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#1
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Biersdadt vs. Clavel
Bikersdadt said 3 level adr.
I have an update after having Dr. Clavel look at my films. Here's Clavels recommendation Quote:
Peterson says might as well have L3-L4 done and Clavel says leave it. Clavel says fusion at L5-S1 and Peterson says ADR. In all honest opinions i've read that there is very little motion at L5-S1 and i actually agree with Clavels rec. more Any advice?
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Born 1970/1995-Hurt at work/1996-Right disc fragment L4-L5 discectomy-On/off back pain,no serious leg pain until/2007-Right herniation L5-S1,recurrent small herniation at L4-L5 with unbearable leg pain/6/08 discectomy L5-S1/leg pain relieved/occaisional mechanical pain/2012-Cymblata 60 mg,occasional aleve/2014-LB pain not debilitating but chronic,Rhizotomy relieves facet pain on right side/2015-L4-S1 facets shot/4/15 PLIF L4-S1 with facectomy |
#2
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M6
I received an email, reply, someone that had an M6 at the L5-S1, this preserved motion to the rest of the lumbar, think about it, if this one degenerates, then it will cause the next higher to degenerate, and then have problems even higher up.
I know, this is what happened to me. Will have another evaluation on 3 March, but this will most likely be a fusion or possibly a first or second generation all metal and plastic disc. Have had a recommendation from Bierstedt, and may end up pushing this to the insurance. I tried another avenue, this did not pan out. Personally, go with the M6 and someone that has done many, Boree(sp?) or Bierstedt. If I could only do one (and this may be what I do) it would be the L5-1.
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Jerry, Somewhere Ohio L2-3 herniation, two days before Thanksgiving, 2012, Discectomy/Laminectomy, 3/13 Numbness in the right leg, lateral femoral, gone, July 10, 2014 L45 M6 ADR, July 15 PLIF L5-S1, Not able to access L51 Anterior. |
#3
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Clavel vs Petersen
Quote:
I am wondering if Malte is a trained medical professional, and should he be deciding on the what disks to replace? I am jsut thinking out loud here...don;t shoot me! Not the saw either please!
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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 |
#4
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Malte is not, to my knowledge, a medical professional. He relays medical information from Dr. Bierstedt. He is well versed in medical terms and procedures. I've never seen him as a medical professional and I don't believe he ever claimed he was. Imo, if you get an opinion from him it was passed on from Dr. Bierstedt or Dr. Illerhaus. Malte was my main contact point between Dr. Bierstedt and myself. To be clear, I never spoke to Dr. Bierstedt prior to my surgery until I got to Germany, all the contact was between Malte and myself via email.
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#5
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Stone, thing is i went to see them in person in NY.
Illerhaus and Biersdadt barely talked and Peterson did all the talking. My question here is i have 2 well known doctors with 2 different surgical recommendations. Biersdadt through Malte Peterson says 3 level Clavel says hybrid fusion/ADR due to my steep sacral slope and leave L3-L4. I would of course contact Dr. B again before considering the actual surgery. I also came across a nice article about a steep sacral slope Dynamic Reconstruction of the Spine - Google Books
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Born 1970/1995-Hurt at work/1996-Right disc fragment L4-L5 discectomy-On/off back pain,no serious leg pain until/2007-Right herniation L5-S1,recurrent small herniation at L4-L5 with unbearable leg pain/6/08 discectomy L5-S1/leg pain relieved/occaisional mechanical pain/2012-Cymblata 60 mg,occasional aleve/2014-LB pain not debilitating but chronic,Rhizotomy relieves facet pain on right side/2015-L4-S1 facets shot/4/15 PLIF L4-S1 with facectomy |
#6
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Pete,
What a terrible decision to have to make; divergent surgical prescriptions from two respected surgeons. I was lucky in that before my double ADR, five of the six surgical opinions were the same. The odd man out was a surgeon that didn't do ADR. I don't know which way you should go, but were it I ... I'd probably learn everything I could about the reason behind Clavel's contraindication and then quiz Bierstadt about it. Good luck, Jeff
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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 |
#7
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Jeff, thanks for the advice.
That is probably my gameplan moving forward. Since my current pain is manageable yet chronic, i have some time. L3-L4 has been bulging for 13 years or so. I really have to investigate how bad my facet joints are at the lower levels even though Peterson told me they weren't bad. This steep sacral slope thing has me concerned and i'm going to pick both Clavel and Dr. B's brains on it. My concerns are the longer i wait the more my facet joints will worsen.
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Born 1970/1995-Hurt at work/1996-Right disc fragment L4-L5 discectomy-On/off back pain,no serious leg pain until/2007-Right herniation L5-S1,recurrent small herniation at L4-L5 with unbearable leg pain/6/08 discectomy L5-S1/leg pain relieved/occaisional mechanical pain/2012-Cymblata 60 mg,occasional aleve/2014-LB pain not debilitating but chronic,Rhizotomy relieves facet pain on right side/2015-L4-S1 facets shot/4/15 PLIF L4-S1 with facectomy |
#8
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Pete,
just had mine done in Dec 18. L345. Sacral slope deep on me as well. L5S1 close to almost fused naturally. Upon discussion with Clavel he adivsed that the thinking of ADR at L5S1 is being looked at harder with all the stats and at a symposium supposedly in March this year with all the world surgeons. Since mine wasnt giving me pain then we left it alone. If it was giving pain then Clavel said he would recommend fusion there and ADR above. Also if you look on here many that have problems had previous surgery or micro lamidiscos which have scar tissue buildup problems and movement now in that area might cause problems. Keep in mind any surgeon, if they could in good faith, would want to have another triple under their belt. I bet if you were to have new scans done and sent to Dr. B (who I have alot of respect ) he would look at them and most likely have the same opinion as Clavel as well Just sayin brother, i have two and wouldn't want three in me in the Lumbar. Well i aslo have two in my cervical as well. Peace in your choice. Feel well! F
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Lumbar issues 18 yrs herniations lumbar L3-5 multiple Epis etc etc Annular tears L3-5 cauda equina Cervical herniation symptoms 2011 C5-7 M6C by Dr Clavel on June 5 2013 L3-5 M6L by Dr. Clavel on 12.18.13 Living life instead of living the condition |
#9
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I've contacted Dr. Zeegers as well.
Couldn't hurt to have recommendations by 3 of the top ADR surgeons in Europe.
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Born 1970/1995-Hurt at work/1996-Right disc fragment L4-L5 discectomy-On/off back pain,no serious leg pain until/2007-Right herniation L5-S1,recurrent small herniation at L4-L5 with unbearable leg pain/6/08 discectomy L5-S1/leg pain relieved/occaisional mechanical pain/2012-Cymblata 60 mg,occasional aleve/2014-LB pain not debilitating but chronic,Rhizotomy relieves facet pain on right side/2015-L4-S1 facets shot/4/15 PLIF L4-S1 with facectomy |
#10
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Dr Zeegers' opinion would be a very valuable one to have in any case; but doubly so as you have divergent opinions from Bierstedt and Clavel. Good move.
__________________
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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