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  #1  
Old 07-22-2013, 07:15 PM
ansnj ansnj is offline
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Default On the fence-Need your help

I am still on the fence with going out of the country for surgery. I am contemplating reaching out to Dr. Lauryssen in CA. I don't know what his track record is with the M6 or how many he has implanted. I also realize he doesn't take insurance but I would be paying out of pocket if I go to another country for the surgery as well. Granted he is in the US but on the opposite side of the country from me.

Of late it seems Dr. Clavel's patients are having complications, not sure why this is happening but it concerns me greatly. Beirstedt told me cervical patients don't need physical therapy and he cuts the neck vertically, which I don't want. That said, I feel like I have gotten no where fast, just keep ruminating on this.

I need to make a decision and put a period at the end of the sentence.

Any thoughts would be greatly appreciated! Thanks!
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Progressive cervical degeneration
MRI 12/2012- DDD C4-5, C5-6, C6-7
Neck pain and intermittent finger numbness
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  #2  
Old 07-22-2013, 08:45 PM
NJ Gene NJ Gene is offline
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Hi ANSNJ, Dr. Bierstedt has his patients go through a week of rehab immediately after surgery at a facility that is connected by an indoor walkway to a Courtyard by Marriott Hotel. I have only heard great things about that facility on these boards. I recommend you contact member, Stonewall_Boris, who recently had surgery with him. Once one goes through that type of rehab and follows the PT's instructions, no further rehab should be necessary. I have had four cervical operations here in the U.S. and never had P.T. afterwards. However the surgeon showed me some exercises to do on my own. As far as a vertical cut vs a horizontal one goes, what is the issue with that? Is it scarring you're concerned about? If that is the case, I'm sure it can be dealt with in other ways several months post-op. I have doubts that any other ADR surgeon would do the incision differently. Have you posed this same question to Mr. Dare in the U.K.? You could also find out how Dr. Ritter-Lang does his incision (not that I suggest you use him)? Knowing a little about how Ritter-Lang's team works, you can probably get that question answered by e-mailing one of his team members directly. You can find those addresses directer on his website, www.betterdiscreplacement.com

I hope this helps you at least a little bit. BTW, there are a lot of advantages to staying in the U.S., even if it's across the country. You don't lose accountability if there are complications afterwards. This is what you mentioned regarding Dr. Clavel. Furthermore, airfare from the NYC area to LA is significantly less than to Europe. Finally, you're more likely to get follow-up care locally if you stay within the 50 states.

Good luck with your ultimate decision.

Gene
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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 07-22-2013, 10:57 PM
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jss jss is offline
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ansnj,

The recent spate of complications from Dr Clavel's patients has me concerned as well. We've all read stories of Dr Ritter-Lang performing cervical ADR's in 30-45 minutes. When Dr Clavel began performing surgeries with Ritter-Lang a year or so ago, I feared that Clavel might adopt some of Ritter-Lang's less desirable practices. I don't know if that's happened or not, but it is hard to ignore Clavel's recent rash of patients with complications.

On the vertical incision... Dr Naftalis, who performed my cervical fusions, and Dr Clavel, who performed my cervical ADRs, both did horizontal incisions because as I aged, the scars would fold right into the wrinkles when they develop and hide the scars. If you requested that Dr Bierstadt use a horizontal incision instead of his preferred vertical, he might oblige you.

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 07-22-2013, 11:56 PM
Stonewall_Boris Stonewall_Boris is offline
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Hi ANSNJ,
As NJ Gene points out I went to see Dr. Bierstedt in Hattegen. I went for lumbar spine ADR's, 3 levels. Maybe not the same for cervical spine ADR's. I did see patients on the same floor with the cut on the side of their neck and they seemed to be doing well. Ran into another patient at Medicos that had had the cervical ADR 7 years ago at the time we met him.

A few things that made my decision;
- Dr Bierstedt is world class amongst ADR surgeons
- He will only do 2, 3 if its a emergency, surgeries a day
- He uses a fluoroscope to make sure the implants are in the correct position
- The hospital in Hattegen is "full service" which means if you have a complication not related to your surgery the hospital has other doctors that will deal with it. ie heart conditions, whereas some other facilities will
take you to another hospital for treatment.
- They use a device that captures your blood from the surgery and "recycles" it so you don't need a transfusion from someone else
- The price they quoted was the complete price, even if I had to stay in the hospital longer, they arranged insurance to cover for some of this as I recall up to 250,000 Euro

What I discovered post op;
- Dr Bierstedt is a very personable man
- Maltle Peterson takes care of the details of your trip and hospital stay
- The doctors, nurses and all staff at the Hattegen hospital are first class, they know what you are going to go through and are prepared for it as they have done it so often
- Free wifi at the hospital and Avantgarde hotel
- The Courtyard Marriott and Medicos was kind of a work in progress when we went there as the info was not on the website
- The Courtyard Marriott is a very fine hotel, my wife enjoyed the exercise room at the top of the hotel, I liked the steam and sauna rooms. Wifi was limited to 30 minutes on the main floor area
- The Marriot has an awesome breakfast buffet as does the Avantgarde (first hotel)
- Medicos care and PT was very good. They came up with a program of daily routines that you are to follow. If you don't show up for a PT session they will follow up to see if you're okay.
- Medicos PT was pretty much all day but not overly tiresome, much of it being like massage therapy
- Lunch at Medicos was good
- The 3rd floor lounge at Medicos is awesome, free wifi, nice snacks, juice and Cappuccino, great view
- Everyone in Germany was nice
- With Dr. Bierstedt they knew where we should always be. They had set-up transportation from the airport, to the hotel,
to ONZ, to the hospital etc etc etc and if something got missed they were on top of it. We forgot a bag at Avantgarde and the desk clerk noticed and phoned the cab driver and we had to return to pick it up. Through a scheduling mixup at Medicos my wife got a phone call to the hotel room as to where I was
- At Medicos I had my dressing changed daily and my progress monitored
- At Medicos I had my blood pressure and blood work checked routinely.
- Breakfast was included at Avantgarde, my wife got lunch and dinner with me at the Hattegen hospital
- Breakfast, lunch and supper was included at Marriott/Medicos
- Medicos and the Marriott are a bit out of the way, we rented a cab to get us to a supermarket to pick up a few things, ask the PT's
- Member TPatti is there right now and may have more updated info
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  #5  
Old 07-23-2013, 10:02 AM
mary2013 mary2013 is offline
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Hi. I am currently in Spain and had my surgery last week with Dr. Clavel. I had a truly amazing experience and am not sure where all the negative energy is coming from regarding Dr. Clavel. There are complications and risks for every surgery and every surgeon has experienced patients that have had complications. I personally would highly recommend Spain. Please see my post today on the post-surgery page. It discusses the decision making process.
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Aug 2010 Disc Herniations at L4/L5 and L5/S1
Natural Recovery with PT, Chiro, Pilates, Inversion
Dec 2012 Head on Car Accident
Feb 2013 DDD at L4/L5 and L5/S1
June 2013 Stem Cells at Centeno in Colorado
July 2013 2 level ADR with Clavel
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  #6  
Old 07-23-2013, 11:50 AM
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jss jss is offline
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Mary,

Congratulations on your successful surgery. I know you're going to have a great outcome.

Yes, all surgeons have occasional complications and even bad outcomes. Until recently such things were unheard of from Dr Clavel's patients on this site. I wouldn't call it "negative energy", but rather simply an observation or acknowledgement that as of late Dr Clavel's patients are experiencing an unusually high complication rate. Dr Clavel was my ADR surgeon in 2009; I will need another ADR or fusion at C7/T1 in the future, and I intend to have him perform that surgery when it is needed (provided his complication rate drops back to its usual level).

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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  #7  
Old 07-23-2013, 12:30 PM
marlin5353 marlin5353 is offline
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Sorry to hear you have more problems Jeff. I have surgery in the future as well and always follow your posts to give me some hope for a healthy future. I am sure you looked into it but I didn't think they could do an ADR in the "T" section of the spine.

Wishing you good health.

Mark
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  #8  
Old 07-23-2013, 02:12 PM
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jss jss is offline
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Mark,

Thank you so very much for you well wishes. I'm not having problems with C7/T1 yet, but it was on the way out at the time of my last MRI in 2009; dessicated and bulging, but not yet symptomatic. The expectation from Zigler, Naftalis and Clavel was that it would have to come out one day. I am aware of at least one poster on this site that had an ADR at C7/T1 with Clavel. Like you, I've never heard of an ADR anywhere between T1 and T12.

Thanks, 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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  #9  
Old 07-23-2013, 09:32 PM
ansnj ansnj is offline
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Thanks for all of your replies.

SB sounds like you had a wonderful experience with Dr. Beirstedt, am glad for you. I had spoken with TPatti pre-surgery and have been following his post surgery postings. It sounds like he is doing swell.

NJ Gene: I totally agree with you that there would be accountability even if it was across the country but at least I would be in the same county . Today I spoke with Lacey from Dr. Lauryssen's office and they can offer a consult once they review my MRI'S. I have to decide if I want to pursue this. Dr. Lauryssen has used a few M6 discs of course he won't have the track record of Drs. Beirstedt and Clavel.

As far as the incision, that probably should be the least of my concerns. It just struck me as odd that all the other surgeons I had spoken with, cut horizontally on the crease of the neck. No folks I am not entering a beauty contest where the scar is an issue, I am not that vain.

So here I sit on the fence pondering what to do. I hope I can make my decision sooner than later. Since we all know this is degenerative and I would hate to have to change my signature to needing 4 discs rather than 3.
__________________
Pedestrian hit by a car 1996
Progressive cervical degeneration
MRI 12/2012- DDD C4-5, C5-6, C6-7
Neck pain and intermittent finger numbness
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  #10  
Old 07-27-2013, 06:24 AM
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TPatti TPatti is offline
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Everything Stonewall and more is correct about this being a first class operation! There are 2 cervical patients here at the same time, I have enjoyed meals with them on numerous occasions this past week, and they both have horizontal incisions and participate in the comprehensive rehab program at Medicos. If only you could have the experience before making the decision-I am here now, doing better then I ever thought I could be such a short time after such a big surgery. As of 2 days ago I have not taken any opiate based pain killers, only NSAID's and Lyrica. The rehab program is awesome-soccer players from all over Europe come her for rehab and they are responsible for rehab and training for Schalke 04 soccer team of which their stadium is on the premis. They are also know to rehab dancers from all over Europe, I met one that is here now from Germany and her roommate is a dancer from Australia. Now that I have had the experience I know that I would not have done this any other way except for not waiting 3 years while trying other method to relieve my pain. I am not saying that surgery should be your first choice, but I would have made the decision after 1-1/2 to 2 years if I could go back in time.
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*9/10: Unstable pelvis & SI joint, sore IT band. Chiro care, I would shift out hours to days after adjust
*12/10: PT & chiro
*4/11 to 11/11: 5 sessions prolo and 3 prolo w/ PRP
*12/28/11 ESI L L4/L5 - 1/13/12 ESI R L4/L5 - 1/24/12 L SI joint capsule - 3/8/12 TPI - 3/23/12 L L5/S1 - 4/11/12 ESI caudal - 5/23/12 TPI - 7/10/12 Facet inj L3/L4, L4/L5, L5/S1
*9/12/12: 30 - DRX9000
*12/21/12 schedule. for L4/L5 fusion-CANCELLED 1/7/13
*7/16/2013: 3 level M6(S1-L3) w/ Dr. Bierstedt
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