My 3 mo X ray - Discs tilted all over the place

[Jessica]

just wondering... not defending... I understand your frustration.
I wonder if there is any difference between the type of revision and fusion between the two docs. I saw that Drs. Fenk-Mayer was referring to some specific cage for your revision. I do not know anything about the surgery you are looking at, I just wondered if that might explain the cost difference.

We all know that Germany is usually less expensive. I spent 4 days in the hospital, as most people here talk about going home same day from cervical adr. Could that be part as well? Is it a comparable time in the hospital? Not that we all like to stay in the hospital any longer than we have to

[steve55]

Good point, I dont know anything about different cages out there. Perhaps I should ask exactly what kind of cage they plan to use? Does it matter? Are some better than others? DO I need to ask specifics as to the name of the cage Dr B or Dr Bitan would plan on using? I know nothing about fusions and the different cages/hardware for them. Maybe MArk or someone can step in and educate us a little bit. Dr Fenk meyerer did not specify what type of cage , she just said " Removal of the ADR. Fusion of this semgnet by a zero-profile cage, which can be fixed with little titanium screws."

[Katie]

Steve, I don't know anything about the different fusions either. I have been told by Dr. Bitan that I will be in the hospital for several days following my cervical ADR hybrid surgery. I realize that is different than just ADR but wanted to add this for you. There was no 'throwing you out the door' there. He was being very cautious with me.

I wish you luck, and have wondered about the costs with the original doctor too, from the very beginning of your posts. It just did not seem right to be charged for that situation.

I'm glad you have found someone closer to home, with a great reputation, to do the job.

[Cindylou]

Steve, I truly am sorry for the predicament you are finding yourself in. I think the prior person raised a valid point that the two surgery options here and abroad likely have differing levels of expertise for what they are going to do, hence price point differences. Boy, I think if I were in your situation, all things considered, I would make every attempt to go back to Dr. B and let him do the revision. He knows your body intimately from the first surgery and he is so trained in this type of complicated surgery. He might see something else while he is in there and adjust the treatment even then. I do know money can and ultimately always is a huge consideration. Me personally? I'd live in a tent, just to be pain-free. No joke. I will keep you in my prayers in these days and weeks ahead while you make your final decision. My very best wishes to you whatever you do.

Cindylou

[dshobbies]

Steve,

This decision is yours and only yours.

to help complicate this decision, everyone has an opinion. Though Dr. B is the go to Dr. if any American doctor can do just as good a job and at a reduced price, why not? The question is, can he do just as good a job? He has an excellent reputation.

Honestly, I don't know what I'd decide. Apparantly, you're trying to decide too.

Good luck, Dale

[Maria]

(not probably more like most definately) Dr. Bertagnoli has whatever type of hardware at his disposal to use for supposed best patient outcome unlike here in the States.. but I don't know what that means re zero profile and how small are tiny titanium screws. This is Mark speak.. he'd know this kind of information.

Actually I don't even know what is available to the US surgeons anymore in terms of type of cages but it seems insurance companies rule too many decisions re what is used re cost here unless you're going cash pay

[steve55]

Originally Posted by Cindylou

Steve, I truly am sorry for the predicament you are finding yourself in. I think the prior person raised a valid point that the two surgery options here and abroad likely have differing levels of expertise for what they are going to do, hence price point differences. Boy, I think if I were in your situation, all things considered, I would make every attempt to go back to Dr. B and let him do the revision. He knows your body intimately from the first surgery and he is so trained in this type of complicated surgery. He might see something else while he is in there and adjust the treatment even then. I do know money can and ultimately always is a huge consideration. Me personally? I'd live in a tent, just to be pain-free. No joke. I will keep you in my prayers in these days and weeks ahead while you make your final decision. My very best wishes to you whatever you do.

Cindylou

Well, the way Im seeing it is that as long as Im going to one of the heavy hitter US docs, I should do fine. I went to Dr B initially because he is the multi level ADR guru and there were so many successful outcomes posted with him, and he has done so many of them while the US docs have done so few. It was a no brainer. But what I need done now is a BASIC fusion, and really, that is not a complicated procedure right? And extracting a disc shouldnt be either as long as you go with a reputable heavy hitter US doc. Dr bitan seems to have done many ADR extractions and Mark speaks very highly of him also. My local doc , dr peloza is also a heavy hitter (he was in newsweek, on german Sat TV and local TV alot), and Mark feels he would be a very good option also.
I think the US options (hardware/procedures) for fusion will be sufficient. Im not a "complicated " case anymore. Even Mark, who many have accused of being too heavily favored towards Dr B, hasnt suggested that I really need to go back to Dr B for the b est possible outcome.

Anyways, this is my take.

Im going to trust Dr peloza's opinion tommorrow when I speak with him. Mark said Dr B was going to call Dr peloza this week prior t o my visit. Dr Peloza is one guy I really feel will shoot me straight. He is really very conservative and doesnt come across as a guy who is looking for business. He never even suggested ADR, I think he would have suggested fusion if I had stayed with him. If he thinks I really am better off going back to Dr B due to better cages/fusion procedures or because he did the original ADR's, then Ill follow his advice. Ill be asking Dr peloza many of these type questions tommorrow.

[mark-perth]

Sorry to hear that your going thru this as well. I know how you must be feeling, its horrible but you seem to be doing amazing in the way you have dealt with this. You have achieved more in a few weeks than ive achieved in months so you are doing great. You have had alot of great advice here so I dont need to chip in apart from support you. Your post has actually helped me alot as well. I too contacted Dr Bitan and have been blown away at his quick response, within a day, thats just amazing. He seems like such a helpfull and easy to deal with surgeon, I understand the comfort you get from him puting you at ease as I had the same response. He cheered me right up today.
From the quote I got from Dr B I'd say that you have recieved a substantial discount although I do agree that maybe it should be less especially if he is still higher than in the US. It seems like he's maybe only charging for the costs that dont go to him like the hospital and hardware costs but not his fee maybe.
Do you know if Dr Bitan's cost of $15000 included the hospital costs or was that just his fee's? Will your insurance not cover any of the costs now or is just the surgery costs they wont pay?

I have found this article regarding the zero profile fusion cages:

A New Stand-Alone Cervical Anterior Interbody Fusion Device: Biomechanical Comparison With Established Anterior Cervical Fixation Devices
Scholz, Matti MD; Reyes, Phillip M. BSE; Schleicher, Philipp MD; Sawa, Anna G. U. MS; Baek, Seungwon MS; Kandziora, Frank MD; Marciano, Frederick F. MD, PhD; Crawford, Neil R. PhD

A New Stand-Alone Cervical Anterior Interbody Fusion Device:... : Spine

send me an email if you want the full copy. It looks like its just a low profile fusion cage that is quite new to the market so may not be approved in the US yet. I would ask what type of fusion hardware they will be using, it cant hurt. Great to see that you are getting it dealt with so quickly and best of luck with your decisions.

Mark

[Cindylou]

Let us know how your appt. went with Dr. Peloza Steve. I think you have a solid plan in place.

My best to you,

Cindylou