Surgery this summer in Germany (Stenum, Spinal Kinetics M6 Lumbar)

[dagmountain]

Hello everyone I am getting very close to scheduling surgery this summer in Germany and would like to get some feedback on what to expect. I am definitely having l4/l5 and l5/S1 replaced, but there is a slight bulge on l3/l4 that might be asymptomatic. I can only afford two discs so I hope this does the trick. Also I would be lying if I didn't say that I'm absolutely terrified of surgery, although with the quality of life I have now it is really a no brainier. Any advice or encouragement would be greatly appreciated. Thanks.

-Dave

[scduggan]

Hey Dave,
Welcome to the website. I am seven weeks post op from a single level ADR here in the states. There are a lot of folks here who have traveled out of the country for ADR. I hear lots of good things about Germany. :thumpup: How long have you been having problems with your spine? I can only assume if you are planning on surgery you have reached the end of your rope.

The only advice I can give is to do a lot of research and, if possible, get multiple opinions for your condition. ADR is the best option for a LOT of people but definitely not all. It seems like the two biggest factors are patient selection and surgeon skill. I know you are terrified. This surgery is huge and I cannot imagine facing two levels. There are people here who have been in your shoes and they can give better advice. Please keep us posted. Do you have any idea which surgeon in Germany will be performing your surgery?
CD

[dagmountain]

CD-

Thanks for the welcome. I have been having troubles for about 17 yrs. The doctors I am considering are #1 Dr. Bertagnoli and #2 Dr. Ritter-lang. I am 33 and I don't want to reach the point of no return with my spine so it's time to go, also is it bad form to cheer the collapse of the Euro?--LOL--I am just kidding I don't want to see anybody else suffer although a slight correction would be nice. Thanks again CD for welcoming me.

-Dave

[ajj1001]

Hi, I had 2 level adr at L4/L5 L5/S1 in 2002 when I was 36, my symptoms went away nearly straight away but I found recovering from the anterior approach. Its a big op and I was something like normal 18 months later. I returned to very good health with only slight numbness and motor control problems in my right leg. I started to have problems in 2007 with major deterioration at the L5/S1 level and problems further up in my spine. What to do when ADR goes wrong is quite tricky so make sure its the right thing for you and get as many opnions as you can. Saying that I do not regret my ADR as it gave me a good quality of life though only for a short time.

[dagmountain]

Ajj1001-

Thanks for the info! When you say, "major deterioration at the L5/S1 level" are you talking about facet ossification or stenosis and do you feel that the ADRs caused or accelerated this problem? I have heard anecdotally that ADR relief lasts about five years and I am in total agreement with you that that in itself would be worth it. I guess I'm just hopping the technology has gotten better over time and that maybe I could even get a decade or so. Thanks again for your insight.

-Dave

[ajj1001]

Hi, I had facet deterioration, stenosis, bone spurs, cysts. My surgeon no longer uses the type of disc I have, though he does still perform ADR. I was told it would be good for ten years so was making the most of it whilst they lasted! The problems higher up could of happened anyway but the facets were a direct result of the adr in front of them. I've not fused at L5/S1 where the disc is still in place and instrumentation and bmp has been placed to hold it still.

No way am I saying not to have it done just to make sure you ask what the options would be if it were to go wrong in the future.

[dagmountain]

ajj1001-

I have discogenic pain that I know will be helped by disc removal. I was hoping that if in the future, there was a nerve root impingement due to facet deterioration a facet nerve block would work. Did you have any luck with nerve blocks? Thanks again.

-Dave

[ajj1001]

I started out on the route of treating by injections with a caudal epidural steriod injection and then was planning on facet blocks. However I had a really bad reaction to the caudal and it made my symptoms far worse so that was abandoned as a treatment option. The changes in the facets became much worse so their removal and fusion was the option offered to me. I could have pursued removal of the adr and then fusion but this is was not offered to my in this country and is a life threatening surgery. I'm still not fused so the jury is out on whether this was the right choice, I am alot better than when I had the surgery when my pain levels routinely reached 8/10 - 9/10. Now I the worst I go is the occasional 7/10 & 8/10 with it much lower most of the time.

[Justin]

Hello everyone I am getting very close to scheduling surgery this summer in Germany and would like to get some feedback on what to expect. I am definitely having l4/l5 and l5/S1 replaced, but there is a slight bulge on l3/l4 that might be asymptomatic. I can only afford two discs so I hope this does the trick. Also I would be lying if I didn't say that I'm absolutely terrified of surgery, although with the quality of life I have now it is really a no brainier. Any advice or encouragement would be greatly appreciated. Thanks.

-Dave

Hi Dave,

Welcome to the Spine Patient Society.

I would most definitely "work up" your L3-L4 to see if it is a pain generator. Sorry to be blunt: the worst thing you can do is "pick" a surgery based on price. I know price is a concern for many people (including myself); however, back surgery is MAJOR surgery. You don't want to leave any stones unturned and you don't want to go in to have yet another invasive operation. Spine surgery burns many bridges and the collateral damage to surrounding structures is significant, especially with an anterior approach where there is scarring down of the aorta and inferior vena cava during the healing process. The adherence of the aorta and/or inferior vena cava to the vertebral wall is possible and can cause significant problems if future surgical interventions are needed (ie the aorta & IVC can tear, leading to significant blood loss and possibly death).

My words above are not to scare you anymore than you are, which is normal by the way or you wouldn't be human. They are to make that point that having surgery on only the worst levels might be setting yourself up for problems down the road. It L3-L4 is truly a pain generator, then you want to have it addressed. Discs very rarely "heal" themselves and problems tend to get worse over time due to the continued degeneration of the spine.

Have you had a discogram to see what levels are your pain generators?

[dagmountain]

I definatley am going with the discogram on l3/l4 no doubt about it. My thinking was that if in the future, from maybe a lateral approach i.e. nuvasive, that a higher level on the spine might be less of a risk. I am merely speculating though and so I appreciate your expertise, thank you. Should I wait to have the doctors in Germany do the discogram or would it be just as good to have it done here in the States? Thanks again.

-Dave