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Surgical Outcomes and Blogs Discuss Coflex f Implants still in pain? in the Main forums forums; Dear Mr. Denis, your x-rays arrived and were reviewed. So good to have the full info now. the scoliotic ...

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  #11 (permalink)  
Old 03-26-2014, 05:25 PM
Gil Denis's Avatar
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Location: jackson Wyoming
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Default Dr B Reply

Dear Mr. Denis,

your x-rays arrived and were reviewed. So good to have the full info now.

the scoliotic curvature is more than expected from the MRIs – but apparently fully due to the degeneration.

So Prof. Dr. Bertagnoli expects to correct this along with eliminating the disc pain and realigning facets by:

a) ADR into your l23 l34 l45 and l5s1 (this is maximum surgery already, app 5-6 h OR time, bu feasible in very experienced hands
b) dorsal removal of the present implants, re-instrumentation with a dynamic pedicle screw system (DPI), at L2-l5


a) and b) can and should be done in separate anestehsias, app 1 week apart, to give your systems time to recover. Primary stability is there after the ventral procedure, so you can be mobilized.

Prof. Dr. Bertagnoli wants to point out, that the “standard” solution for your constellation is a (min) l2-s1 fusion, expectedly to be widend to thoracic for better alignement. In his eyes and experience this would however sacrifice mobility without need (even if a dorsoventral combination is not as mobile as a virgin disc would be or once was). And he has gone to use this hybrid construct for comparable cases since several years, if feasible. It is in your case..

Pro-spine will send you a preliminary cost-estimate for the proposed surgical plan. Be back to me via this e-mail account, if you wish to be scheduled. Of course our staff will be here to support you with local travel arrangements like airport pick-up and hotel etc. I am here to answer your further medical questions. We thank you for the honor of your inquiry. Feel free to be back with any questions you might have.


Well this is huge all the options in this country none had offered and help except a Spinial Cord Stimulator or a four level fusion and fusing my S Joint
Now how to come up with the money arround $100 grand
__________________
L5-S1 lam 1994
L2 to L5 DDD
L3 -L4 hern Dec 2007.
L4-L5 Annular fissure with mild central stenosis and moderate facet hypertrophy.
L5-S1DDDDD
L2-L3 Right-sided neural foraminal narrowing at and L3-L4 related to posterolateral hypertrophic spurs and facet hypertrophy.
C3-C4 limited DDD
9 injections Depo. P.T. 13 months 5 dose packs,
Nerve Block Injections.4 ESI S1
L5-S1 foraminotomy 09
L4-L5 Microdiscectomy 09 Reherniate 4-2010
Coflex-L Implants L4 to S1
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  #12 (permalink)  
Old 03-26-2014, 05:55 PM
mmglobal's Avatar
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I would ask... with the coflex-f in situ for 3 years, plus the severe degeneration for so long before, what are the odds of auto-fusion.

You may be able to get insurance to pay for a 2 or 3 level fusion, then cap it off with ADR or other motion preservation? Minimally invasive fusions may be possible with XLIF or ALPA approach (but not likely at L5-S1).

With all the "I'm not a doctor" qualifiers... just asking questions!

Mark
__________________
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
President: Global Patient Network, Inc.
Founder: www.iSpine.org
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  #13 (permalink)  
Old 03-26-2014, 06:09 PM
Gil Denis's Avatar
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Location: jackson Wyoming
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Default Done

Hi Mark

I have included some questions to Pro Spine Well see what they say

One quick question for you, Are there any surgeons in this country who could do this multy level surgery ??

Thanks

Gil'
__________________
L5-S1 lam 1994
L2 to L5 DDD
L3 -L4 hern Dec 2007.
L4-L5 Annular fissure with mild central stenosis and moderate facet hypertrophy.
L5-S1DDDDD
L2-L3 Right-sided neural foraminal narrowing at and L3-L4 related to posterolateral hypertrophic spurs and facet hypertrophy.
C3-C4 limited DDD
9 injections Depo. P.T. 13 months 5 dose packs,
Nerve Block Injections.4 ESI S1
L5-S1 foraminotomy 09
L4-L5 Microdiscectomy 09 Reherniate 4-2010
Coflex-L Implants L4 to S1
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  #14 (permalink)  
Old 03-27-2014, 11:35 PM
Gil Denis's Avatar
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Join Date: Nov 2008
Location: jackson Wyoming
Posts: 349
Default Reply to questions

Would this stop the degeneration of my spine to other levels?
actually no. No surgery (but fusion, which eliminates any mobile function) can keep a segment from aging.
But: an ADR can no longer age. And the facets as the mobile junction left would be realigned and supported by the implants. So there is reason that their aging is reduced as compared to what you have now (hypercompression by lack of disc height, unphysiological movements).
Degeneration of the segments ABOVE the implants however is a relevant issue: This should not be influenced by the surgery suggested by Prof. Dr. Bertagnoli. Because it is motion-preserving. The adjacent segmetns would however be heavily overloaded and be prone to degenerate faster-than-normal in an alternative fusion. This is one of the core reasons why Prof. Dr. Bertagnoli recommends and takes the efforts to go non-fusion even in an extent case like yours.

Could i be pain free?
Very unlikely, this just is no realistic goal (at least not without pain meds):.
Could i began to get some activity back in my life? Sports?
This is a realistic goal in Prof. Dr. Bertagnoli`s view. (not competitive martial arts etc., of course).
With the coflex-f in situ for 2+ years, plus the severe degeneration for so long before, what are the odds of auto-fusion.
No realistic, we never have seen this happen
How long is the recovery?
recovery is very individual, and this can be a prognosis based on experience: we`d expect you to be up on day one, mobile in a hotel setting to care for yourself at app day 6-8 after the second surgery. Sitting is allowed immediately, but not comfortable expectedly for 2-3 weeks for a prolonged time. Which limits driving. Light exercise like swimming and walking or light work-out: start at week 4-6. For heavy manual labor, or sports with a higher risk of trauma wait 3-4 months to give your bone ample time to integrate your implants even in extreme mechanical loads.

Now what

Gil
__________________
L5-S1 lam 1994
L2 to L5 DDD
L3 -L4 hern Dec 2007.
L4-L5 Annular fissure with mild central stenosis and moderate facet hypertrophy.
L5-S1DDDDD
L2-L3 Right-sided neural foraminal narrowing at and L3-L4 related to posterolateral hypertrophic spurs and facet hypertrophy.
C3-C4 limited DDD
9 injections Depo. P.T. 13 months 5 dose packs,
Nerve Block Injections.4 ESI S1
L5-S1 foraminotomy 09
L4-L5 Microdiscectomy 09 Reherniate 4-2010
Coflex-L Implants L4 to S1
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  #15 (permalink)  
Old 03-31-2014, 09:16 PM
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Join Date: Mar 2013
Posts: 7
Default Removal of Coflex

Hi Gil,

Am I reading correctly that Dr. B would remove your implants dorsally? And he would replace them with an ADR?

Just wondering because it was kind of confusing for me to interpret the post.

If so and he can do that, that is just awesome. Maybe you can appeal to the insurance company to pay for at least some (most) of it.

Ses
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  #16 (permalink)  
Old 04-01-2014, 12:54 AM
mmglobal's Avatar
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Posts: 2,508
Default

As I understand the recommendation, the coflex removal must be dorsal surgery, while the ADR implantation would be abdominal surgery. I have seen Bertagnoli use a system that allows ADR through a posterior approach, but it is not a posterior ADR replacement... it is for people who need ADR AND facet replacement.

Mark
__________________
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
President: Global Patient Network, Inc.
Founder: www.iSpine.org
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  #17 (permalink)  
Old 05-08-2014, 08:13 PM
Senior Member
 
Join Date: Sep 2006
Posts: 2,405
Default penny

for your thoughts Gil.. have you scheduled surgery, had surgery, are thinking of how to get the $ to have surgery? Just wondering what you're up to these days and hoping you're doing Ok.

Maria
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  #18 (permalink)  
Old 06-27-2014, 06:01 PM
Gil Denis's Avatar
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Join Date: Nov 2008
Location: jackson Wyoming
Posts: 349
Default Update

Hi all

I cannot afford to go out of country for surgery Not winning the lottery at least not yet
My surgeon has just called me and suggested a four level dynamic stablization DSS at four levels removing the coflex implants or leaving them in and fusing the L4 to S1 My concern is what keeps the damaged disc from continuing to degenerate and what holds the spine in place ?

Will let you know what happens better than a spinal cord stimulator ??

Gil
__________________
L5-S1 lam 1994
L2 to L5 DDD
L3 -L4 hern Dec 2007.
L4-L5 Annular fissure with mild central stenosis and moderate facet hypertrophy.
L5-S1DDDDD
L2-L3 Right-sided neural foraminal narrowing at and L3-L4 related to posterolateral hypertrophic spurs and facet hypertrophy.
C3-C4 limited DDD
9 injections Depo. P.T. 13 months 5 dose packs,
Nerve Block Injections.4 ESI S1
L5-S1 foraminotomy 09
L4-L5 Microdiscectomy 09 Reherniate 4-2010
Coflex-L Implants L4 to S1
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  #19 (permalink)  
Old 07-18-2014, 06:52 AM
vnf vnf is offline
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Location: Florida
Posts: 43
Default Update?

Gil

Any update?
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  #20 (permalink)  
Old 07-18-2014, 03:57 PM
Gil Denis's Avatar
Senior Member
 
Join Date: Nov 2008
Location: jackson Wyoming
Posts: 349
Default Update

HI Vickey

I am still dealing with insurances workers comp dissability

Surgeon is sending surgical procedure to WC four level DSS With very bad disc or no disc left at lower level I do not think this is the best solution?

Contacted Dr Zeegers Still no reply I would like to hear his take on this and his cost?

I just had a major set back and finished a dose pack things have now setteled down for now!

Thanks Gil
__________________
L5-S1 lam 1994
L2 to L5 DDD
L3 -L4 hern Dec 2007.
L4-L5 Annular fissure with mild central stenosis and moderate facet hypertrophy.
L5-S1DDDDD
L2-L3 Right-sided neural foraminal narrowing at and L3-L4 related to posterolateral hypertrophic spurs and facet hypertrophy.
C3-C4 limited DDD
9 injections Depo. P.T. 13 months 5 dose packs,
Nerve Block Injections.4 ESI S1
L5-S1 foraminotomy 09
L4-L5 Microdiscectomy 09 Reherniate 4-2010
Coflex-L Implants L4 to S1
Reply With Quote
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