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  #1  
Old 03-27-2013, 09:13 AM
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t.hynes31 t.hynes31 is offline
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Join Date: Mar 2013
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Default New to ADR- Seeking Information

Good Morning Everyone,

I am new here and looking for information. I have been dealing with constant back pain for over 8 years. I am trying to find information regarding ADR and fusion combined. My L4-S1 are degenerating, the disc space between L5-S1 is basically gone at this point. I have had Dr's in my area offer either a multi-level fusion or to do a One level fusion with the possibility of having to undergo another surgery within 5 years.

I have been doing research, and searching for other Dr's who offer ADR- Which seems to be VERY hard to find in the Florida area. If anyone is around this area, or knows an amazing Surgeon who performs ADR combined with fusion PLEASE help!

I greatly appreciate responses, Thank you!

Tiffany
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  #2  
Old 03-27-2013, 12:01 PM
NJ Gene NJ Gene is offline
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Quote:
Originally Posted by t.hynes31 View Post
Good Morning Everyone,

I am new here and looking for information. I have been dealing with constant back pain for over 8 years. I am trying to find information regarding ADR and fusion combined. My L4-S1 are degenerating, the disc space between L5-S1 is basically gone at this point. I have had Dr's in my area offer either a multi-level fusion or to do a One level fusion with the possibility of having to undergo another surgery within 5 years.

I have been doing research, and searching for other Dr's who offer ADR- Which seems to be VERY hard to find in the Florida area. If anyone is around this area, or knows an amazing Surgeon who performs ADR combined with fusion PLEASE help!

I greatly appreciate responses, Thank you!

Tiffany
Dear Tiffany,

For this type of surgery, you may have to travel. One of the best I've heard of in the United States is Jack Zigler of the Texas Back Institute in Plano, TX. I'm also not sure how much insurance will cover if any. Although the FDA has approved certain ADR's at one level, I don't believe they've approved them if they're adjacent to a fusion. You might be able to get the fusion covered, which is more expensive, and pay for the ADR off label. There are a number of surgeons in Europe who can help you if you're willing to pay and have no expectation of insurance reimbursement. The best ones I've heard of on here are Dr. Pablo Clavel in Barcelona, Mr. Dare in the U.K. and Dr Bierstedt in Germany. To go overseas, you are looking at $40k and that's without the flights. Most packages include hotel, hospital, surgery, etc. If you're willing to get a fusion, the hybrid approach may be most cost effective. Even if insurance doesn't pay for ADR, you are covered for most of surgeon costs (certainly for the fusion), anesthesia, hospital, etc if all done in one surgery.

I hope this helps.

Gene
__________________
Car Accident 2002 - Small Herniated Disc C3/C4
1998 Larger Herniation and Cervical Fusion C3/C4
2005 Herniation C4/C5 - 40 epidural steroid injections from Oct 2005, - Oct, 2007
2008 - Foraminotomy at C6/C7 on left side
Feb, 2010 - Cervical Fusion C4/C5
Dec, 2010 - Lumbar Fusion L3/L5
2013 - Bulge on C5/C6; herniation C6/C7 right side
Mar 26, 2013 - Foraminotomy at C6/C7 on right side
May 5, 2015 - ADR with Dr Blumenthal of TBI for C5/C6 using Mobi-C
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  #3  
Old 03-27-2013, 03:57 PM
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jss jss is offline
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Tiffany,

I ditto everything Gene posted and add something.

Most major insurance carriers will cover the off label ADR procedure known as a "hybrid"; which in your case would be a fusion at L5/S1 and a ProDisc-L at L4/5. That is possibly your only hope for insurance coverage with ADR in the US. If that's what I'd do, Dr Zigler at TBI in Plano, TX is the only one I'd let do it.

Before going with your surgeon's recommendation, I would encourage you to spend a few dozen hours (no I'm not exaggerating) researching your various options, the outcomes others have had with each of those options; the procedure involved, the implant(s) involved, the surgeon, etc... Not just on this site, but every site that you can find. There are no mulligans in lumbar spine surgery and bad outcomes tend to be tragically bad. You have to get it right the first time.

While we've seen glowing reports of numerous US surgeons on this site, I don't recall that any of them were in Florida. Anyone?

BTW: In my non-medical opinion, Jack Zigler does meet your description of "amazing" for ADR surgery.

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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  #4  
Old 03-27-2013, 04:27 PM
firemedix911 firemedix911 is offline
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Quote:
Originally Posted by t.hynes31 View Post
Good Morning Everyone,

I am new here and looking for information. I have been dealing with constant back pain for over 8 years. I am trying to find information regarding ADR and fusion combined. My L4-S1 are degenerating, the disc space between L5-S1 is basically gone at this point. I have had Dr's in my area offer either a multi-level fusion or to do a One level fusion with the possibility of having to undergo another surgery within 5 years.

I have been doing research, and searching for other Dr's who offer ADR- Which seems to be VERY hard to find in the Florida area. If anyone is around this area, or knows an amazing Surgeon who performs ADR combined with fusion PLEASE help!

I greatly appreciate responses, Thank you!

Tiffany
Hi there. I'm in the same boat as you. Where in FL are u? As far as ADR goes I'd only trust Dr Rolando Garcia Jr he works out of Aventura Hospital in Miami. He started doing ADR surgeries since 2000. First in FL and I believe the Southeastern US to do it. He also helped on the design of the Active-L disc. From my research his bedside manner isn't the best but he came highly recomended by a Dr who I have the upmost respect for. He flat out told me he'd trust his spine to Dr Garcia. With that said if traveling is an option I second what the others have stated.
__________________
-On duty injury in 2005 resulted in DDD
- L4-L5 Central-posterior herniation/annular rupture superimposed on circumferential disc bulge 1cm stenosis.
-L5-S1 Broad-based posterior disc herniation/annular rupture superimposed on a circumferential disc bulge with impression on the anterior the cal sac and the lateral recess bilaterally compressing the descending nerve roots. Mild bilateral foraminal stenosis.
-L2-L3 1cm herniation and early DDD signs asymptomatic.
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  #5  
Old 03-27-2013, 05:31 PM
Dingie Dingie is offline
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Posts: 146
Default Jacksonville, FL

Hi,

If you are near Jacksonville, FL. Dr. Gregory Keller at JOI-Jacksonville Orthopedic Institute has probably done the most in the city. He has been involved in the FDA trials for the ProDisc since the beginning. When I saw him about a year and a half ago, he wanted me to wait a while as he was planning on participating in the 2 level lumbar trials.

I obviously did not wait, but it may be an option for you. He is an Orthopedic surgeon and has a good reputation in the area.

Dr. Garcia-Benchochea-spelling? Is a neurosurgeon that has done some ADR's, not that many. He is a very skilled neurosurgeon and developed some the techniques and tools for minimally invasive fusions.

St. Vincents Brain-Neuro Institute has some experience, more with cervicals.

That's about it that I know of for northern Fl.

Laurie
__________________
50 y.o.
WW athlete- triathlete, runner, tennis
2008-0nset of pain..MRI-DDD L4-L5 annular tear. Pain labeled discogenic with radiation to unilateral hip, no radiculopathy
2009-facet inj, radiograph ablation, SI joint injections, cryoablation stubborn no relief
2010-retired d/t pain. more injections
2011-IDET of L3-L5. Pain unchanged, up 50 lbs!
2011-Lumbar ADR recommended by Ortho and 2 neuros. In appeals w/ins. May choose Europe for M6
Need to lose lbs
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  #6  
Old 03-28-2013, 04:03 PM
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t.hynes31 t.hynes31 is offline
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Join Date: Mar 2013
Posts: 4
Default Thanks

Thanks everyone for the advice! I have been doing hours upon hours of research, the Dr's in other countries have come up numerous times. I am not too worried about insurance covering the ADR- I will find means if I am eligible for the procedure. I have seen two Dr's here in FL and both of them do not do ADR.

I am meeting with Dr. D' Ariano in May, and fingers crossed for good news. Nothing but great reviews on him.

I finally got my second MRI report back, For a 23 year old it looks like my back belongs in an 80 y/o's persons body.

I am located North of Orlando. I've been to Miami and heard of Dr's down there as well. The Dr I am meeting with in May works in Tampa, Orlando and Lake Worth area.
__________________
Degenerate Disc Disease L4-S1
Spinal Stenosis, annular tears, neural narrowing
Herniated disc L4-L5 and L5-S1
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  #7  
Old 03-28-2013, 04:27 PM
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jss jss is offline
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Posts: 1,411
Default

Best of luck Tiffany. Do the doctors have any idea why you're in such bad condition?

Please keep us posted.
__________________
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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  #8  
Old 03-28-2013, 07:58 PM
Slackwater Slackwater is offline
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Join Date: Aug 2007
Posts: 782
Default

Quote:
Originally Posted by t.hynes31 View Post

DEL.TEXT
I am trying to find information regarding ADR and fusion combined. My L4-S1 are degenerating, the disc space between L5-S1 is basically gone at this point. I have had Dr's in my area offer either a multi-level fusion or to do a One level fusion with the possibility of having to undergo another surgery within 5 years.

DEL.TEXT
If anyone is around this area, or knows an amazing Surgeon who performs ADR combined with fusion PLEASE help!

Tiffany
Dr. Rolando Garcia, Aventura Florida, was part of the FDA clinical trial process for ADR / TDR from my limited recall. Dr. Garcia possibly did work in the Aesculap active-L TDR FDA Clinical Trial. He may have written some articles with Dr. Yue of Yale about ADR / TDR.

You asked about a hybrid surgery: adr L4-L5, fusion L5-S1. You need to ask the surgeon about that question.

Insurance coverage for a hybrid lumbar surgery may require some work, ie. paperwork and an appeal, work by the surgeon also.


------------
slackwater_sf
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  #9  
Old 03-28-2013, 08:06 PM
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Harrison Harrison is offline
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Tiffany, were you in a car accident, or any trauma to the spine?
__________________
"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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  #10  
Old 03-28-2013, 08:32 PM
newleaseonlife newleaseonlife is offline
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Tiffany,

I am glad you found this board. There are a lot of people here who can offer some excellent advice. I am not familiar with any surgeons in FL who do hybrids. Would going overseas be a possibility for you. I know of several posters who have traveled to Europe and had successful surgeries, myself included.
__________________
02/2010- Car accident resulting in C4/C5 & L5/S1 bulging and extruding discs.

06/2012- Successful ADR surgery for C4/C5 disc in Cyprus using PCM by NuVasive. Performed by Dr. Mark Peterson through the help of AIMIS.

09/2012- Successful Disctectomy of L5/S1also performed by Dr. Mark Peterson.
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