Choosing ADR or fusion

[WayDownInCoCrMo]

"Maybe it was our pure bad-luck to be living in Germany" ...

Meaning, in the USA, with the Prodisc not approved, we probably would not have had so much access to so many clinics (Stenum, AK, Pro_Spine) ... which specialize in ADR. Of course, we thought it was amazingly good luck at the time, that we lived only 1 hour from Straubing, and 30 minutes from AK. Of course, if we were natives, we may have had more success finding other Orthopaedic clinics.

Let me balance my criticism: Over half of the FDA Prodisc trial surgeons in the USA had financial conflicts of interest. They should be fined at least - for the amount invested. The Prodisc FDA approve must, by Federal law, be thrown out. That's not from me, its from the Senate Finance Committee, headed by Senator Grassley. I do not subscribe to the line that the surgeon must invest in a company in order to improve the technology. They should put themselves above it - its their oath.

Please note, we did get a lot of inputs from German neurosurgeons AFTER the ADR ... but that was only because I found a site listing ever Prodisc specialist in Germany ... and emailed to every one of them.

It would be great if you could post the names of the surgeons/kliniken who have more conservative views on ADR.

Thanks! Best Regards,
Matt

[ans]

Matt: given all the (perhaps rightful) criticisms of ADR/ProDisc, there have been some outstanding successes (and w/Charite). I wonder, given both of these ADR's shortcomings, what happens to make a sucessful ADR? I'm thinking of excellent placement, no pain relief from facet injections, etc. I hope I don't seem insensitive, I'm not. Maybe there's some factors that have not been fully recognized. (As I'm in the middle area of MRIs showing facet "arthroses", the nuances of this maze confuse me). With Regards ~ Allan

[fuzzy]

I did go to AlphaKlink. Many reasons for that. Dr. Z. did a fusion on my L5/S1 even though he originally offered ADR. He did not charge me extra for the fusion, which normally goes for 3000 euros more, which he did using my own bone, again, for a very good reason. After taking double xrays he spotted a minute shift in my L5 vertabrae on flexion. He said it was not worth to risk putting ADR there but to do fusion instead so now I have 1 fusion and 1 adr, with no complications. The improvement was immediate. Ask Mark, I met him there and he saw me walking better then in 7 years, after only 1 month. This shows that they will not just do ADR no matter what. They do reject patients as well. I know of several.

I have researched this since 2000 and read a lot of the negative stuff. In US they told me don't have surgery, its bad news, its too risky, the word "guinea pig" came up. Live with it. Go home. PT, pain killers what ever. I read and read and read. Everytime I had another level 10 episode I read again. So when I finally showed up in Germany it all fell in place with everything I knew and read. Yes, I personally felt that there was more "money" behind Bertagnoli" then with Zeegers *EVEN* though the Alpha is so darn flashy that all one can think is whoah, there is a lot of money in this place. I went there 4 month before I actually had the surgery so I had time to think. But then if they did bad operations all the time there would not be there anymore with that big sign on the front. So I know I was taking a big risk when I walked in the back door and layed down on that stretcher and prayed when they stuffed the IV in that all the bad stuff I had read about would not happen to ME because it probably would and I don't like gambles, I never go to casinos and I did it anyway, even with all the concerns. I guess I hurt long enough and knew that was the only way it could get better. Mind you 10+ years of this backpain sh*t, getting worse every year.


ADR vs fusion. The STALIF fusion that Z. did to me worked fine out the door. Yes, the hip site hurt, real good. But if you need to decide weather to have fusion at L5/S1 don't rule it out. It seems like it worked just fine, just as good as the ADR above so I am somewhat glad I only have 1 ADR...

[WayDownInCoCrMo]

Hi Ans: Please note, I have not criticized ADR/Prodisc. IF the stats were true, (as I believed), I would be all for it. That's why we chose it. If your conditions indicated ADR strictly (as nearly ALL surgeons state ... including Dr. B.) then you will fit those high stats. If a surgeon disregards the indications, then you no longer benefit from the stats. The trials used highly selected patients - perfect candidates. If your facets are half-blown, then forget about the stats.

My points were:

1) The success stats highly correlate with the degree of financial investment of some surgeons
2) No one even discussed fusion - ever. My wife was absolutely contraindicated. I got this from numerous US/UK/FR/NL/DE surgeons afterwards.
3) We were told revision would be easy. We were very concerned about the keels. We were not told that everyone in Germany would refused to do it.
4) We were appalled that the surgeon never even visited ... even though it had been 5 months since our original visit - where our images were already 5 months old. He never even said hi ... until 3 months later ... with a legal team.

Fuzzy: We agree that Dr. Zeegers is incredibly nice and accessible. Our beef is with the knee surgeon ... who did not show up for any of the 4 visits we made specifically to see him. In any case, AK did say 'ADR' for us ... and nothing else. I didnt mean to imply that AK or Stenum or ProSpine never do fusion. The question is really: Do they ignore the rules when desired ... although following them strictly in their stat gathering trials? Some here say that facet arthrosis is NOT a contraindication, and that a collapsed disc is also not. I say that is crazy.

Cheers,
Matt

[ans]

Thanks for clarifying M. I have a bad chest cold and am not quite "here". My sense is to beware re: facet arthropathy and ADR - 'tho I wonder if others e.g. Active - L might be better.

Again, my sentiments - I'm sorry you two have to go through all this. I hope that A continues to mend and regain her spirited life.

Best, Allan

[B13s]

Originally Posted by WayDownInCoCrMo

It would be great if you could post the names of the surgeons/kliniken who have more conservative views on ADR.

I don't have names at hand - would need to look at all my papers, but at least remember clinics:
1. Orthozentrum München - from ADR's they do Prodisc only and said that it would be difficult/impossible to remove it. Suggested PT, microdiscectomy, fussion.
2. Klinikum Grosshadern - again do only Prodisc, but suggested microdiscectomy and fussion down the road.
3. Alphaklinkik - ADR (Active-L).
4. Neurochirurgie Innenstadt München - ESI, microdiscectomy, said that ADR was a big thing 1-2 years ago but they do not recommend it anymore because they didn't have a very good experience (didn't ask why).
5. Neurochirurgie Dr.Obermüller & Dr.Fritsch - well, they do surgeries only (~2500 a year) - not a big surprise that they against ADR's. Recommended microdiscectomy - and I think I'll go for it...

[WayDownInCoCrMo]

Sorry for interrupting ans/blair/sharman ...

Thanks B13!

1. Orthozentrum München - Dr. Mayer and Siepe. You have probably seen their papers where they point out that Dr. B's results are $%^!
Therefore, I was really impressed with their candor ... Another surgeon told us that Dr. Mayer refused to ever take another Prodisc out ... because he had a very very bad experience. You guess.

5. Neurochirurgie Dr.Obermüller & Dr.Fritsch: I met one of them - very nice guy, fluent English too. They also offered to do a minimal-invasive on A way back in 2005 ... but we passed because they said it would be open-back ... i.e., not exactly micro. We eventually had it done by emergency with the AK ... which was endoscopic. They, of course, know nothing of ADR revisions.

Best wishes and regards ...
M

[Michelle]

Just a note about the disc height question. I don't have any info on normal disc height, or what sizes ProDisc comes in. All I know is what my surgeon told me: I watched him with a ruler measuring my X-ray before surgery, with 4mm between the vertebra, and after, with 21mm. That's just what he said. Matt&Anastasia, I wanted to say that I'm sorry that despite all diligence on your part, the research, the time, the questions asked, that it didn't work out for you! It seems you did everything you could, and to still have a bad outcome... I'm so sorry! It's so hard not to be excited by a procedure that worked for you, and want that success, thus that procedure for others, but it may not be right. Puts things in perspective. I'm sorry that you'll have permanent pain and damage! No one should have to live with that, but I hope you can find peace and happiness in this world, however you can! Hang in there, and thanks for sharing so much of your story!