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  #1  
Old 02-11-2014, 07:40 AM
MMsC5-6-7's Avatar
MMsC5-6-7 MMsC5-6-7 is offline
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Join Date: Feb 2014
Posts: 13
Default Dr. Bierstedt's findings - HELP PLEASE!

I just posted this morning about wanting a 2-level ADR (vs the 2-level fusion two surgeon's recommend), but now Dr. Bierstedt has taken a look at everything and I've just heard back from them. I am in shock at the moment.

FINDINGS: kyphotic alignment of the cervical spine, max at C3/4, severe DDD and herniations C3-C7, stenosis - mild signs of myelopathia

PROPOSED TREATMENT: Intraoperative decision on 4 level disc replacement C3-7 vs 3 level disc replacement vs 1 level rigid cage at C6/7

Surgical decompression of the spinal canal by total discectomy, removal of osteophytes and artificial disc replacement.


Please advise who you would suggest I get a 2nd opinion from - Dr. Clavel? The doctor in Texas that I've heard about on here (can't recall name right now)?

I'm so thrown right now, and to make matters even better, just learned that I will be leaving my job at the end of February to return to Texas. I need to get whatever surgery I need before my insurance (Aetna International) is cancelled within a few months. I'm hoping they cover surgery - but my goodness a 4-level? What chance do I have that would be approved?
__________________
--------------
DEC 2013 MRI/CT scans show severe spondylosis at C5-C6/C6-C7; moderate at C4-C5
Spondylotic spurs C2 thru C7
Left vertebral artery medial loop at C4 body
Foot / hand numbness
Throat tightening and on/off lump sensation
Neck pain, upper back ache between shoulder blades
52 years on this planet (most of the time)
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  #2  
Old 02-11-2014, 08:14 AM
MikeC MikeC is offline
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Sorry to hear about your diagnosis. The doctor you are thinking of in Texas might be Dr Ziglar at the Texas Back Institute near Dallas. He uses the Pro-Disc and can only do one level from what I understand. Also, a cervical artificial disc has been approved recently by the FDA for a 2 level procedure. I think it is called the Mob-C. Other forum members can correct me if I am wrong.
__________________
Feb 2011; X-ray + diagnosis; Spinal Stenosis
Physical Therapy + Oral Steroids
March 2011: MRI
April 2011: 2 level laminotomy; L4/L4 & L5/S1
More PT, pain meds and injections.
...and 2014, still researching ADR.
February 2014: endoscopic foraminotomy, Dr Bitan
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  #3  
Old 02-11-2014, 08:19 AM
MMsC5-6-7's Avatar
MMsC5-6-7 MMsC5-6-7 is offline
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Default

Thank you Mike...seems I need 3 or 4 level (per Dr. Bierstedt) so that rules out surgery in Texas.

Has anyone else had a 4-level cervical adr, or 3-level adr plus rigid cage? I am feeling a bit (ok a lot) overwhelmed so would love to hear from others that know of or have experienced this.

Thanks in advance...Melissa

Quote:
Originally Posted by MikeC View Post
Sorry to hear about your diagnosis. The doctor you are thinking of in Texas might be Dr Ziglar at the Texas Back Institute near Dallas. He uses the Pro-Disc and can only do one level from what I understand. Also, a cervical artificial disc has been approved recently by the FDA for a 2 level procedure. I think it is called the Mob-C. Other forum members can correct me if I am wrong.
__________________
--------------
DEC 2013 MRI/CT scans show severe spondylosis at C5-C6/C6-C7; moderate at C4-C5
Spondylotic spurs C2 thru C7
Left vertebral artery medial loop at C4 body
Foot / hand numbness
Throat tightening and on/off lump sensation
Neck pain, upper back ache between shoulder blades
52 years on this planet (most of the time)
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  #4  
Old 02-11-2014, 08:28 AM
jss's Avatar
jss jss is offline
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Join Date: Nov 2009
Posts: 1,411
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Melissa,

What a shock that news must have been!

Dr Zigler has done many multilevel ProDisc's. One poster on this site, davidj8121, received a four level lumbar ProDisc-L from Dr Zigler (over two or three surgeries) and as of his last posting is still doing great. Perhaps Dr Zigler now uses the Mobi-C as it has been FDA approved for multilevel? If you do see Dr Zigler, he is conservative to a fault and may not want to do all four levels?

As you noted, good luck getting your insurance to pay. I don't recall anyone coming to this site receiving a state side Mobi-C.

Good luck, Jeff
__________________
C4/5 - ACDF in 2000
C5/6 - ACDF in 2002
C3/4 & C6/7 - M6 ADR, Nov 2009, Barcelona
Conceded defeat to a manifestly disingenuous BCBS-TX in my quest for reimbursement, Jan 2011
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  #5  
Old 02-11-2014, 10:25 AM
Brewster Brewster is offline
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I received a bit of a shocker from Dr. B as well. He says that my cervical problems cannot be operated on because of auto fusion. I have full lateral mobility, vertically, 90% up and 100% down. My lumbar problems would be handled with an anterior ADR and a posterior TOPS. Anybody else heard of the TOPS device. I'm nor dissing Dr.B, he's well thought of on here, but such are the possible vagaries of diagnosis over the internet.
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Cervical DDD, Lumbar stenosis
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  #6  
Old 02-11-2014, 10:32 AM
MMsC5-6-7's Avatar
MMsC5-6-7 MMsC5-6-7 is offline
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Join Date: Feb 2014
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Default

Hi Brewster - sorry for the bad news. Was the auto fusion visible to Dr. B on your MRI/CT that you provided to him? If your cervical problems can't be operated on, how are they resolved?



Quote:
Originally Posted by Brewster View Post
I received a bit of a shocker from Dr. B as well. He says that my cervical problems cannot be operated on because of auto fusion. I have full lateral mobility, vertically, 90% up and 100% down. My lumbar problems would be handled with an anterior ADR and a posterior TOPS. Anybody else heard of the TOPS device. I'm nor dissing Dr.B, he's well thought of on here, but such are the possible vagaries of diagnosis over the internet.
__________________
--------------
DEC 2013 MRI/CT scans show severe spondylosis at C5-C6/C6-C7; moderate at C4-C5
Spondylotic spurs C2 thru C7
Left vertebral artery medial loop at C4 body
Foot / hand numbness
Throat tightening and on/off lump sensation
Neck pain, upper back ache between shoulder blades
52 years on this planet (most of the time)
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  #7  
Old 02-11-2014, 10:40 AM
MMsC5-6-7's Avatar
MMsC5-6-7 MMsC5-6-7 is offline
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Join Date: Feb 2014
Posts: 13
Default

Yes Jeff shocking it was - had to close the email before reading it completely on my phone and wait until I got home.

I just spoke with Malte and I'm penciled in for 4 March. But I have a lot to do before then (contact insurance to see if there's any hope of coverage, speak with employer again, etc.).

I also want to get a second opinion from Dr. Clavel and Dr. Zigler - can someone provide a contact person / info rather than the website, or is that the best method for a speedy consult from both of them?


Quote:
Originally Posted by jss View Post
Melissa,

What a shock that news must have been!

Dr Zigler has done many multilevel ProDisc's. One poster on this site, davidj8121, received a four level lumbar ProDisc-L from Dr Zigler (over two or three surgeries) and as of his last posting is still doing great. Perhaps Dr Zigler now uses the Mobi-C as it has been FDA approved for multilevel? If you do see Dr Zigler, he is conservative to a fault and may not want to do all four levels?

As you noted, good luck getting your insurance to pay. I don't recall anyone coming to this site receiving a state side Mobi-C.

Good luck, Jeff
__________________
--------------
DEC 2013 MRI/CT scans show severe spondylosis at C5-C6/C6-C7; moderate at C4-C5
Spondylotic spurs C2 thru C7
Left vertebral artery medial loop at C4 body
Foot / hand numbness
Throat tightening and on/off lump sensation
Neck pain, upper back ache between shoulder blades
52 years on this planet (most of the time)
Reply With Quote
  #8  
Old 02-11-2014, 07:47 PM
ian ian is offline
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Join Date: Jan 2014
Posts: 155
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Hey MM! I'll be there through March 10. If you end up going I'll be about a week post op when you're scheduled for surgery. I'd be happy to check in on you and say hello.

Quote:
Originally Posted by MMsC5-6-7 View Post
Yes Jeff shocking it was - had to close the email before reading it completely on my phone and wait until I got home.

I just spoke with Malte and I'm penciled in for 4 March. But I have a lot to do before then (contact insurance to see if there's any hope of coverage, speak with employer again, etc.).

I also want to get a second opinion from Dr. Clavel and Dr. Zigler - can someone provide a contact person / info rather than the website, or is that the best method for a speedy consult from both of them?
__________________
- 20+ years of constant back pain
- Sacralization (natural fusion) at L5/S1
- DDD at L4/L5 dating back to mid twenties
- Torn ligaments in SI joint
- PRP injections at SI joint
- Tarlov cysts on sacrum
- Lumbar stenosis
- L4/L5 ADR Feb 25, 2014 with Dr. Bierstedt.
http://iansroadback.blogspot.com
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  #9  
Old 02-12-2014, 01:10 AM
Stonewall_Boris Stonewall_Boris is offline
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Join Date: Feb 2013
Posts: 547
Default

MM,

I suggest getting as many opinions as possible. See if they converge as to what the problem is. They probably will have different solutions though. I assume you have your MRI in digitized form, its as easy as sending an email so why not get more opinions?
You've heard about TBI and Clavel, very good choices. There are a few others in Germany. There are some in the UK as well, Google on adrsupportuk.
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  #10  
Old 02-12-2014, 08:58 AM
jss's Avatar
jss jss is offline
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Join Date: Nov 2009
Posts: 1,411
Default

Yes Melissa, the information on those respective web sites are the ways to contact them. Be aware that both are notoriously bad at getting back to you quickly.

Texas Back Institute in Plano
Barcelona Spine Center

Good luck, Jeff
__________________
C4/5 - ACDF in 2000
C5/6 - ACDF in 2002
C3/4 & C6/7 - M6 ADR, Nov 2009, Barcelona
Conceded defeat to a manifestly disingenuous BCBS-TX in my quest for reimbursement, Jan 2011
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