Hello - Request for Help Selecting a Surgeon

[Spiney]

Hello Everybody,

First off, I would like to express my sincere gratitude to Harrison for creating adrsupport.org. I have found it to be an an invaluable resource. Thank you, Harrison! Additionally, my appreciation goes out to all of you who have populated this site with your knowledge, experiences, insights, and support. Thank you, everybody!

It has been said on this forum to consider the surgeon first and then the artificial disk appliance second.

I have my second appointment with a neurosurgeon in my area this week. How does one properly interview a surgeon? How do I know how “good” he/she is?

Is there a list of questions that have been compiled by the ARDSupport community that I could bring with me to my second appointment? I have searched on the forums but not found anything. Did I miss it?

What are the current preferred surgical techniques to use when doing a anterior artificial disc replacement? I would like to know if my local neurosurgeon is using them.

In my experience doctors often speak in an indirect manner. This is understandable given the liability exposure they live under. How does one get tangible facts regarding a surgeon’s ability, experience, technique, outcomes, etc.?

When we first met the neurosurgeon I asked him about his experience. He intimated he was doing one to two ADRs using the Mobi-C per week. Is that a lot?

He didn’t say how many ADRs he had done in total.

Is there a way to verify this claim? I have no reason to disbelieve him, nor do I want to impune the doctor’s good name or reputation, but I would like to get some hard data if possible.

He said that he and his partners prefer ADR (w/ Modbi-C) over ACDF when appropriate. Sounds good to me, but this does not tell me if he is the surgeon I should go with.

He did tell me upfront that the surgery would have risks. Possible issues with throat and voice box.

He explained that he would remove the muscle from my cervical vertebrae in front to provide access to the herniated disk (the longus colli I believe). When asked if the muscle would be reattached he said no they just flop it back in place. He said the muscle was of little importance and would have no affect on me for the future. Is this true?

Holy cow, after reading tomes of information on the interwebs, I remain thoroughly unqualified to select a surgeon first. At least with the artificial disks there is data available to consider. Where is the data on surgeons?

[aeromarkco]

Hi Spiney,
That's a vestigial muscle left over from some other time in human development i.e. Wisdom teeth.
I am sure that there are many compilations for question on how to select a spine surgeon. This site for starters as to the names.
I like the "Burton Report" a website edited by a spine surgeon which has a good article on selecting a surgeon.
There is also a "Best Doctors" service nationally that has referral services based on peer review data.
Good Luck,
Mark

[Harrison]

Spiney, welcome and thanks for the kind words. I wish I could answer all your questions but cannot now. In the meantime, to help you get started on reviewing spine surgeons, see:

https://www.adrsupport.org/forums/sh...ad.php?t=11140

Scroll through the different topics. The one from Nov 2011 is a good start -- these are the docs that start disc trials in the US in 2000. So the docs that are still performing ADRs have 17 years of ADR experience as well as other spinal procedures.

10 Spine Surgeon Investigators of Artificial Discs Featured
Written by Laura Miller | November 02, 2011

[Spiney]

Mark and Harrison, thank you for your suggestions.

I had my second meeting with my local neurosurgeon. My wife went with me to the meeting. The doctor seems very competent, but neither of us was able to get from him or his staff the number of Mobi-C ADRs he has performed. This evasion regarding his experience seems a little weird.

He is not requiring a DEXA test before surgery. A number of posts on adrsupport.org suggest this is an important test to have before moving forward with surgery. I would like to hear what others think. How important is a bone density test?

So, we are still deciding if I should go with this local neurosurgeon or look further afield. We are considering Dr. Scott L. Blumenthal, MD of the Texas Back Institute. It is my understand that Dr. Blumenthal was part of the Mobi-C trials.

Thanks again for your responses.

Regards,
William

[Blizzaga]

Originally Posted by Spiney

He is not requiring a DEXA test before surgery. A number of posts on adrsupport.org suggest this is an important test to have before moving forward with surgery. I would like to hear what others think. How important is a bone density test?

Hi William,

DEXA is mandatory. I highly suggest getting it. It does not cost much and the radiation dose is low compared to standard X-ray. Most likely your results are fine. But there is always the small probability of "unexpected poor bone quality". Some of the bad complications have been due to poor bone quality. If that happens, you are looking at risky revision surgery where they will try to fuse you, often with not so perfect results. Why risk your life for a few hundred $?

[Harrison]

Well said, Blizzaga. Though the DEXA is not mandatory -- it SHOULD be!