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Old 05-04-2017, 03:07 PM
cavalier cavalier is offline
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Default outcomes with multiple Cervical ADR with Dr B

Hi All- I had a lumbar single ADR done by Dr Bertagnoli in 2004 I was on a waiting list for the trials here in the USA but after not moving up after 18 mos I ran out of time due to a progressive spondylo by that time was over 99% slipped off and was close to being someone emergent 2 level fusion. I had L3L4 herinated while not the source of my pain it would have had to been included as all said if I went with a fusion I obviously didnt want a 2 level fusion. and I really felt I was given not a real expectation from TBI as I never did get move up on the supposed list being only #3 for 18 mos I knew they were doing at least 3 ADRS a week As a matter of fact that call even with my calling them regularly never did come thru - so for me Dr Bertagnoli saved my life! - he truly did! I woke up with not the long standing pain I had been enduring and he spent over 3 hrs just taking out fragments out of my spine. My surgery was 6 hrs for what I was told was his worst single level disc ever that the MRI didnt show how bad it really was truly. So while I owe him my life, I knew ahead of my going there his success stories of his ADR work on the lumbar due to the thanks of this forum and a couple of others. In other words I had done my homework and I had vetted him thru other patient stories. It also cost me in cleaning out our small savings at the time we had exactly from a house we had sold enuf funds to go down to o in savings. I never wanted to leave our country to do a operation but thanks to the FDA back then and the lack of movement I ran out of time and Dr B opened up his schedule to fit me in we had 4 days to secure travel and be there! It was not easy.

Ive read on here patient stories who have had the Prodisc C and even the new Nova Prodisc that are a bit mixed - I realize Dr B doesnt cherry pick his patients like the USA is known for - but I'm wondering - since he is so talented is it the actual device used has some limitations? Then i found this on a older post from 2015 that said this -
"Harrison can comment more on Cervical levels with Bertagnoli"
Can you Harrison if you are comfortable elaborate or any others jump in here plse? im just collecting facts and information and I dont want to have a blind eye to anything. The talents and devices in the low back may not be the same as the neck and i should entertain any info.

The deal is Ive also read some mixed results coming from the States here using the Prodisc C also preformed by some who have some depth to their surgery skills so I am wondering truly IF it is the device to some degree? While Im very grateful for my lumbar Prodisc it seems that the overwhelming successful patient stories are coming from the Prestige and the Mobi C, that is FDA approved for 2 levels.

Yet I got a article written by Dr B that in his feelings both of these and the M6 in his opinion he doesn't like the elastomer ADRS and the unconstrained design of the other ADR 's for the neck - he feels the semiconstrained is more sparing on osteoarthritic facets which when I go to those Manufacturers pages they limit their devices to Mild Osteoarthritis Facets. I have Moderate Osteoarthritis at the 2 levels Dr B wants a Discogram done on C3/C4 and C4/C5 to see if they need to be included or not - what I call the marginal 2 discs. The 2 levels that I am bone on bone at do NOT have any facet Osteoarthritis at that are the 2 levels so far that both Dr B and a N.S. say need to be replaced by either 2 ADRS Nova by Prodisc or a 2 level fusion. as the 2nd Doc feels he cant distract my bones far enuf apart to put in a ADR. Where Dr Bertagnoli feels he can and likely its due to the fact that Dr B has taken on less than ideal patients who normally I would have been disqualified from entering into the FDA trials here so in this Docs case he has not had to push that envelope yet and he says if he tries and cant I would wake up with a 2 level fusion.

So would you present your findings to more Spine Docs here who have done ADR? and let them decide if the Mobi C or Prestige will work with my facets, at these 2 levels or should I ask them point blank, if they dont bring this up?

And if they only say for the 2 levels the worst ones and dont mention the other 2 should I ask them or just move on like I did with the 1st Doc.? I dont have tons of depth with Docs here and to keep traveling is difficult on me to do right now - and I could run out of options fast.

I definitely agree with Dr B. I would like a Discogram done 1st. Id rather be careful on the front end than have regrets later. The 1st doc didnt feel the need to do a Discogram and thats just not how Im used to doing things granted its not great to do but I personally feel they do clarify and give both myself and the Doc confidence we are not missing anything.

I have at least 2 levels a Discogram should clarify on 2 other marginal discs - that I would still like to have the Discogram done here 1st like I did before so I can know for sure what to expect and if I will still be just 2 levels or if I need a hybrid or 3 to 4 ADRS overseas. After all, I do have limits and it is tiring to pay for this out of pocket, as hubby is wanting to retire and I cant blame him, especially since i know insurance will pay for a discogram here and I need to get this going. Im not in the place where I have the luxury of time on my side.

Im just trying to make sense of this as logic is important to me to help have understanding. To me part of that process is understanding the devices and their strengths and limitations. I know at the time for what I had going on with a progressive spondylo and bad osteoarthritis in my facets - that both Zigler and Blumenthal i flew in to see each one of them said Prodisc would be my better option. So while I could not get into their Trials there despite trying they helped immensely to give me confidence that leaving here to get what I needed done I was getting the right device by not just what Dr B said but they had other brands to choose from and they felt so too.

This is why I want to get in front of a Doc at TBI again - see what they have to say and hopefully give me confidence in making a decision. I also had my discogram done down there and I would like to do that again down there as they do them alot!

I really DO feel at this point I am a surgical candidate, IF a Doc wants to fool with me that is they make look at me and say no as they maybe worried I have too much going on to fool with I dunno.
Ive already been told surgery by Dr B in 09 I just couldnt pull it off $ wise and hoped I could hang for FDA approval for 2 levels. And Ive been told this again by him just this week and I trust him completely with his eye! I have never felt he offers surgery when it is NOT needed! Ive also been told this by a NS for a 2 level fusion - so if i get word from someone to do nothing I will be surprised but then again Ive been surprised before ask 3 docs for a opinion you can get 3 different answers - but Im hoping for one to give a vote to ADR for me of some sort.

On a small side note Ive never found communication with someone as the go between due to the language barriers to be easy they often can misunderstand our meaning not so much in talking but the written word can be tricky its likely on our end. But Ive had things taken not how I meant them and its adds to some of the stress that is already there but I put that on me to take the time to be more clear and really try hard but sometimes it can be taken differently, when I dont see how it could be, but I just have to reexplain and have worked thru that I hope. I just remember to not take it personally

Any input is welcomed and much appreciated! I kept hoping I could somehow continue to keep getting by the changes in my neck dynamics, but here I am once again.

Is the Cervical really that much of a different animal than Lumbar? Ive been told things are much tighter in the neck than the low back.
Thanks,
Jill aka Cavalier

MVA 94 broke pelvis 3 places blew L3/4,L4/L5 neck weak.
Progress.spondylo 99%(lamatomey)ADR L4/L5 Dr B. 07/04 Successful!#3 in world w/Progres.Spondylo w/solo ADR. Cerv.MRI Dr B '09. C5/6, C6/7 & disco. to deter. C4/5. Surgery not done! '08 2 aneurysms Transverse Cerv. & Subclavian Arteries. full L.Cerv.rib remv'd. R. C. Rib still intact. Post-op complic. paralyzed L. Phrenic Nerve, not cut. '09, Phrenic Nerve graft Surgery d/n work. 1/16 hit & run Whiplash 3mo's. got better. 12/16 Basement work overhead now 6 mos. >worse. Conserv. measures failed includ. ozone, acupunc.MRI 03/17 C5/6, Spondylosis,Narrowed Interspace,borderline Canal, Mod. Bilat. Foraminal Stenosis C6/7 Disc bulge, Osteophyte, Mild Central Canal & Mod. Bilat. Foraminal Stenosis. C3/4 Mod. Foraminal Stenosis,C4/5 Mod. L. Facet Osteoarth.Opinions- Discogram-C3/4 & C4/5, ADR 2 level C5/6 & C6/7. Discogram=3-4 level ADR. Or 2 level fusion. EMG-abnormal 4th fingers, L. delt.& tri's.
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Old 05-04-2017, 03:23 PM
cavalier cavalier is offline
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Join Date: Nov 2004
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Oh forgot to state in reading on this forum I found a article from TBI in interviews that stated there is not drastic differences between the Cervical ADRS they do have some differences but they were felt to be small so that made me feel I should explore seeing a couple more docs here for their opinions.

As the old Michelin ad used to say there is alot riding on these tires - the input I can gather will carry alot of importance.

Jill Aka Cavalier

MVA 94 broke pelvis 3 places blew L3/4,L4/L5 neck weak.
Progress.spondylo 99%(lamatomey)ADR L4/L5 Dr B. 07/04 Successful!#3 in world w/Progres.Spondylo w/solo ADR. Cerv.MRI Dr B '09. C5/6, C6/7 & disco. to deter. C4/5. Surgery not done! '08 2 aneurysms Transverse Cerv. & Subclavian Arteries. full L.Cerv.rib remv'd. R. C. Rib still intact. Post-op complic. paralyzed L. Phrenic Nerve, not cut. '09, Phrenic Nerve graft Surgery d/n work. 1/16 hit & run Whiplash 3mo's. got better. 12/16 Basement work overhead now 6 mos. >worse. Conserv. measures failed includ. ozone, acupunc.MRI 03/17 C5/6, Spondylosis,Narrowed Interspace,borderline Canal, Mod. Bilat. Foraminal Stenosis C6/7 Disc bulge, Osteophyte, Mild Central Canal & Mod. Bilat. Foraminal Stenosis. C3/4 Mod. Foraminal Stenosis,C4/5 Mod. L. Facet Osteoarth.Opinions- Discogram-C3/4 & C4/5, ADR 2 level C5/6 & C6/7. Discogram=3-4 level ADR. Or 2 level fusion. EMG-abnormal 4th fingers, L. delt.& tri's.
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