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The Big File All issues not easily categorized in the above forums are here. Comments on general health, diet, "getting comfortable," and more are here.


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  #1  
Old 10-02-2006, 02:01 PM
David David is offline
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<rant>

Grrrrrrr...........
(not the words I really want)

I finally make the call to Dr. Y to try and schedule 1 level Prodisc + 1 level Prodisc off-label, and I find out that Synthes is not "allowing" off-label Prodisc usage for 'an indefinite amount of time'.

Meaning, of course, had I made this call 6 months ago, I would already have been operated and, done, and fine. But...because I am stupid enough to have waited, I get screwed all over again (don't get me wrong, I am not blaming Dr. Y).

I guess this doesn't leave me with much options, other than Dr. B once again, which was (probably) the cheapest solution to begin with. What is the coordinator's email address again???

</rant>

David
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47 years old
Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.)
L4-S1: Prodisc
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  #2  
Old 10-02-2006, 02:42 PM
chasswen chasswen is offline
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sorry to hear that after waiting so long.
patient-affairs@pro-spine.com
theres a good place to start anita should pick right up on it..
chuck
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ddd 1990
2003 mri,xrays,shots,emg
2004 discogram ouch pos l4 l5
facet block neg
lost all appeals BCBS 5 months of that
3 surgeons later
surgery with dr. bertagnoli aug 2nd 2006 in Bogen Germany Successfully ProDisc-L L-4 L-5
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  #3  
Old 10-02-2006, 03:02 PM
ans ans is offline
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Have you discussed fusion at L5-S1 and Pro-Disc on the higher level? The reason is that when I spoke to Dr. Regan, he didn't think that was such a bad idea.
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Severe, extensive DDD, considered inoperable by Dr. Regan, Lauressen, & some guy at UCLA. Severe foraminal stenosis (guess they can't operate!) and some spinal cord compression that Lauryssen would fix if gets outta hand.
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  #4  
Old 10-02-2006, 03:15 PM
David David is offline
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Quote:
Have you discussed fusion at L5-S1 and Pro-Disc on the higher level? The reason is that when I spoke to Dr. Regan, he didn't think that was such a bad idea.
Actually, yes. About 5 minutes ago, I just had that very conversation with Dr. Y about that.

I gave him and his surgical coordinator the go ahead to try and schedule me for Prodisc @L4-L5 and fusion @L5-S1.

In my opinion (after years of medical school...NOT!), it remains to be seen if ADR will put 'extra' stress on a lower fusion level, but some studies have indicated that the loss in range of motion for fusion @L5-S1 isn't noticeable.

Therefore, it is definitely worth the shot.

David
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47 years old
Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.)
L4-S1: Prodisc
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  #5  
Old 10-03-2006, 04:52 AM
David David is offline
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To respond to my previous post (since I didn't sleep last night and made it to work over an hour earlier than normal), I guess I am giving Dr. Y one last option before I offically 'give up' and go the Germany route.

I know that Germany has the best surgeons available for the most reasonable cost, yet something (inside me) that I am still unable to identify seems to be holding me back.

To be honest, I think that I have about 3 possible scenarios:

1. Insurance covers Prodisc/Fusion 100%: Then I have a tough decision to make.
2. Insurance won't cover Prodisc/Fusion at all: Easy decision to make.
3. (Highly likely) Insurance will cover Fusion, but not Prodisc: this would probably mean around $12k in costs for me, which is significantly less than around $40k for Dr. B.

Ultimately, I guess the question is whether or not I would be better off with L4-L5 Prodisc & L5-S1 Fusion, or L4-L5 Prodisc and L5-S1 Prodisc? Some of the studies I have read tend to indicate that ADR @ L5-S1 doesn't seem to offer much advantages over Fusion, which is the primary reason why I am even considering it. Even though I have known for the last two years that I have wanted ADR over Fusion, I guess I (maybe?) should be realistic and at least consider the option (?!)

David
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47 years old
Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.)
L4-S1: Prodisc
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  #6  
Old 10-03-2006, 05:44 AM
chasswen chasswen is offline
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well david
one problem with the fusion is healing time its much greater.and the possbily of a non fusion
althou you are correct in maken the statement about there not being much movement at s1-l5. the other question is and i didnt think much about it before is how much disc height have you lost? as i was bone to bone and i have had god awefull leg pain since about 5 days after surgery it just keeps going day after day its now been going on 9 weeks postop.
but is getting better. thank god.now my room mate in germany was larry he is 26 and didnt have much lost and at 6 weeks postop he only has muscle pain from PT. and i was running cirles arround him in the hospital as apossed to now where im praying to be able to return to work at 12 weeks. you have a tough call. but if you go to dr b cost diff isnt going to be much diff from two adr or adr and a fusion. the charge for the device was 4500 euro.
good luck to you in which ever route you take.
chuck
__________________
ddd 1990
2003 mri,xrays,shots,emg
2004 discogram ouch pos l4 l5
facet block neg
lost all appeals BCBS 5 months of that
3 surgeons later
surgery with dr. bertagnoli aug 2nd 2006 in Bogen Germany Successfully ProDisc-L L-4 L-5
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  #7  
Old 10-03-2006, 05:49 AM
chasswen chasswen is offline
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david
your films dont appear to show to much disc height lose so you should fair well.
chuck
__________________
ddd 1990
2003 mri,xrays,shots,emg
2004 discogram ouch pos l4 l5
facet block neg
lost all appeals BCBS 5 months of that
3 surgeons later
surgery with dr. bertagnoli aug 2nd 2006 in Bogen Germany Successfully ProDisc-L L-4 L-5
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  #8  
Old 10-03-2006, 06:37 AM
David David is offline
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Quote:
david
your films dont appear to show to much disc height lose so you should fair well.
You make some excellent points, and thanks for taking a look and offering some advice.

I imagine that the recovery period for a 2 level Prodisc versus 1 level Prodisc + fusion is probably somewhat similar (although you are right 2 Prodisc would probably be a bit better). Neither is a walk in the park though.

Really a tough decision, no matter how I look at it .... At this point, I guess I will see what my insurance company says, and go from there.

David
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47 years old
Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.)
L4-S1: Prodisc
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  #9  
Old 10-03-2006, 07:03 AM
chasswen chasswen is offline
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well i am a single level at l4-l5. and larry had 2 prodisc at l4-l5 and s1-l5 i believe i do have have a picture of his x-ray. larry was back to school and had pains but from PT in less then 6 weeks.
i am 9 weeks postop and my legs from my knees down in the morning feel like i had them tucked up under my butt all night.which sucks i had no idea how bad the distraction pain would be. i knew before surgery that i would hurt more durning recovery then i did pior to surgery. i though how bad could it be. well on day 5 or 6 after surgery my legs just about stopped working and it took all i had to walk about and forget about sleeping ack!! but as i said my disc pain had stopped about 3 months before surgery because the nerve had been wore away all i felt was rubbing of bones. i think you should just do it go see dr b and let him work his magic. and one thing i found is once i chose dr b i didnt worry about the surgeon any more that i would recieve the best possbile outcome. all i had to do is be there.althou after the lala pills before surgery i got sarced to death being as i never was under the knife and the first time,just happened to be spine surgery.
and fusion was out of the question as i am a smoker so that wasnt in the cards. what it came down to was i was just plain out of time when it came to this surgery. either bite the bullet and pay out of pocket or fusion was to become my only chose.
chuck
__________________
ddd 1990
2003 mri,xrays,shots,emg
2004 discogram ouch pos l4 l5
facet block neg
lost all appeals BCBS 5 months of that
3 surgeons later
surgery with dr. bertagnoli aug 2nd 2006 in Bogen Germany Successfully ProDisc-L L-4 L-5
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  #10  
Old 10-03-2006, 07:31 AM
David David is offline
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Join Date: Mar 2005
Posts: 455
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I am pretty much out of options at this point...

Either I could try and have Prodisc + Fusion here with Dr. Y, or I could go with Dr. B, whom I have almost chosen several times over (and, in retrospect, whom I should have chosen a couple of years ago).

To be honest, I wonder if the whole Prodisc + Fusion gamble is even worth the time and effort? I know that Dr. Y is an experienced surgeon and would do a great job, but I seriously doubt my insurance is going to agree to cover it.

If I have to go out of pocket for any costs, I probably should just suck it up and pay the best available (can you tell that I am just trying to talk myself into it?)

David
__________________
47 years old
Surgery: 14-NOV-2006; Straubing, Germany (Dr. B.)
L4-S1: Prodisc
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