Another L4-L5-S1 story

[AZMtnman]

But the benefit of having a new device like Activ-L in the US is to use US doctors with US insurance. And most of those doctors are starting from scratch with experience with a "new (to US)" device and new surgical protocol. Hence my comment about not wanting to be the first person to sign up.

International surgery is clearly a different conversation and process maturity and surgeon experience are not the risk factors I'm concerned about there.

Just my opinion. And my opinion is subject to wild fluctuations depending on how my back feels on a given day.

[NJ Gene]

Originally Posted by AZMtnman

I've read about injections but haven't pursued it with my doctor. For me, I think facet issues are secondary to the progressively bulging discs. But I do plan to look into it more.

How long have the injections helped before the effect wears off?

The facet injections work differently for everyone. For some people it does nothing at all, which means the facets were probably not the cause of the pain. For those that it does help, the effect can last anywhere from a couple weeks to a few months. More importantly, it if it does work, there is a longer lasting procedure, called a Rhitzotomy, in which an injection is made with heat that effectively "deadens" the pain causing nerves. I'm told this can last for years and sometimes for life.

[pittpete]

These doctors arent starting from scratch.
Many were involved in the initial FDA trials.
Depending on where you live you may find one close to you.
Do your research https://clinicaltrials.gov/ct2/show/NCT00589797
Investigators
Principal Investigator: Rolando Garcia, M.D. Orthopedic Care Center
Principal Investigator: James J Yue, M.D. Yale University
Principal Investigator: Dom Coric, M.D. Carolina Neurosurgery and Spine Associates
Principal Investigator: Steven Dennis, M.D. Hoag Memorial Hospital Presbyterian
Principal Investigator: Federico P. Girardi, M.D. Hospital for Special Surgery, New York
Principal Investigator: Mick Perez-Cruet, M.D. Michigan Head and Spine Institute
Principal Investigator: Harel Deutsch, M.D. Rush University Medical Center
Principal Investigator: Glenn Buttermann, M.D. Midwest Spine Institute
Principal Investigator: Dzung Dinh, M.D. Neuroscience Education and Research Foundation
Principal Investigator: Vikas Patel, M.D. University of Colorado, Denver
Principal Investigator: Christopher Ames, M.D. University of California, San Francisco
Principal Investigator: John Regan, M.D. St. John's Hospital and Health Center
Principal Investigator: Andrew Dailey, M.D. University of Utah Medical Center
Principal Investigator: Darren Bergey, M.D. Rancho Specialty Hospital
Principal Investigator: Brian Dalton, M.D. Hamot Medical Center
Principal Investigator: Scott Leary, M.D. Scripps Memorial Hospital La Jolla
Principal Investigator: David Hart, M.D. University Hospitals Cleveland
Principal Investigator: Antonio Castellvi, M.D. Foundatin for Orthopaedic Research and Education
Sorry to sound snippy but if you think its easier to fly across the world and let a doctor you never met, who you hope has your best interest at hand while paying cash with no follow up to future problems you need to invest the time

[AZMtnman]

Looking at that trial report, there were 414 total patients and only 2 in 3 received the Activ-L. Spread that out across all of the PIs and you're left with a pretty small sample set.

I meant no disrespect to the PIs. My point was simply that there isn't much experience with the device and that just takes time. I personally hope the adoption rates for new devices take off because it would make my personal research and choices easier if there were thousands and tens of thousands of successful cases vs dozens and hundreds.

[AZMtnman]

NJ Jene, Thanks for the info on facet injections. I'll definitely need to look into this further. I always thought that I had a good relationship with my doctor but I have to admit that I'm getting a bit frustrated with the waiting game. Particularly if the end game is fusion.

[JeffR]

Originally Posted by pittpete

Sorry to sound snippy but if you think its easier to fly across the world and let a doctor you never met, who you hope has your best interest at hand while paying cash with no follow up to future problems you need to invest the time

It takes hundreds if not thousands of procedures with a device to become adept with it. I personally wouldn't let a doctor who has done less than 50 touch me - which is the case for pretty much every Doctor on your list I suspect.

Sometimes paying cash and going across the world is the best answer. There are excellent surgeons out there who DO have their patients best interests at heart. Yes follow-ups aren't free, but you can get someone locally to follow you after. If you need another surgery in the future (god forbid) then you pay again - I realize that isn't option for everyone but it is for me. Once there are experts in the US and Canada with 3rd generation discs that are FDA approved then my opinion will likely change but before that I will be highly sceptical.

[pittpete]

That not my list, that is a list of doctors that participated in the clinical trials.
I wasnt talking about free follow ups but the fact that an out of country doc cant see me next Tuesday for a follow up.
Also getting doctors to follow up after someone whose done thousands of ADR implants?
Why would you need a follow up if these doctors performed thousands of implants?
Some people might not have the luxury of paying cash and then oh well, let me just pay again...
A doctor like James Yue is one i would trust and the reason why is because of research.
Zeegers who is the so called pioneer continues to use the Activ-L.
An ADR is not a magic fantasy prosthesis that will cure all your back ailments.
I will quote again that Bierstedt looked at my MRI,listened to my complaints in NY city and told me my facets joints were good enough for adr.
Lets also replace the slightly bulging one and make it a 3 for 1 trip.
Like a FN oil change i was going in for...

[DrewDotNet]

Originally Posted by AZMtnman

I saw those posts also. But I don't want to be the first person to sign up for a few device and/or process if I can help it. I don't even like to buy a new cell phone until it's been on the market for a bit, let alone a new spine.

Hopefully I can hold out for awhile and the market will respond positively to new devices.

Activ-L has been on the market in Europe for several years, as has the M-6L.

I don't know if traveling to Europe is an option for you, but you may want to consider it.

Whatever you do, I suggest reading plenty of that device (and surgeon's!) patient stories to get a good feel for both good and bad outcomes. Give yourself plenty of time to let the information "sink in." You'll eventually find the "right" answer for you.

[JeffR]

That not my list, that is a list of doctors that participated in the clinical trials. You posted it, hence I called it your list.
I wasnt talking about free follow ups but the fact that an out of country doc cant see me next Tuesday for a follow up. A surgeon in NA isn't going to see you on that short notice either.
Also getting doctors to follow up after someone whose done thousands of ADR implants?
Why would you need a follow up if these doctors performed thousands of implants? Good to ensure everything is going on track. For me it was to make me feel at ease and confirm everything was healing as per normal, I'm sure there are tons of reasons.
Some people might not have the luxury of paying cash and then oh well, let me just pay again...I said the same thing in my post, and I agree when things go sideways it is a bad scene but often this is preventable by doctor and device choice.
A doctor like James Yue is one i would trust and the reason why is because of research. I don't much care if someone is a researcher since that doesn't make them a great surgeon. Those are different skill sets that may or may not overlap.
Zeegers who is the so called pioneer continues to use the Activ-L. I agree that Zeegers is top-notch, but keep in mind that doctors often stick with what they know to work, sometimes to a point that is detrimental to the potential outcomes of their patients (e.g. Dr. Bertagnoli)
An ADR is not a magic fantasy prosthesis that will cure all your back ailments. Was for me, but your mileage may vary
I will quote again that Bierstedt looked at my MRI,listened to my complaints in NY city and told me my facets joints were good enough for adr.
Lets also replace the slightly bulging one and make it a 3 for 1 trip.
Like a FN oil change i was going in for...I have no idea of your story and can't comment, but I've never vouched for Bierstedt on this board.

[pittpete]

A doctor like James Yue is one i would trust and the reason why is because of research. I don't much care if someone is a researcher since that doesn't make them a great surgeon. Those are different skill sets that may or may not overlap.

To clarify, i know him to be an excellent surgeon and in fact trained in the activ L because of the research i(me) have done on the subject..NOT because he is a good researcher...LOL


The point im trying to make to the original poster is anyone thinking of going to Europe for an ADR has to do their due diligence.They need to research, research and then research all options again..Just because Joe Schmo had a successful 3 level ADR with disc XXX, doesnt mean **** and shouldnt mean **** to Joe.
I won't go into the reasons why Zeegers uses and still believes in the Activ-L.
I know why, but if someone wants to know thereis plenty of info on this site and on the internet..
The Activ-L being so close to FDA approval is a major step for back sufferers in the USA in my opinion.