c6 fusion reversal to cp-esp, the doctor who made my fusion didn't clean well my bone spurs and my cage was not well placed/chosen.. so I decided to revise and to try adr by the way.

I am still in pain cause my spinal cord and nerves were damaged by my former giant hernia due to an accident, also an adr will not be 100% as a natural disk so you can expect discomfort.

I think I am better with the change though.

ESP and M6 models are the most used elastomeric adr in europe (and axiomed in usa), but recent studies show that M6 causes debris and probably osteolysis in long term.. as well as its design can provoke core failures.

Anyway any decision in this field is very personal, even "specialist" doctors cannot take this kind of decision for you. It really sucks cause sometimes you feel very alone and misguided when you have a problem like this..
Reply With Quote
Reply

Bookmarks

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
New member Rufus2000 New Member Introductions 4 03-06-2014 01:29 AM
New Member hobbes1212 New Member Introductions 7 01-29-2014 02:14 AM
Greetings - New Member Zach New Member Introductions 5 01-04-2014 12:51 AM
New ADR Member mrunc136 New Member Introductions 0 04-26-2011 04:09 PM
New member Discinterested New Member Introductions 7 07-22-2009 10:19 AM


All times are GMT -4. The time now is 11:11 AM.


© Copyright 2006-2023 ADRSupport.org All rights reserved.