Advice needed on cervical ADR decision

[drewrad]

I have been absolutely thrilled with Dr Clavel. Coming up on 5 month mark. The actual worked on area is the least of my problems. I'm old, and Dr Clavel MRI'd my entire spine. I have crappy discs all over the place. Talk about multilevel! But my bottom 3 worked on areas are great now! I can sit at the dinner table, drive a car etc.

I just need to learn to slow down which is hard for me. The MRIs showed some cervical stuff to be aware of as well as a few ugly thoracics which do cause issues if I swim too much so now I'm thinking I just need to take her easy. Walking is fantastic though. Still do machine weights but I'm not doing MMA, too much of a chickenshart for that.

Docs here at Kaiser were going to consign me to a life of pain management drugs and PT. Pffffft.

I chose to live life abundantly instead and decided to turn into the punch head on. Glad I did. When I see my lumbar before it just sends shivers looking at it.

Call me if anyone needs help in making a decision, but I admit I'm biased in leaving this banana republic behind.

And anti fragile, I like your style. You should talk to Frank. He went to Clavel also and rolled his jitz mats out again a few months ago. And is rolling on em again. He's a four level, neck and lumbar.

And Throttle, can I see your wife's pre/postop? I really want to see that reversal of curve re established by El Maestro.

[Antifragile]

So Dr. Bierstedt called me today and we spoke for about 35 minutes on my condition. He apologize about my not hearing from Malte but said that they are swamped and very busy. The good news is that both Dr Bierstedt and Clavel agree on my condition and recommend the same thing. What I wasn't clear on was what ligament/s are removed, because Dr. Clavel mentioned my posterior ligament being enlarged.

Colorado Babe,

Throttlejockey explained iit well and had a similar experience as I did here. You're lucky in that you found a wonderful doctor here in the states. However, if you read my initial post and my reply to Harrison, I've already explained in detail why my options in the US are not ideal, including my experiences with doctors, as well as why I would rather have the M6 over the Mobi-C. On top of that, I discussed the Mobi-C with Dr. Bierstedt today and he said that he and his other surgeons are not "married" to the M6, they can use whatever device they choose, but in his experience the M6 is a better, stronger disc and the only one that has undergone 30,000,000 cycles.

Drewrad,

You train MMA? I would like to get in touch with Frank if he does BJJ. What did he have done?

[TPatti]

In my follow up appointment with Dr. Cappuccino(Buffalo, NY) yesterday(see my thread) the doctor and I discussed cervical discs because I also have some cervical issues that may have to be addressed at some point. He has been using the mobi-c and recently performed a 2 level with it. He said that it was his opinion that anyone that could wait for the M6 to be cleared by the fda should wait. He did not give me specifics but said based on research and data that he has seen he feels the M6 is superior especially in multi level situations. Dr. Cappuccino has also been involved in research and development of spinal products.

[jss]

Antifragile,

Isn't it a challenge to decide which is the best course? The trouble is that you likely won't know for years down the road if the decision you made was the right one.

Anyway, you've been given great points all the way around and a lot to consider. I think that either way you go, Mobi-C or M6, both are great 2nd and 3rd generation devices. BTW: the trauma required to deliver 497 newtons of sheer stress to your cervical spine will likely leave you dead or paralyzed; so I wouldn't worry about that being the limit of the Mobi-C. As you've probably discovered, more important than the device is finding a gentleman that has a long and successful track record with that device.

I wouldn't trade my pair of M6-C's. I've had them five years last week. Had the Mobi-C been available in the US and covered by my insurance when I needed it, I would have gone with that one. Either way is a good decision. Find the right surgeon.

You're going about the process the right way.

Good luck, Jeff

[TPatti]

I should note that Dr. Cappuccino also said that if you do need surgery now that he feels the mobi-c at least gives him an option in this country that he feels is a good one. He was never a fan of the Pro-disc and used to prefer to use the kina-flex in Cyprus thru AIMISS before the Mobi-c was approved here.
On another note, he conveyed some interesting feedback from a meeting he recently had with 2 local insurance companies regarding persuading them to pay for adr over fusion. He said that presenting some new data on must-level fusion showing that there was only an 8% success rate! They agreed that adr made more sense but said that they do not want to start approving because they fear that more people will opt for surgery if there is a better option!

[jss]

Originally Posted by TPatti

... He said that presenting some new data on must-level fusion showing that there was only an 8% success rate! They agreed that adr made more sense but said that they do not want to start approving because they fear that more people will opt for surgery if there is a better option!

There is so much wrong with these two statements that it's hard to know where to start. While I appreciate the fact that the medical insurance industry is a for-profit business, the last statement is outrageous.

[Brewster]

Other than this great board the general public seldom hears about post op spinal problems. My wife is near three years out from a lumbar fusion. The pain is starting to come back, what's that I hear about adjacent disc breakdown?

[jss]

Originally Posted by Brewster

... My wife is near three years out from a lumbar fusion. The pain is starting to come back ...

Sincerest condolences. What's the plan?

[Antifragile]

Very interesting. after my experiences and reading the experiences of others, I feel better about having it done overseas.

There's an opening for surgery with Dr Clavel on Dec 15th (one week away) and if I take it, I would have to make all the arrangements now and rush to get everything done. On the upside, I would get the surgery over with before the holidays, and get on with my life sooner.

On the downside, I'm confused about the procedure and the different opinions I got. I had a bit of a different opinion recently when I spoke with Dr. Bierstedt by phone a few days ago. Apparently, Dr. Bierstedt was going to partially remove the annulus (it's torn) but leave the posterior ligament in tact. From what I was told by Dr. Clavel, my posterior ligament is enlarged and he wants to remove part if it. I feel like I am well out of my expertise here, but I would like to know why the difference of opinion. Of course, I would rather not cut a ligament if I don't absolutely have to.

If I don't get it done with Dr. Clavel on dec 15th, he has January dates available, and so does dr Bierstedt. I'm not sure what to do.

Thoughts?

[jss]

Antifragile,

I don't know what you should do, but I know what you shouldn't do; go into a European surgery without knowing all of the options and opinions. Example: you need to understand the problems that ossification of the PLL cause, what happens if you leave the ossification and what does it mean for your future if you remove the effected segment of the PLL.

You are liable to discover that the opinions are just different; not necessarily right or wrong. I don't know.

I do know that thickening of the PLL will cause compression of the spinal cord. I don't know if that thickening can be arrested surgically, if the PLL can be debrided, or if it can only be removed.

That's not definitive, but I hope it's helpful.

Good luck!