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Old 10-27-2019, 08:58 PM
peach395 peach395 is offline
Junior Member
Join Date: Oct 2019
Posts: 1
Question Anticipating ADR C4-5; already have fusion C5-6

Hi Everyone,

I'm looking to have an ADR performed at C4-5 in the near future. I've been in moderate but worsening main since I had an anterior fusion of C5-6, and then a posterior fusion of the same site because the first fusion didn't completely set.

My insurance company's initial response to the ADR was a denial, since a hybrid fusion/ADR is not recommended by the FDA (at least, that's what I understand). I'm pushing forward with an appeal, but that's one of the issues I'd like to ask here:

- Has anyone had luck appealing insurance decisions in cases similar to this?

I've reached out to Dr. Bertagnoli for another opinion, as well as another option if I decide to have the ADR performed outside the US on my own dime. If this is what I have to do, then so be it, but I'm curious if anyone has had a case very similar to mine and can share some wisdom on what kind(s) of artificial discs have worked best, and any other recommendations.

(Note that I'm sure some stories and wisdom have been posted here before that might be very useful information, but I figure I could ask these questions directly while I pore over all my search results!)

Thanks all!
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Old 10-28-2019, 10:56 AM
annapurna annapurna is offline
Senior Member
Join Date: Dec 2004
Posts: 1,597

Typically, the hybrids that you'll find discussed here take place when the surgeon places both ADR and fusion at the same time. Less often is the ADR followed by fusion, and even less often than that are situations like yours where a fusion was first. That said, I wouldn't be surprised if you found a similar case if you searched the board.

You asked about recommended device types. I'd approach that by choosing surgeons you're willing to pursue and whether the devices they use are suitable. The reason I'd prioritize the selection of the surgeon is that placement of the ADR above a fused level will stress the device, even if it's been optimized for that kind of use. Getting it placed as close to perfectly will have a huge effect on long term success or failure of the device. My suggestion is to look for surgeons who've done multiple levels, and multiple levels over multiple surgeries, and are old hands at such work. Don't consider someone who's got a lot of experience with single level work and sells an optimized ADR over someone who's done hundreds of multilevel surgeries.
Laura - L5S1 Charitee
C5/6 and 6/7 Prodisc C
Facet problems L4-S1
Knee, Shoulder, Toe, Finger, Elbow Problems

Jim - no spine problem but lots of other fun medical challenges

"There are many Annapurnas in the lives of men" Maurice Herzog
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Old 10-28-2019, 10:00 PM
Cheryl0331 Cheryl0331 is offline
Senior Member
Join Date: Dec 2010
Posts: 840
Default Echo

I echo Anna's sentiment.
Placement and experience with multiple levels is key.
Hope this helps.
53 yr old female 5'7" 141 lbs. non-smoker conservative treatments failed
2007 fusion @ C4-6 peek cages, failed due to long term use of cox-2 inhibitor
2008 revised C4-6 donor bone, plate & screws
2009 fusion with Roi-C @ C3-4
2015 MRI & CT mjr ddd @ C6-7, segmental kyphosis at C7-T1, 2-level M6-C prosthesis by Dr. Clavel Barcelona Spain
2019 H.O. formed behind M6-C @ C6-7 left nerve rt & in spinal canal.
2020 Revision C6-7 to a cp-ESP prosthesis by Dr. Schmitz Dusseldorf Germany
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adr, cervical, fusion, hybrid

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