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Surgical Outcomes and Blogs Discuss L4-5 & L5-S1 Chartie Stenum - kc0iet in the Main forums forums; Welcome back, sorry under such bad pain circumstances. I pray you can find someone to help you with your pain. ...

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Old 03-28-2009, 02:18 AM
Kathy's Avatar
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Welcome back, sorry under such bad pain circumstances. I pray you can find someone to help you with your pain. Don't lose hope, God can do Anything! God Bless, Kathy
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34 years old-
1/06- In wreck with 18 wheeler
Numerous MRI's, PT, chiropractic, accupuncture, TENS therapy, massage therapy, facet injections, epidural injections, Nerve study, Discogram, confirms pain in L4/5, IDET, decompression, Bi-lateral neurotomy L3/4/5, denied by insurance twice, in Active L clinical trial, had surgery March 17, 2009 in Miami, FL- received Active L disc
Had Baby #3 after ADR!
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  #12 (permalink)  
Old 03-28-2009, 01:14 PM
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Quote:
Originally Posted by treefrog View Post
Can I ask if you got bone density tests done before you had surgery, or since then even?

Also, what was your reasoning for asking to have the Charite discs removed and putting in Maverick discs?

I am struggling to figure out how to determine which disc is better. Though from all I have heard, I don't think I would ever want a Charite. I assume that the Charite was the disc to use though, back in 2004.

Again, thank you for sharing your story, and I hope you find some pain relief.
Hi Treefrog,

First; I have never had a bone density test done; then or now. Remember, I live in an area where medical treatment is at least 20 years behind the rest of the country! In fact, I just got a post card in the mail yesterday from my GP letting me know that my last x-ray's (View New Films Here) looked good! They even drew a smiley face on the card!!!!!!!!!! The ADR's have subsided to the point that almost half of the plate is in the bone; there is a non-union of the fusion, and it looks to me as if there is a substantial vertical crack in the vertebra that was not there before. Not to mention what ever is going on at L2-L3. But here in the middle of nowhere - everything looks good!

Second; The reasons that I asked (even begged) to have my Charitie's removed and replaced with the Maverick discs are:
1) I DID NOT want a fusion. I did not want the loss of motion and the progressive complications associated with fusions.

2) The surgeon I had seen in TX talked to me a quite a bit about the problems with the Charitie discs; the degeneration of the core, the problems with rotation, etc.

3) I still, then and now, remember the weeks after my original ADR surgery when the pain was gone and I was doing well. At that time I felt strongly that the reason the ADR's had failed was because I returned to work too soon. Now, I think that may have been part of it, but also feel that too small of a size was used lending to the substanence.

4) The Maverick disc is what Stenum was using at the time I was begging for the replacement.

Third; You are correct. In 2004, when I had my ADR surgery the Chartie was the only disc used at Stenum. The Alpha clinic was using the Pro Disc. At that time, a couple of things that led me to favor the Chartie was the reports that if there was ever a need to have the disc removed it was possible with the Chartie but not the Pro Disc, due to the notch made in the vertebra for the Pro Disc. Overall, it looked like - and posts I had read sounded like- the procedure for the Chartie was less invasive and recovery time shorter with the Chartie. Also, the Chartie was very close to FDA approval here in the US at that time. I assumed if future care was needed, here in the states, I would have a better chance of finding a physician that would take my case with an FDA approved device. Pro Disc and Chartie were the only two options in 2004.

Believe it or not, if I had the money and was given the option of having my ADR's and fusion replaced with new ADR's today, I would do it! But, I do not have the money, or even the means to get the money, for a consultation with Dr. Bertagnoli.

Last edited by kc0iet; 03-28-2009 at 05:45 PM.
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Old 03-28-2009, 03:17 PM
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kc0iet,

Thanks for sharing your story. I wish you the very best in the future.
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-Justin
1994 Football Injury
1997 Snow Skiing Injury
Laminotomy L4/L5 (3.7.97--17 years old)
1999 & 2003 MVA (not at fault both times)
Grade V Tears L4/L5 & L5/L6
2-Level ProDiscģ L4/L5 & L5/L6* *lumbosacral transitional vertebra (11.15.03--23 years old)
Dr. Rudolf Bertagnoli -- dr-bertagnoli.com
Pain-free for the last 4.5 yrs.
5.14.09 DSS with Dr. B.
I'm here to help. Only checking PMs currently.
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Old 03-28-2009, 06:49 PM
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I am so sorry that you have continued to struggle. You've remained incredibly strong and brave in spite of all that you have went through. I can only imagine the hell that you have gone through though I have been through some similar bouts with my spine. I have two Prestige discs and two Maverick discs in my spine.

I hope and pray that your situation can and will improve.

Go with God.

Terry Newton
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1980 ruptured L4-L5
1988 ruptured SI-L5
1990 ruptured C5-C6
1994 ruptured C6-C7
1995 Hemi-Laminectomy C5-C6, C6-C7 Mayo Clinic
Bicycle Accident 2004
MRI, EMG, Facet Injections, Epidural Blocks, Lumbar Discogram.
Stenum Hospital Surgery November 4, 2006
Prestige Disc C5-C6, C6-C7
Maverick Disc S1-L5, L4-L5
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Old 03-30-2009, 06:35 AM
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I would try to get consultation with Dr Regan and one with Dr Bertagnoli to see what they have to say. Dr Regan has worked miracles with people who have had bad ADR's. He has dealt with extremely complicated ADR removals in the lumbar on patients that no other doctors would touch. He removes ADR's and does fusions. DOnt be so afraid of fusions now that your ADR's arent working out. The one lady who was at her wits end (same situation as you) had dr regan remove the ADR's and fuse her at both levels and she is fully healed and back to normal now. ANy type of health insurance should cover a 2 level fusion done here in the US Id think?? Dr Bertganoli is one of the top surgeons in the world and his advice would be well worth considering also. Seems to me that ADR's may not be good for you, maybe some people's spines just arent well adapted to have ADR's??
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Old 03-30-2009, 04:17 PM
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Default Thanks for answering

Thanks for the answers kc0iet. It sounds like you made the best decisions under the circumstances.

I really hope that you are able to get help. Even with no money.insurance, I would try to contact some of the doctor's that Steve55 mentioned. It wouldn't hurt to explain your situation, and ask for help. Their hands may be tied, but then again, there may be options available for those without the means to pay for treatment themselves.
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Cathy

46 years old. 12-15 years of intermittent pain, 2 years with constant pain.

DDD, L4-5 and L5-S1, pain confirmed by discogram.
PT, ESI's, Facet injection and block, Acupuncture - all no help.

2-level (Prodisc-L) ADR surgery with Dr. Bertagnoli, May 26, 2009.

Currently taking Opana-ER (tapering off) and oxycodone
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Old 07-29-2009, 02:24 AM
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June 2009 - Both Chartie ADR's removed and replased with cages. Ten days later the non-fusion of L4-5 was also removed and proper fusion rods for both levels L4-5 - S1

July 2009 - I developed sever blood clots due to the 7+ hour surgery to have the Chartie's removed. I have begun my L O N G recovery, but am doing well. My GP says the leg with the blood clot will bother me the rest of my life and that I will likely be on coumidan forever too. As per doctors orders - no activity other than walking for the first three months. As of today, I have walked one half mile or more; twice daily, for the past six days! That is walking - unassisted by anyone or anything!
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  #18 (permalink)  
Old 07-29-2009, 02:54 PM
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K,

Sounds like things are going well.

Thank you for the update!!

I've checked in on this site almost every day to see
how you are doing.

Walking that far is great news!! Take it slow......

Please keep us all posted as you heal.

Todd
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Stenum Hospital * Germany

Surgery 10-19-07 ( L4-L5 Maverick disc )

For my true life story ...

go to -----> www.youtube.com

print -----> ADR surgery into the space bar

or ... http://www.maverick-disc.blogspot.com (my picture & movie updates)
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  #19 (permalink)  
Old 08-04-2009, 09:19 PM
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Default Interesting findings during KC's surgeries.

I spoke to KC a few days ago. It's tough to listen to the descriptions of the limitations imposed by the DVT and the impact that will have on the rest of her life. However, it's wonderful to listen to descriptions of walking longer distances than ever possible without crutches, canes, wheelchairs... and without the RSD-like symptoms that occurred whenever she tried to do this before the surgery. It's been a tough road for KC and I hope that after a few months, it will all seem to be VERY worthwhile.

You may already know that I was able to observe her surgeries. It was planned to be anterior and posterior surgeries on the same day. The surgery started with the anterior procedure to remove both prostheses and replace them with synthes synfix cages. These anterior cages are similar to the STALIF cages that provide big-footprint fusion cages PLUS screw fixation to make them even more stable and rigid than the more traditional style cages.

One thing of note is that the surgeon was somewhat surprised to discover a significant amount of tissue behind the prosthesis, seeming to indicate that inadequate preparation of the disc space was performed in the original ADR surgery. A typical ADR surgery may go very quickly if there is not very much tedious work to do to prepare the site for the prosthesis and to adequately decompress behind the disc if there are osteophytes, calcified remnants of disc herniations, scar tissue, etc.. Inadequate preparation (simply not following the recommended procedure) substantially increases the risk of less than optimum outcomes. That's why the procedures exist.

After the anterior procedure was complete, it was decided that it would be prudent give KC an opportunity to recover some from the first surgery before proceeding with the posterior surgery. The risk of complications from 2 shorter surgeries is far less than the risk of complications from one longer surgery. (I have always wondered about the combined cervical/lumbar surgeries they do in one OR session at Stenum. I know no other facility that will do that. Interestingly enough, my client for my next trip overseas is an MD who needs both cervical and lumbar surgeries. When I started a discussion about the options, she just cut me off... "absolutely medically inappropriate!")

10 days after KC's anterior surgery, they went in posteriorly to explant the existing fusion hardware at L4-5 and implant new hardware at both L4-5 and L5-S1. We had never been able to understand why the revision surgery at Stenum only included L4-5 because there were clearly structural problems emanating from L5-S1 before the revision. There were more surprise findings upon exposing the fusion site at L4-5. Not only was there no fusion mass present, but there was no evidence of any effort to create one. I suppose itís possible that morselized bone was implanted and was completely resorbed, but the surgeon noted that apparently no effort was made to decorticate the bone before laying down the graft as is typically done during a fusion. It may be the case that the 2006 Stenum fusion procedure did not include an attempt to create a fusion mass. I donít know the reason for this because in a typical posterior fusion, the hardware needs to function as a load bearing device until bony fusion occurs. After the fusion occurs, the hardware is redundant. Without bony fusion, the pedicle screws will continue to bear the load and the system will be more at-risk for future problems. Iíve never seen another fusion procedure with no attempt to promote bony fusion. I still donít understand.

In any case, KC is progressing, albeit slowly. I hope to hear more good news soon!

All the best,

Mark
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1997 MVA
2000 L4-5 Microdiscectomy/laminotomy
2001 L5-S1 Micro-d/lami
2002 L4-S1 Charite' ADR - SUCCESS!
2009 C3-C4, C5-C6-C7, T1-T2 ProDisc-C Nova
Summer 2009, more bad thoracic discs!
Life After Surgery Website
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Last edited by mmglobal; 05-07-2014 at 07:09 PM. Reason: No text change, only highlighting the most egregious issues.
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  #20 (permalink)  
Old 08-06-2009, 02:56 PM
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Thank-you for that detailed explanation of the surgery and reversal Mark. Boy, KC has been through the ringer. I hope this latest revision holds the key to your recovery KC so you can begin to get back to the task of living your life! My very best to you.
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bicycle accident 6/01: 2 compression fractures @ T12-L1; vertibroplasty; 4/06: right hip labral tear & arthroscopic repair; 4/07: lumbar prodiscs @ 3 levels, L3-6 by Dr. Bertagnoli; 7/02/08: ALIF L6-S1; 7/30/08: reopened to remove bone cement, leaked onto S1 nerve root; 8/08: pulmonary embolism, double pneumonia, collapsed left lung, pleurisy, pleural effusion; ALIF fusion complete; 3/10/09: SI Joint Fusion by Dr. Stark; Jury still out.
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