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  #11  
Old 01-21-2016, 11:50 AM
annapurna annapurna is offline
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Don't be surprised if the new opinion is more or less diametrically opposite to the ones you have. It seems like the more opinions patients here get, the more different opposing views then end up with. All I can suggest is to really ask a lot about why the new surgeon suggests what he/she suggests so you can understand what they see as the driving forces in their recommendation.
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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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  #12  
Old 01-22-2016, 05:12 AM
JinSong JinSong is offline
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Wow you were so right--well, I was misinformed I suppose from the get-go. The surgeon doesn't even DO disc replacements! The staff assured me when I was making my appointment that though they couldn't tell me what kind of disc he preferred to use, he does work with another surgeon in the practice that does use the mobi-c (the other surgeon is booked into antiquity), and that they often work together/share techniques. Uh uh. Yeah, so that was a totally awkward appointment--I knew more about disc types than this guy did! He was very nice at least, and said that it sounded like I had done my research. He only does fusions, and he said because of my age, he wouldn't do a fusion unless I was pretty much unable to walk or use my arms anymore. Not a total waste of time, but also not very informative. Now my only option for a different disc type is to go to another city. *sigh*
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33-year-old female
C3/4 Disc bulge and bone spurs
C4/5 Disc protrusion
C5/6 Disc extrusion with cord compression, bone spurs due to uncovertebral arthropathy, right foraminal stenosis and bilateral nerve compression.
C6/7 disc protrusion

Lost appeals for ADR. C5-6 ACDF on 3/10/16
ACDF never fused, and ACDF accelerated damage of the other levels. Someone please kill me.
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  #13  
Old 02-13-2016, 07:39 AM
JinSong JinSong is offline
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I actually made a separate thread for this question, but I thought maybe for consistency in case anyone is following this in the future that I might post it here too. Here's the latest with my decision-making process:

This week was super busy with surgical consults for me, and now I'm at the point where I just have to make a decision. I've seen three surgeons in total now, and of course each had slightly different opinions of what kind of surgery to do (or not do).

I had a remote third opinion earlier in the month with a surgeon in the city north of me, which preliminarily said that he would do an ADR with the Mobi-C implant. I was super happy, because my first surgeon used the Pro-disc, which I wasn't sure about, and then I was unable to get an appointment to ask more questions about it until very close to the surgery.

Two days ago I saw the other surgeon in person. I was excited because I thought I already knew what he would say, given that he'd already written up an initial opinion. However, this surgeon had me get a new MRI, and also had me do flexion/extension x-rays. So then he tells me that on the x-rays have retrolisthesis, and because of that, he would no longer want to do the ADR; he'd want to do a regular fusion instead. I understood the rationale perfectly, but I was pretty upset because I've been so sure that ADR is the way to go, and the second surgeon I saw told me to avoid a fusion basically until things were really dire.

Given that information, I tried to push harder to have a follow-up consultation with my first surgeon. I must be getting better at this whole medical office persuasion business, because I got an appointment for the next morning! I tell the original surgeon what the other guy said about the retrolisthesis/fusion thing. He looked at my films and said yeah, there is in fact some retrolisthesis there, but it's really mild, and that he would still prefer to do the ADR. In fact, he said if it was his own neck, and his films looked like mine, he would put an ADR in his own spine. He was definitely confident.

Then I brought up my concerns about the Pro-disc, and he said that he usually defaults to the Pro-disc for a single-level ADR because it's got the most data on it, since it's older. To my surprise, then he said that if I felt more comfortable about the Mobi-C, he does use that one too, and he would have no problem using the Mobi-C instead if I wanted it! I was so happy because that was pretty much everything I was hoping to hear, but didn't think I would.

So now I guess my only concerns now are about the retrolisthesis issue--both surgeons seem equally and diametrically confident that it either is or is not a problem for the ADR. I obviously really prefer the ADR option, but I just want to make sure I'm not making a foolish decision by ignoring the third surgeon and his concerns about the retrolisthesis.
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33-year-old female
C3/4 Disc bulge and bone spurs
C4/5 Disc protrusion
C5/6 Disc extrusion with cord compression, bone spurs due to uncovertebral arthropathy, right foraminal stenosis and bilateral nerve compression.
C6/7 disc protrusion

Lost appeals for ADR. C5-6 ACDF on 3/10/16
ACDF never fused, and ACDF accelerated damage of the other levels. Someone please kill me.
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  #14  
Old 02-13-2016, 11:50 AM
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Fathub Fathub is offline
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JinSong,
Have you had a consult with Bertagnoli in Bogen GmbH?
He is reputed to be quite skilled in C level ADRs so I am just wondering as I haven't seen anything in your posts regarding looking his way...
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Dec 1/15 - 3 level ADR from S1/L3 c/w 360 mobility preservation at L3/L4 for Spondylolisthesis done by Dr. Bertagnoli in Bogen GmbH.
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  #15  
Old 02-13-2016, 08:16 PM
JinSong JinSong is offline
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Hi Fathub,

I haven't looked into any of the surgeons in Europe--unfortunately, there'd be no way for me to afford a trip or a surgery out of pocket like that. I'm a PhD student in the U.S., so I'm pretty much tied to whatever my health insurance will cover. In fact now that's the other part of this equation: waiting to see if my insurance will approve the ADR in the first place.
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33-year-old female
C3/4 Disc bulge and bone spurs
C4/5 Disc protrusion
C5/6 Disc extrusion with cord compression, bone spurs due to uncovertebral arthropathy, right foraminal stenosis and bilateral nerve compression.
C6/7 disc protrusion

Lost appeals for ADR. C5-6 ACDF on 3/10/16
ACDF never fused, and ACDF accelerated damage of the other levels. Someone please kill me.
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  #16  
Old 02-14-2016, 02:14 PM
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Harrison Harrison is offline
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Regarding this:

"...there is in fact some retrolisthesis there, but it's really mild, and that he would still prefer to do the ADR. In fact, he said if it was his own neck, and his films looked like mine, he would put an ADR in his own spine. He was definitely confident..."

You may want to get a more precise assessment on this. Every doc and disc mfr. has slightly different contraindications regarding retrolisthesis, so be careful. The flexion-extension images are usually helpful to the patient and doctor on this. Make sense?

See this link, table 1 and references: http://www.ncbi.nlm.nih.gov/pmc/arti...25514/#CIT0007

And for review: https://en.wikipedia.org/wiki/Retrolisthesis
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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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  #17  
Old 02-15-2016, 02:56 AM
JinSong JinSong is offline
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The flexion/extension x-rays are what made the retrolisthesis problem come up in the first place--the first and second surgeon I saw didn't ask for them, but the third surgeon did, so I went and got the images. Then during the third surgeon's consultation he noted the retrolisthesis on the flex/extension films. After that, I went back to my first surgeon to review the x-rays and discuss the third surgeon's hesitation for doing the ADR, because I wanted his opinion on that issue.

Neither surgeon gave me a measurement in terms of grade of retrolisthesis, although the one that still wants to do the ADR said, "It's literally just a few millimeters," so I'm guessing that it's a grade 1 retrolisthesis. I asked for the notes on both appointments, but neither has come back from transcription yet.

I would really prefer the ADR, and the first surgeon is so sure about doing it, but yeah, I don't want to make the wrong choice by going that way. It's so hard to decide what way to go...
__________________
33-year-old female
C3/4 Disc bulge and bone spurs
C4/5 Disc protrusion
C5/6 Disc extrusion with cord compression, bone spurs due to uncovertebral arthropathy, right foraminal stenosis and bilateral nerve compression.
C6/7 disc protrusion

Lost appeals for ADR. C5-6 ACDF on 3/10/16
ACDF never fused, and ACDF accelerated damage of the other levels. Someone please kill me.
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  #18  
Old 02-15-2016, 02:26 PM
JinSong JinSong is offline
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I had the x-rays done at my primary orthopedic doctor's, so I contacted him to see if he had the radiology report on my flexion/extension films. I was hoping I'd be able to get a written number for the grade of retrolisthesis, but he told me that there was absolutely none noted. Both neurosurgeons showed me on my films, so I know there is SOME retrolisthesis in there, but like the second guy said, I'm guessing that it's very slight, since the radiologist didn't even mention it in their report. Not sure if that means I don't need to worry about it and should still go with the ADR option, or if I should be super concerned still. Tough choice!
__________________
33-year-old female
C3/4 Disc bulge and bone spurs
C4/5 Disc protrusion
C5/6 Disc extrusion with cord compression, bone spurs due to uncovertebral arthropathy, right foraminal stenosis and bilateral nerve compression.
C6/7 disc protrusion

Lost appeals for ADR. C5-6 ACDF on 3/10/16
ACDF never fused, and ACDF accelerated damage of the other levels. Someone please kill me.
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  #19  
Old 02-15-2016, 09:48 PM
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Fathub Fathub is offline
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Posts: 156
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JinSong,
I had 3 ADRs S1-L3 and because of my Spondylolisthesis at L3, I had a 360 mobility preservation cage put in.......http://www.dr-bertagnoli.com/360-mot...n-surgery.html
So far so good but it's really early.......Harrison can probably comment better on this as far as others and long term......

It's an option and Bertagnoli is good on C level.....
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Dec 1/15 - 3 level ADR from S1/L3 c/w 360 mobility preservation at L3/L4 for Spondylolisthesis done by Dr. Bertagnoli in Bogen GmbH.
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  #20  
Old 02-18-2016, 05:29 AM
JinSong JinSong is offline
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Oh my I've heard of heard of 360 fusions, but not of mobility preservation. How's it going for you? I'm curious about whether or not I really need to be concerned about the retrolisthesis at all since I have two very different opinions about it. I wish seeing one of the big name surgeons was an option, but at the moment, I'm just left to choose between the ones on my insurance that are at least in my same state. Still waiting for insurance clearance on the ADR...and then I have to figure out whether I pull the trigger on that or opt for the regular fusion.
__________________
33-year-old female
C3/4 Disc bulge and bone spurs
C4/5 Disc protrusion
C5/6 Disc extrusion with cord compression, bone spurs due to uncovertebral arthropathy, right foraminal stenosis and bilateral nerve compression.
C6/7 disc protrusion

Lost appeals for ADR. C5-6 ACDF on 3/10/16
ACDF never fused, and ACDF accelerated damage of the other levels. Someone please kill me.
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