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  #1  
Old 11-06-2021, 12:35 AM
Diesel562 Diesel562 is offline
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Join Date: Sep 2021
Posts: 2
Default L4-S1 ADR decision

Hello everyone. I want to say thank you for this site and everybody involved sharing their experiences. This is my first time posting and I’m hoping to get more answers. I’ve had lower back pain for close to a decade that I can recall but like most cavemen I never looked into it. I learned how to be mindful in the gym and moving heavy objects for the most part.

My back pain is typically around a 4 to 5 and it’s constant. Approximately four or five years ago I started having trouble sleeping through the night. I’m guessing I get around three or four total hours of onset to ruptured sleep a night currently. The lack of sleep is most definitely affecting my every day life and is by far the biggest concern as far as my symptoms. I wouldn’t find out until later that I am waking slightly and adjusting as a result of my back tightening up.

After a turbulent day driving some heavy equipment at work my back seized up as it has from time to time over the years. I went into my chiropractor who recommended PRP injections which we did. A few months later I felt maybe 15% better and just went on with life. Around six months ago I switched to a new chiropractor who did x-rays and felt I needed to do more imaging and recommended an MRI because she suspected herniated disc. After we got the imaging and the radiologist report back it was confirmed I have a 5 mm herniation in my L4 L5 with 60% disc space and a 4 mm herniation in my L5 S1 with 30% disc space left. She recommended I see an orthopedic surgeon and I decided to see three. The first two I looked at the imaging and recommended pain management for a few years and then possibly a fusion from L4 to S1. The third recommended total disc replacement with the pro disc L.

After looking into disc replacement online and watching a ton of video on YouTube I decided to move forward with the replacement only to find out that my insurance probably isn’t going to cover two and Best will only cover one if I’m lucky. At this point I’ve looked into ways I could finance everything.

Basically where I’m at now is deciding if I’m going to pay out of pocket for surgery here in the states which could be anywhere between $60-$75,000 I was told or deciding to go go overseas. I’ve read a lot of posts in regards to getting disc replacement in Germany or England and I am intrigued by the M6 versus the pro disc because of the major difference being compression and not wanting adjacent disc failure. I submitted my imaging to Enande with Ritter Lang ( i’m aware there’s been some negative reviews).

Id like to get in contact with some of the surgeons that have been talked about on this site to see what my options could possibly be. Any recommendations on other surgeons and opinions on types of ADR discs are appreciated.
__________________
Lower back pain began 2011
PRP injections April 2020
X-ray and MRI September 2021 showed 5 mm herniation L4 L5 and 4 mm herniation L5 S one. Disc space at L5 S1 30% and L4 L5 60%.
Two orthopedic surgeons recommended pain management and then said fuse L4-S1. Third orthopedic surgeon recommended two level artificial disc replacement with pro disc L.

Last edited by Harrison; 12-03-2021 at 11:29 AM. Reason: Added paragraph breaks & moved topic
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  #2  
Old 11-06-2021, 01:16 PM
annapurna annapurna is offline
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Join Date: Dec 2004
Posts: 1,641
Default

First thought - I'm often the contrarian here on this subject but I'd suggest concentrating on finding a surgeon you like and you feel confident of first instead of thinking of the device. Again and again over the past decades, having the device placed correctly seems to do more for a successful surgery and good long-term outcome than having the best device. This isn't an attack against Ritter-Lang in particular, just a reality that you get what you pay for applies to the surgeon's skill far more than the device itself.

Second - European surgeons tend to be more aggressive in using ADR on borderline cases. To me, it's because they think in terms of someone who's going to get a lot of post-op ongoing care and physical therapy to allow those borderline cases to be successful, but that's an opinion. As an American overseas, you're going to get limited post-op help unless you plan on staying there for months; that means you're going to have to be a little more conservative in whether you're a good candidate for ADR.

Side note about the PRP - it's not a bad idea to investigate them post-op. Laura used it to help post-op healing but, by itself, they're not likely to do more pre-op than buy a little time to deal with the failing disk.
__________________
Laura - L5S1 Charitee
C5/6 and 6/7 Prodisc C
Facet problems L4-S1
Knee, Shoulder, Toe, Finger, Elbow Problems

Jim - no spine problem but lots of other fun medical challenges

"There are many Annapurnas in the lives of men" Maurice Herzog
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  #3  
Old 11-07-2021, 01:38 AM
Diesel562 Diesel562 is offline
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Join Date: Sep 2021
Posts: 2
Default

Thank you I appreciate the information more than you know. I’m currently getting ready to send imaging to Dr. Clavel and Dr. Bertognoli. If you have any other surgeons to suggest please let me know. Thank you again
__________________
Lower back pain began 2011
PRP injections April 2020
X-ray and MRI September 2021 showed 5 mm herniation L4 L5 and 4 mm herniation L5 S one. Disc space at L5 S1 30% and L4 L5 60%.
Two orthopedic surgeons recommended pain management and then said fuse L4-S1. Third orthopedic surgeon recommended two level artificial disc replacement with pro disc L.
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  #4  
Old 11-08-2021, 04:43 PM
Cheryl0331 Cheryl0331 is offline
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Join Date: Dec 2010
Posts: 890
Default Warning!

I would steer clear of Ritter Lang and there are very few accomplished ADR surgeon s in Britain.
Many misleading websites about artificial disc replacement come up then you get into reading and d I d out its fusion they specialize in.
__________________
54 yr old female 5'7" 147 lbs. non-smoker conservative treatments failed
2007 fusion @ C4-6 peek cages, failed due to long term use of cox-2 inhibitor
2008 revised C4-6 donor bone, plate & screws
2009 fusion with Roi-C @ C3-4
2015 MRI & CT mjr ddd @ C6-7, segmental kyphosis at C7-T1, 2-level M6-C prosthesis by Dr. Clavel Barcelona Spain
2019 H.O. formed behind M6-C @ C6-7 left nerve rt & in spinal canal.
2020 Revision C6-7 to a CP-ESP prosthesis by Dr. Schmitz Dusseldorf Germany
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  #5  
Old 12-03-2021, 11:33 AM
Harrison's Avatar
Harrison Harrison is offline
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Join Date: Oct 2004
Posts: 6,969
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I would consider the higher volume spine centers in the US; and/or the the surgeons in the US that have been performing ADR since 2000. By now, there are hundreds of them, like Texas Back.

A "hybrid" procedure of a fusion and spinal artificial disc are usually reimbursed by insurance in the US, especially at these larger spine clinics.
__________________
"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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  #6  
Old 12-05-2021, 08:24 PM
Cheryl0331 Cheryl0331 is offline
Senior Member
 
Join Date: Dec 2010
Posts: 890
Default Exceeding care in California

Please contact Dr. Ali Mesiwala in California. He will not BS you. He does except insurance. I have BCBS. He will give it to you straight. If he thinks he can help he will& if you don't need surgery, he will tell you that too.
__________________
54 yr old female 5'7" 147 lbs. non-smoker conservative treatments failed
2007 fusion @ C4-6 peek cages, failed due to long term use of cox-2 inhibitor
2008 revised C4-6 donor bone, plate & screws
2009 fusion with Roi-C @ C3-4
2015 MRI & CT mjr ddd @ C6-7, segmental kyphosis at C7-T1, 2-level M6-C prosthesis by Dr. Clavel Barcelona Spain
2019 H.O. formed behind M6-C @ C6-7 left nerve rt & in spinal canal.
2020 Revision C6-7 to a CP-ESP prosthesis by Dr. Schmitz Dusseldorf Germany
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  #7  
Old 12-15-2021, 10:16 AM
Harrison's Avatar
Harrison Harrison is offline
Administrator
 
Join Date: Oct 2004
Posts: 6,969
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Hi Diesel, what's the latest? How are you managing your physical activity these days?
__________________
"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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