L4-5 Charite ADR Stenum

[Katie]

I second that sentiment.

I do have a question though that I think is relevant. We have all heard about several of these unfortunate surgeries in 04/05. Has anyone had solid evidence of anything similar happening since then, especially in the last two years?

I have heard nothing but wonderful things from at least a dozen recent patients, who had everything from one level to stem cell work done along with multi-level ADR. The results with all of these people have been nothing but amazing. I keep calling and asking them how life is going, and it's certainly better than mine.

Just asking.................

[trkdoc714]

I agree with Terry but I'm more blunt. For whatever reason, this poor man's passing from a drug related problem and what his family has had to endure has unfortunately been turned and twisted into more bashing of a truly great surgeon. This negative marketing of medical tourist companies really does interfere with people that are sincerely looking for help and advice. I doubt that they care if anyone gets commission on the surgeries or treatments as long as they find relief.

This particular thread has extremely bad timing. I had just left for Stenum for a 2 level ADR when my wife read this thread. She has been a wreck. Due to this negative marketing technique, she didn't know if I was coming home in a wheelchair or a body bag. This is an extremely irresponsible and juvenile act on his part. My wife called the hospital while I was in the recovery room. They brought a phone to me so I could talk to her and ease her worries. Dr. Ritter-Lang was at my bedside when this happened and told us both that the surgery went well.

Mark. You claim you don't use this site as a marketing tool for your medical tourist business. You most definitely do to a great extent. Why don't you disclose exactly your motivations, your medical credentials and education. You may as well also disclose your commission per patient with Dr. Bertgnoli and others as well. Let's really get to the root of all of this. I think your "noble" facade will be seen for what it truly is if you finally admit to using this site to sell, sell, sell. I wonder if you would have this vicious attitude toward Stenum had they hired you when tried to be employed here. I guess that ethics exam was a tough one, eh?

By the way, my L4/L5 and L5/S1 Mavericks are well placed and I haven't had any serious pain meds since 48 hours post surgery. The entire staff here at Stenum has been terrific and very helpful. If anyone would like first hand details, I'd be happy to answer any and all questions. Additionally, I do not get any renumeration for relaying my experience at Stenum Hospital nor do the other four patients that had the exact great experience I have had with Stenum.

One last thing. Mark, do not ever call my house again. Each time I've mentioned Stenum in a post either here or on ADR Support, you seemed it your duty to call me and try to sell me away from them. If you feel compelled to apologize for the anguish you put my wife through, do it by discontinuing this Amway marketing practice. By the way, I checked. Stenum doesn't perform ADR on dogs. Perhaps you should take yours to Dr. Bertgnoli?

Bob Threlkel at yahoo.com

[Cindylou]

trkdoc714, I am so happy for you that your surgery went so well. Bottom line, that's what we all want to hear. Results. Successful results. I will pray that pain free days surround you, in the days and months ahead, while you heal from your surgery. Of course, we all want to make the "right" decision as to where we go and who we pick for a surgeon. Who knowingly wants to pick the wrong surgeon, or the surgeon with a very high failure rate? Obviously, no one. This is the tricky business for we spine sufferers, who on top of being miserably in pain, have to buck up and do endless hours of research so that we can make an informed decision. I can even understand your lashing out at Mark, because who else is speaking so strongly against Stenum? And he has the platform, this community, right? But here's where I have to differ, so please hear me out. When Mark flew out for the observation of my most recent surgery, I did not pay him one dime. Fact. He flew out on a wing and a prayer, because he really wanted to see what this Dr. Stark had up his sleeve, in regards to SI Joint Fusion, and the future this might hold for numerous failed back syndrome folks like myself and so many others who are not living the pain free life they are so desperately seeking. Fact. This community was born of love and compassion for our fellow man. My belief and conclusion. Now, here's the kicker we all need to pay attention to: does Mark need to make a living, like everyone else?? You betcha. After speaking with Mark in person, I can testify that this is how Global Patient Network was born. So he could attempt to carve out a living, doing what he does best, helping fellow spine patients find relief from their pain. Is Mark rich from this new career? Hardly. At best, he is breaking even. If I were Mark I would be very offended that you would accuse him of taking kick backs from Dr. Bertagnoli. Outrageous accusation. Absolutely not true. If Mark is guilty of anything, it is caring too much and having seen too much from all the surgeries he has had the good fortune to observe. Yes, he is merely speaking from his experience and observations. Just remember, HE HAS SEEN ALOT. I believe he sees it as a moral duty to comment on what he has seen take place at Stenum. So now he is guilty of having a conscience. Could Stenum have turned around over these past 4-5 years in their practice? Absolutely. That's why it is up to us, in the final hour, to make the best, informed decisions we can for our care. Happy healing to you, trkdoc714. May the force be with you!!

[wilsonrob]

I spent 6 weeks at Stenum. Probably more than anyone on this forum. I can certanly vouch for the wonderful people working at Stenum. As well it is a wonderful place. There certainly seems to be some major improvements at Stenum in the last few years borne out by the improved results.

I also know Mark very well. He is very passionate in his work. I can safely say that money is not the all consuming factor for Mark. He sincerely cares and wants to know more and more about spines. He can only go by what he has seen and his past experiences.

We are just thankful that you had a successful surgery. I can tell you that I have prayed specifically for Stenum and its surgeons that they slow down and do it right. It seems they are making great progress. Congratulations.

[Katie]

I can't speak for Bob, but I think he may have the same issues as I have with all this Stenum bashing. If no one has any evidence of poor surgical practice in the past four years, why is this continuing?

If there were bad choices made, I believe that they must have learned from them and moved on. I know in the year and a half I have been waiting to raise funds to go there, they have changed several practices to improve the patients' outcomes.

I have personally spoken to over a dozen of their patients from the past two years, and all have had wonderful results. If someone else can come forth with legitimate issues, then fair enough. If not, let's drop it. We can find all sorts of mistakes from other surgeons. I would like to make an educated decision as much as anybody, but I cannot when this is so one-sided. Give me the stats on the others too, please. They are out there.

[dshobbies]

Bob,

I understand your anger and am very sorry the timing of Mark's post scared your wife. I don't think I would have reacted differently. But, and it's a big one, you are reading Mark very wrong.

Though Mark has to make a living, he doesn't do what he does for the money. There isn't enough time in the day for him to hold down a 'normal' job and still be the patient advocate he has become. He helps people because he wants to but altruism does not pay the bills. The fees he charges are quite reasonable and affordable by most. Choices to use and/or which services to use are completely up to any individual. I have often posted that Mark was my best investment into my back and he made my journey so much easier. I had spent two years walking in circles until I found him and then, voila, my surgery was scheduled. If you want to go it alone, you still have his support as well as those on this and other forums.

In a recent phone conversation I had with Mark, I asked how to educate 'newbies' about Stenum's history. This post may (or not) be a result of that conversation.

This is a right to know issue. Stenum rang their own bell too many times, however in the past, to ignore this history. If any individual feels corrective measures have been in place for four or more years, they also have the right to choose this hospital for their ONE shot at getting better. As posted often, it's your body and you have the final word. BUT you also have the right to know all the facts and make that determination for yourself. One scenario goes as follows;

You go to Stenum for back surgery which ultimately is unsuccessful. This happens even with the best surgeon and care. You come to discover their history and the first thing that comes to your mind is, 'Why didn't anyone tell me'. Well for anyone currently posting or reading this forum, he told them and showed them, nothing more, nothing less. Just as you have a right to your opinion, so does he. I understand because of what he’s done, how much of it and for how long, his opinion will generally carry more weight. This does not minimize your opinion and/or choice.

History is hard to live down and you have to prove yourself over and over again. It's the price you must pay for doing something wrong in the first place. Once a child lies, their truthfulness is always doubted.
Bob, you made your choice, you’re happy with it and your surgery went well. I couldn’t be happier for you. In fact, even though we don’t know each other, I’m thrilled that your suffering days are over. A life of pain is no way to live. I wish you and your wife nothing but the best life possible but Mark is one of the good guys. He has no agenda to push other than don’t waste your one chance. Educate yourself.

Dale

[New-disc]

Hello,

Now you know my only motive.

To help others by showing them my true life story.

My gift to others!!!

Todd

[trkdoc714]

I appreciate the loyalty shown by all of Mark's friends. He obviously has earned it. I also appreciate your defences of his points of view.

I did not want to alienate my new online brothers and sisters. I was and still am quite concerned about the increases in Stenum bashing when it is not due. In my work I deal with fact. Verifiable fact. Most if not all of the stories bandied about regarding Stenum and namely Dr. Ritter-Lang may have a morsel of fact but they also have truckloads of urban legend built in. I found this especially true in this thread. Ask yourselves these questions:

Why would this person (first and last post) bring this up now?

What would motivate her to even find this forum to post this information?

How did she get her hands on someone else's XRay/ MRI films?

How do we know these XRay/ MRIs aren't just "stock films" from a Charite class action web site?

Why did the unfortunate death as the result of drugs (Addiction? Overdose?) get twisted into placing the blame on Dr. Ritter-Lang?

Why wasn't the several class action suits against DuPuy (Charite) given the blame as that disc has had multiple failures including several identical as this case?

As my daughter-in-law works for DuPuy, she had given me technical literature on the Charite when I first became aware of ADR. The top and bottom plates are designed to be used in either top or bottom position. The technical explanation for this is the either vertabral surface may be more accommodating to one particular plate. Why is a non-medical professional, non-engineer claiming that this was a factor in the core slipping out? If it was a factor, criticism should be directed on DuPuy not Stenum or Dr. Ritter-Lang.

CindyLou and Dale, I have prayed for you both to finally find the end of your pains. I hope this was the last surgery for CL and I hope Dale finds her "fix" soon as well. I hope I don't offend either of you.

The fact remains however that the leaders of this forum must stop this unethical bashing of Stenum and of Dr. Ritter-Lang in particular. I've held my tongue (typing fingers) a long time but with my wife in tears on the phone with me a few thousand miles away just out of surgery, I was compelled to let it out finally. Mark probably does have his good points. However, once he hurt my wife, I refuse stand by and let it go any longer. The irresponsibility and lack of ethics is inexcusable.

I hope you all still will communicate with me and not think poorly of me. I want to help others on this forum in the same way I've been helped. It feels great to be alive again and I have a lot of you to thank for helping me get here!

Bob

[Kathy]

I think the key word is RESEARCH! You must do research, form your own opinions and make your own choice. I wanted to know that, regardless of my surgery outcome, that I had made the best choice for me. To have absolutely no regrets and I don't.
Some people, my family included, thinks I am crazy for being in a clinical trial (guinea pig). After having surgery out of state, I can not fathom having been out of the country (I am a social butterfly and hated not having more of my family near). While others prefer the out of state or out of country experience (definitely did cut out unwanted visitors ) Others believe the old saying that 'the farther away a specialist is, the better they are'. Some don't understand why the dr down the street wouldn't do. I have heard, on these boards, people bragging that the surgeon they chose would be doing their 1st surgery ever on them! (that was something else I thought crazy) Others, don't mind being the 50th patient or the 150th. While others want at least 1,000 before them. Some want to be the first in on a new technology or first one for a new device. Others prefer that a device be tried and true before getting it.
Bottom line: Different people have different preferences. And that is ok, it is good. Aren't we here to seek different opinions? If we wanted the pretty picture, we could just believe the first thing we heard and go with it. But each and every one of us came here looking for more.
Last, I do feel that the surgeons (who I have absolutely no opinion on) should be able to defend themselves; but as mentioned can not due to privacy.

[trkdoc714]

I'm very sorry for your suffering and continued pain. However, the beginning of this thread is not factual. I'm sure there many failed surgeries. Try to remember, this is elective surgery. There are risks. We're made aware of these risks. There will be failures, there's no way around that. Each of us has taken that chance in the hopes we'll be healed.

As far as the beginning of this thread goes, just go back and look at one thing. The story begins with the surgery being performed in October of 2005. Why does the film of the explanted disc have a date of July 2005 stamped on it?

I truly hope and pray you find a pathway to recovery. Living in pain is horrible.

Bob

[Kathy]

Originally Posted by trkdoc714

The story begins with the surgery being performed in October of 2005. Why does the film of the explanted disc have a date of July 2005 stamped on it?

Wow, you are observant! I completely missed that and I looked and looked at those films!

I would like to know the answer to this as well?

Anyone know?

[mmglobal]

John's surgery was in October of 2004 as Havanna stated in her original post. It looks like the 2005 date is a simple typo.

Why now? Because kc0iet recently sought me out and I suggested that others could benefit from her experiences. Havanna's post is self explanatory. How does she have his films? Because patients email xrays and compare. I also have John's films. Willie's got 'em. So do Vikki, Carmen, Fred and probably many, many others. How do you know they are not some random films taken from the Charite' lawsuit? I knew John personally. They are his films. You may choose to believe or not believe whatever you think appropriate.

I'm sorry that some find this unpleasant. This is not good for the industry, not good for the site. It's great for the patients that it helps. It's not great for the patients that it hurts. I'm sorry that this caused such anxiety for Bob and his wife. There is no way for me to time what other people post and there is no good time. It is what it is and we all have to be adult and understand that internet information is a mixed bag.

People who remember all the way back to my original ADR forum that was the predecessor of this forum and adr support... back pain support group had a thread about Fred's subluxated core. Stenum's representative did come and explain. You'll see that he said:

Originally Posted by ADR-Jim on September 23, 2004

Please don't believe everything you hear, Fred's core did not "pop out", the lower plate failed to adhear to his previously fused vertebrea. A risk they knew of prior, he will have fusion at that level and ADR above in Oct. Also it is my implant on getadr.com and I am now 18 months with no pain, skiing, tennis, soccer, lifting up to 80lbs, no problems.

A risk that they knew of prior? One would think that if they were concerned about such a complication, they might have implanted the disc with the front teeth actually having some purchase in the vertebral body instead of hanging off the edge. Positioning is discussed more, below. (Here is the original thread from back in 2004) Back Pain Support Group: Charite core popping out???? Note that the thread was started by ADRJen who is a successful Stenum patient. She was the first person I called when I resurrected the surgical outcomes posts that I had started at BPSG. Here is her update: ADRJen Charite L5S1 Aug.2003.

Yes, I called Cindy when she posted that she was going to have a total hip replacement, but I remembered her positive SI injection. I suggested that she get evaluated by someone who has a 'bigger picture'. Based on her response, I offered to connect her to someone who specialized in SI joint dysfunction. She has now canceled her hip replacement surgery and has had a much smaller surgery that seems to have resolved her pain. She chose her path with a small assist from me and we have no idea what the future holds. Had I not called her, she would have endured a total hip replacement, and presumably the pain that was resolved by the SI surgery would still be there. I think I have 100 of her dollars.

Yes, I called Bob to convey what I know about Stenum. If anyone thinks that there is a difference between the call to Cindy and the call to Bob, that's fine... I can live with that. Some people may call this marketing. I'm either blessed or cursed with this mission and have never made a profit at this. I have not been paid by the doctors. (Bob, you should not post things that aren't true and you should question the motivation of those who are telling you things that are not true.) I have only worked for the patients.

I don't know why anyone would suggest that the death was "twisted into placing the blame on Dr. Ritter-Lang." What was posted was, Unfortunately, remaining in chronic pain and the stress of the ordeal took it's toll on John and his pain problem turned into a drug problem. The drugs took him from us.

Regarding positioning of the disc: from the Charite' installation manual (2004):
> page 13, step "confirm positioning": The Centre of the artificial disc should be 2mm dorsal of the sagittal midline. (this 2mm posterior positioning is restated on page 14 also)

> page 14, step "endplate insertion" - Load the selected endplate into the endplate insertion tips placing the more angled of the two endplates inferiorly.

> page 17, step "final positioning" - Verify the final position of the Charite' Artificial disc using flouroscopy. It is important that the prosthesis is in the correct position in the AP and Sagittal planes. If necessary, the position of the prosthesis can be altered by slightly using the appropriately sized Grooved Driver. In the event of a gross malposition, the entire prosthesis can be removed and reimplanted, by reversing the previous insertion steps.

There are three grossly malpositioned discs pictured on this page. One of them resulted in a successful outcome. Two of them resulted in disastrous outcomes. I wish I could say that the steady flow of these types of failures from Stenum has stopped, but it hasn't. I have clients with similar problems with Mavericks and M6 discs too.

Regarding the angled plates. The side of the plates with the teeth that provide the bone / metal interface are identical on the angled and flat versions of the plates. Endplate shape, density, etc are not relevant issues with regard the angled plate being up or down. It is about bringing the plates parallel to each other and perpendicular to the load that will be placed on them. Bob, would you share the documentation that says the plates may be reversed? The design of the Charite' has changed somewhat. Perhaps a different device has different technique. In any case, I'd love to see what you have. I'll be happy to share the 2004 installation manual if anyone likes.

When you stand on a chair, do you put your foot in the middle of the chair of all the way on the very edge? Would you rather the chair be on level ground or on a hill. What if you stand on the downhill edge of a chair on a hill? Don't take my word for any of this... ask an engineer.

I know a lot of happy Stenum patients and I look forward to hearing about the success of both Bob and his wife. They have every reason to look forward to success. As I've always maintained... properly implanted in a properly selected patients, all of the designs will be fine.

Sorry for the disjointed ramble... I have tried to address all the questions raised. It's been a long night. I hope this helps to clarify some things. I have more to say, but have to go.

Mark