Hello All...My name is Rajan, but people call me Raj

[srajan0929]

Hey everyone. Some of the members here might know me from other spine forums. A long story short, I had 3 surgeries for my lumbar area. first one was overseas where i had a disectomy/laminotomy at L4-S1 (two levels). I was 24 then. i felt completely cured and then again 2 years ago, I rehearneated my back. I went for another procedure in 2011 october 19th in new york with dr. stieber. it was the same repeat procedure. I felt very good after the surgery. But lo and behold, 6 weeks later, i developed spinal infection in my back. I had osteomylitis and discitis. it was the most painful experience i have ever experienced. i couldn't even get up and was bedridden. i had to crawl just to go to the bathroom. i was rushed to the hospital and put on antibiotics(was on seftriaxone). i slowly started walking within 2 weeks. i felt good but then went for a follow up MRI and found extensive fluid buildup. was rushed to the hospital and they did an emergency debridgement at the L5 vertebra and a complete laminectomy at the L5 area. the doctor also did a half laminectomy at the L4 area. i am currently recovering from the surgery which was on december 29th 2011. I am 28 and trying to find a way to live my old self. currently consulting with Dr. Boeree. i live in New York.

[srajan0929]

hello everyone, i am trying to find a topic on revised M6 disc. how is it possible that since the disc came out there has been no revison on this disc?

raj

[laid up doc]

I don't know of any cases due to device failure. I asked Boeree and Clavel about this. I heard somewhere about significant trauma causing an issue in some patient... don't know anything else. I couldn't find anything about revisions before mine either.

Since only 3 docs use the M6 much, there isn't much in the way of reporting. I hope they told me the truth. Dr Ritter-Lang probably does the most, but what I hear about Germany is that you won't hear much about bad outcomes, unless the pts come on the web.

[trkdoc714]

I would imagine the M6 revision would be as risky as the ProDisc or Maverick (or any other keeled ADR device). I believe as ADR surgeries enumerate, revisions will follow. There haven't been that many in contrast to the number implanted.

I'm not sure the rumor about Germany is very accurate. The fact is, most (if not all) of the few surgical failures from Germany have compounded over time by a few people with ulterior motives. A few of the surgeons have been targeted for not utilizing the services of medical tour guides.

I wouldn't hesitate to make the same choice I made 3 years ago. Life's too short to spend any of it suffering with spine pain.

Good luck Raj. I hope you find your solution soon.

Bob

[laid up doc]

no one want to revise these things... ergo my promise to myself to take care of this implant and my spine in general. i just hope if i do need one that there will be a clear expert to go to

it's 8:30pm on a Friday, and I'm going down to the gym to work off my "back weight".

[srajan0929]

hey LUD, its 10 pm and I just came back from a 2 mile walk off a treadmill. huge milestone from where i was a couple of months back. i just got my MRI today and it doesn't look like the prettiest thing. the L5S1 is literally destroyed. its bone on bone. I need to ask dr. boeree whether i could postpone the surgery to like two years later? I just wanna wait till a little more history is built up with the M6. Obviously, I will listen to what he thinks is the best.

[srajan0929]

i have a question...do you guys think that revision strategies would change in another 8-10 years? Wouldn't it make sense for these medical device companies who make the ADRs to make devices that would make revision easier?

[srajan0929]

the keels on the m6 seems to be much smaller than the single keels like the prodisc or the maverick. So perhaps the revision is much easier? i don't know. i like luiz pimentas method to remove the disc laterally as a safeguard measure. i don't like the ball and socket designs as our spines are not really balls and sockets. m6 makes the most sense to me...I am not going to consider germany because i have heard of enough horror stories. peter's blog is enough to convince me that if a surgeon ignores you, then I will not consider him to be my surgeon.

[Justin]

i have a question...do you guys think that revision strategies would change in another 8-10 years? Wouldn't it make sense for these medical device companies who make the ADRs to make devices that would make revision easier?

I'm sure artificial disc replacement (ADR) revisions would be greatly refined just based on the sheer increase in the number of revisions (which is a relatively low number in regard to the total number of procedures performed). It would make sense for medical device companies to make an ADR that would be easier to revise. However, this is not their primary focus. Device companies are concerned on making a disc that replicates human anatomy, which is an exceptionally challenging task.

the keels on the m6 seems to be much smaller than the single keels like the prodisc or the maverick. So perhaps the revision is much easier? i don't know. i like luiz pimentas method to remove the disc laterally as a safeguard measure. i don't like the ball and socket designs as our spines are not really balls and sockets. m6 makes the most sense to me...I am not going to consider germany because i have heard of enough horror stories. peter's blog is enough to convince me that if a surgeon ignores you, then I will not consider him to be my surgeon.

Revision for an artificial disc in the lumbar spine is a life-threatening operation with any approach (anterior or lateral explantation). The lateral approach does not guarantee an operation with less morbidity / mortality. There is a Spine Patient here on SPS that almost lost her life after a lateral revision of her lumbar artificial disc.

In my opinion, keels are keels. Small keels don't remove the inherent risk associated with revision of a lumbar device. Do they have the potential to make a revision "easier?" Possibly.

In regards to Germany: Dr. Bertagnoli restored my ability to walk and I went from being bed-ridden to living my life again after my operation with him in 2003. Unfortunately, the Internet "skews" the numbers; those with poor outcomes are more likely more vocal, whereas those that have successful outcomes are out living their lives and no longer post on forums, blogs, etc. The thousands of Spine Patient's that have had successful outcomes with Dr. Bertagnoli (insert other German surgeon names here) are overshadowed by those with poor outcomes. This is not to say that we don't care about these patients and their outcomes. At the end of the day, you have to remember there are two sides to every story and the surgeons can readily defend / explain "their side of the story." Just my

[laid up doc]

that's AWESOME Raj.... you have come a long way!!! As an aside - you'll find that a lot more of the posters here went overseas.

As for surgical timing... I'd keep the date you have and continue your efforts to heal from your laminectomies and infection. You may NOT be at the point of needing/wanting surgery just yet as the date comes closer.... or, alternatively, it may become more clear that you can't live with the pain/disability you have by then.

Try not to let what the MRI looks like guide your decision making tooo much... it's more about how you FEEL. plenty of people out there have nasty looking spines on imaging and are not in terrible pain. Conversely, many of us (myself included) have very underwhelming MRI's but were in terrible pain pre-op. The issues my disc had don't image well even on discogram.

The only caveat to the above is if your L5/S1 TODAY could have an ADR and may NOT be able to down the road, and if you are completely opposed to the possibility of a hybrid. I know you need to return to grad school, which would play a role in your decision making too.

What i meant as far as Germany is that there are only 3 places to get an M6 as of today... the way things work with Boeree and Clavel seems to be quite different than with Ritter-Lang, as far as #'s of surgeries in one day and whatnot. Some people would like the group stuff, but I as a health professional wouldn't do that for anything. I have yet to see a patient treated by Boeree or Clavel have a horrific outcome and dedicate an entire website to it. Obviously there is the confounding variable of self-reporting... There is something going on w/ Clavel having some affiliation w/ Stenum, but from what I hear his Barcelona Spine Center is still independent and nothing has changed as far as day to day operations from the patient's perspective.

I do wish those 3 would work together more to publish M6 outcomes, failures, revisions... would help us out a lot as patients. Instead there's heresay and one sided stories, w/o an objective voice saying what REALLY happened. That being said - other than a lady who had issues w/ Nuffield Hospital and another who may or may not have been offered cervical levels she did or didn't need from Clavel -- hard to find any hard complaints against either of them.