Dr. Bertagnoli's Representation on the Spine Patient Society Forum

[Justin]

Note: below is my personal opinion as a Spine Patient and does not represent the views of the Spine Patient Society (SPS).

On any Internet Forum, it is difficult to get an accurate view on any particular spine surgeon. I say this because those Spine Patients that have had poor outcomes are usually the most vocal participants and those Spine Patients that have had their lives changed "for the better" are usually out living their lives & rarely frequent the SPS Forums.

I believe that Dr. Bertagnoli has not been represented well on the SPS Forum.

My personal experience with Dr. Bertagnoli spans over 7 years. When I flew to Germany in 2003 for my 2-level Artificial Disc Replacement (ADR) surgery (Lumbar L4/L5 & L5/L6 ProDisc -- Justin (23 years old, 11/15/03, Dr. Bertagnoli), it was the first time I had been out of the country and Drs. Bertagnoli & Fenk-Mayer really took me "under their wing" when I arrived. (I was 23 years old and my wife was 22—we were both scared of the unknown.) Dr. Bertagnoli spent over an hour with me during our first meeting and answered all the questions I had stressing that ADR is an imperfect science but that it has helped thousands of Spine Patients live their lives once again.

I spent a total of 10 days in the hospital (they released me from the hospital when I felt comfortable leaving—as you know, this would not fly in the United States). Drs. Bertagnoli and Fenk-Mayer visited me everyday post-op to ensure there were no complications and to answer any questions I had; they even drafted a letter to my airline to explain my surgery and to request seating accommodations. Dr. Bertagnoli's wife, a physician, also stopped by to check on me when Dr. Bertagnoli had to fly to the United States to train surgeons that were involved in the FDA clinical trials. She gave me her cell phone number and insisted that I call her if I needed anything. To say the least, my care was phenomenal.

Once I arrived home, my recovery was difficult--many will attest to the roller coaster ride that is recovery after a lumbar ADR surgery. I called & emailed Dr. Fenk-Mayer on many occasions during my recovery (once when I rolled out of bed and onto the floor —I was convinced that something bad had happened to my discs. She assured me everything was fine, and it was.). They also sent me 3, 6, 12 and 18 month questionnaires to document my recovery and the progress of their patients.

Drs. Bertagnoli and Fenk-Mayer gave me my life back. I was bed-ridden before my surgery in 2003; I was only 23 years old at the time. Thus, walking 4.5 miles at 10 days post-op was truly incredible. At 4.5 months post-op I was 100% pain-free and remained that way (living my life once again) for 4.5 years.

I required a second operation in 2009 to address an osteophyte on the posterior aspect of my L4 vertebral body that was compressing my spinal cord. I went to a few surgeons in the Philadelphia area (many at the University of Pennsylvania [an outstanding facility with internationally known surgeons]) and they all stated the operation would be too technically demanding and that it was not possible to remove the entire osteophyte due to its unique position. Dr. Balderston, a well-respected and highly skilled orthopedic surgeon in Philadelphia, advised that I see “the world leader in ADR" (his words & emphasis, not mine), Dr. Bertagnoli.

I traveled back to Germany in May 2009 to have the osteophyte removed and to have a Dynamic Stabilization device implanted at L4. My experience with Drs. Bertagnoli & Fenk-Mayer was once again first-class. They had once again taken my leg pain away. (Dynamic Stabilization System: DSS™--motion (non-fusion, 5/14/09, Dr. Bertagnoli)

I apologize for being so long-winded. However, I want to post this information in hopes that the Spine Patients that frequent our Forums understand that those Spine Patients that post undesired or poor outcomes are usually the ones frequenting the SPS Forums on a daily basis, as they are still in pain. Those Spine Patients that have had their pain "removed" and that have been given a "second chance" at life are out living life. Thus, it should be understood that our Forum self-selects for Spine Patients that are currently still in pain and that are looking for solutions to their spine problems. This is why the Spine Patient Society exists: to support those Spine Patients that are still struggling. Also, I would like to thank those Spine Patients that have returned to a life with minimal pain & increased functionality—those that take time out of their lives to contribute (still post) on the SPS Forums—we appreciate your contributions to the Forum.

Of note, I spoken with literally hundreds of Spine Patients that have seen Dr. Bertagnoli. Are they all doing well? Of course not. Did many of these Spine Patients have decades of spine problems? Yes. Were there Spine Patients that had unfavorable outcomes (no matter the age)? Of course, all spine surgeons have unfavorable outcomes as they are human.

Spine surgery (fusion, artificial disc replacement, etc.) is a life-changing operation and a gamble—it's an imperfect science trying to give each unique Spine Patient their life back.

I wish everyone the very best, and, as always, feel free to contact me if you need anything.

[KBear]

Thank you Justin for sharing with us. I think the last bolded sentence sums it all up. It's a gamble, doing something is a gamble, doing nothing is a gamble and each person has to decide for themselves if it's worth the risk.

[Justin]

Thank you Justin for sharing with us. I think the last bolded sentence sums it all up. It's a gamble, doing something is a gamble, doing nothing is a gamble and each person has to decide for themselves if it's worth the risk.

Very well said, Kathy.

[Justin]

Here's a couple of past posts that I will post here for completeness.

05-05-2009 01:27 PM

Well, it has been almost 6 years since my 2-level Artificial Disc Replacement (ADR) surgery. It is amazing how many devices are now on the market, in clinical trials or in the design process.

Although ADR surgery is not a fix all, I personally believe it was the best option for me when I had surgery at the age of 23. I was offered a 2-level ADR or a 2-level fusion in my lumbar spine. With severe tears in both of my discs that needed to be replaced, it wasn't a question if I needed surgery at the time but which operation I would choose. It was hard to decide between ADR and fusion in 2003, as ADR was still in Clinical Trials in the United States. Having a previous surgery, a laminotomy at L4-L5, at the age of 17 disqualified me for any of the stateside Clinical Trials at the time. Thus, I had to do my research to see what else was available. Ultimately, I ended up going to Germany to have surgery with Dr. Rudolf Bertagnoli.

I have to say it was really amazing going from a bed-ridden way of life before my ADR to mowing the lawn and lifting weights again. ADR gave me my life back--plain and simple. I'm not trying to paint an unrealistic picture for those that are facing a surgery in the near future, just my personal experience. I was 100% pain-free for close to 5 years post-op until April of 2008 when I started having bilateral leg pain once again. (My "new" leg pain is not related to my ADRs, but another issue that presented in my spine.)

Any spine surgery is a major operation and only about ~10% of spine patients with spine issues actually require surgery.

At the end of the day, get as many surgical opinions as you can from qualified medical professionals and become your spine's own best advocate--do your research and ultimately make well-informed decisions regarding your own spine.

Please don't hesitate to contact me via email / private message if you need any help with the SPS Forum.

05-19-2009 12:14 PM

I was 100% pain-free for close to five years after my 2-level ADR with Drs. Bertagnoli and Fenk-Mayer until I started experiencing bilateral leg pain in April of 2008 due to other issues in my lumbar spine (see this thread).

The quoted text below was written in 2004. I hope it helps those of you contemplating ADR. At the time of my car accident and surgery in 2003, I was only 23 years old and it was the 1st time I had been out of the country. In addition, I was one of the youngest cases (if not the youngest case) that Dr. Bertagnoli had ever done at the time. ADR was in its infancy in the US Clinical Trials and there was not much information regarding ADR surgery in general. I extensively did my research with the materials that were available to me and I took a GIANT leap of faith going to Germany for surgery at the time--it was not a widely accepted option for spine treatment as it is today.

First and foremost, I would like to thank Drs. Rudolf Bertagnoli and Andrea Fenk-Mayer for freeing me of my intense leg/back pain and giving me my life back!

Before having my 2nd spine surgery at the age of 23, I extensively researched spinal fusion and artificial disc replacement (ADR) to ascertain my understanding of the risks and potential benefits of these two procedures. My conclusion about these two surgical procedures matched that of Drs. Guyer and Bertagnoli: that ADR was statistically superior to fusion for pain reduction, improved functionality and better prospects for long-term health. Below is a synopsis of my spinal medical history, which eventually led to the complete resolution of my pain through the incredibly skilled hands of Drs. Bertagnoli and Fenk-Mayer.

In the fall of 1994 at high school football practice, I was tackled and bent over backwards (called a severe hyperextension injury). The trauma was so bad I could not stand up and had to be carried off the field. I consulted an orthopedic surgeon, and he advised against surgery because of my age at the time (15 years old). Two years later, I injured my spine snow-skiing and on March 7th, 1997, I underwent my first spine surgery, a laminotomy at L4-L5. After the surgery, my symptoms got somewhat better. Unfortunately, that was short lived. In July of 1999, I was involved in a motor vehicle accident (I was not at fault) that instantly caused my legs to go numb upon impact with the other car. Before the accident, I was very healthy and I was lifting weights 5 times a week at a competitive level. My life was normal and I was involved in many sporting activities. Immediately after the accident, I was in intense pain and could hardly walk. I had to withdrawal from the University, as I could not stand the pain to sit through classes or even walk to class. Conservative treatment was subsequently suggested by a local orthopedic surgeon. The conservative treatment included 10 weeks of physical therapy, four steroid-epidural injections, and pain management with medication. Although I did not feel completely healthy, I returned to the University in January 2000 to pursue my premedical studies again.

On January 15th, 2003, I was involved in another car accident (not at fault again) in which my side of the car, the driver’s side, was struck with extreme force. Both of my legs went numb instantly and I felt as if I broke my left hip. I thought I had broken my back and so did the paramedics that arrived on the scene. The paramedics removed me from the car with the “Jaws of Life” and placed me on a backboard. I went directly to the emergency department for X-rays and CT scans. I was released from the ED the next day in extreme pain, but with pain medicine to help with the pain. Later that day, I went to follow-up with my Primary Care Physician (PCP). He immediately ordered an MRI as I could hardly walk into his office. The MRI confirmed a herniated disc at the L5-L6 level that was more significant in size compared to the MRI taken in 1999. I began physical therapy the next week for a total of 4 weeks. My PCP sent a note to my employer explaining that I would be out of work for one month. I slowly returned to work fulltime, but I felt as if there was something “not right” with my back—I continued to have CONSTANT AND INTENSE leg pain and numbness.

I saw my PCP periodically during the year to keep a watchful eye on my physical condition. I continued to do my normal activities at home and at work. Then, my symptoms greatly increased in August 2003. I was having great difficulty walking and doing normal activities, so my PCP prescribed physical therapy once again for many weeks. During physical therapy, I felt as if I was not getting any better. In fact, it seemed like the physical therapy was only aggravating my symptoms. I informed my PCP and he referred me to an orthopedic surgeon for an opinion. The orthopedic surgeon performed a complete physical on me and stated, “You look like an egg shell that is ready to break.” After reviewing my MRI from January 2003, he said I only had two options and that all the physical therapy in the world was not going to help. He said I could have either a 2-level fusion or a 2-level ADR—he told me that surgery was necessary.

Being so young, I followed his referral to the Texas Back Institute instead of pursuing the fusion route. I met with Dr. Richard Guyer on September 10th, 2003. He saw that I was in extreme discomfort and sent me for a lumbar discogram the next day. The discogram confirmed that the L3-L4 level was within normal limits, the L4-5 level showed diffuse degenerative changes and the L5-6 level showed a small central protrusion. The discogram confirmed that two levels were my pain generators and that each level had Grade 5 annular tears: the L4-L5 level produced low back pain with bilateral leg pain at a 10/10 level (with a little low back pain) and the L5-L6 level demonstrated low back pain to below the knees usually worse on the left causing severe 10/10 pain. Dr. Guyer discussed that the Texas Back Institute was only approved to do a single-level disc replacement at the time of my appointment. He suggested that I wait until sometime next year—2004—at which time I would be a candidate for a disc replacement at L5-L6 and possibly at L4-L5 depending on the Federal Drug Administration criteria.

Shortly after I returned home from seeing Dr. Guyer, I became absolutely miserable. I could not stand, sit or lay down for more than 10 minutes. My last day of work was in the middle of September and I was subsequently placed on short-term disability. My pain steadily increased daily and I could not escape it. Thus, I started doing research about a 2-level ADR procedure in Germany. I called Dr. Guyer’s office a couple weeks later and explained to his nurse that I could not wait until the middle of next year—2004—for an ADR procedure. She said that Dr. Guyer had no problem with me pursuing ADR surgeons overseas.

After countless hours of research online, it became clear to me that Dr. Rudolf Bertagnoli was the authority concerning ADR surgery, especially at multiple levels. I contacted Dr. Bertagnoli and started the process of pursuing surgery in Austria via Germany. I sent my films to Dr. Bertagnoli around the first of October. Drs. Fenk-Mayer and Bertagnoli agreed that I was a perfect candidate for ADR at both levels! The earliest day they had available for my ADR surgery was November 15, 2003. While waiting close to 6 weeks for my surgery date to arrive, my pain increased and I became increasingly dependent on others for care, as I could not get in/out of the shower, put on my shoes, etc. by myself. I could not perform most day-to-day activities without the assistance of my wife.

My surgical experience overseas was excellent. Drs. Fenk-Mayer and Bertagnoli were very polite, approachable and demonstrated unparalleled proficiency in ADR. The bedside manner of both Drs. Bertagnoli and Fenk-Mayer are amazing. Dr. Bertagnoli is an extremely sympathetic surgeon that is truly passionate about helping those in pain—one can tell that this is his “calling” in life. Drs. Bertagnoli and Fenk-Mayer thoroughly answered all of the questions I had in regard to the surgery, recovery and long-term expectations with ADR. Dr. Tina Bertagnoli was also an amazing doctor that stopped by many times during my stay in the hospital. She even gave me her cell phone number as well as her home phone. The nurses and staff were very compassionate and professional at the Rudolfinerhaus Hospital in Vienna, Austria. Overall, I enjoyed my surgical experience in Austria—besides some initial post-op pain the first couple of days—and I am so very thankful for having my life given back to me.

[Cindylou]

Thank-you, Justin, for taking the time to post your personal journey back to wellness under the care of Dr. Bertagnoli and Dr. Fenk-Mayer. It is nothing short of miraculous to read how far you have come since all your spine troubles began at the tender age of 15. I only wish you the very best as you continue to pursue your dream of becoming a physician yourself. I predict that you will make one helluva compassionate Dr. I am proud to call you "my friend." Cindylou

[Fuzzy]

I agree Bertagnoli is an excellent Dr. and i will travel again soon to see them personally for their valued opinion on my continuing problems. Its worth the trip to me.

[Gilbert P]

Hi Justin

Thanks for your story. I know its a Gamble but so is driving down the road, Life if full of risk and chances. One must take the risk to try to better ones life.
Its better than the other option!

Thanks

Gil

[KBear]

Wow Justin, not sure if I had not ever seen your full story or just forgot, but you have definitely been through the ringer. It is amazing how Dr. Bertagnoli has helped give you your life back. It's hard to believe when you are in that pain that there will ever be better days, but you are proof that it does happen!