New and looking for input into decision

**pamela51661** · 08-03-2011, 12:02 PM

My name is Pam and I'm a 50-year old female with degenerative disc disease from C4-5 through C7-T1. There is also mild degeneration in mid- and lower back. While preparing for a 4-level fusion I was told about ADR and it seems like a much better option. I trust my surgeon and he gave me the name of Dr. Bertagnoli. The person who informed me about ADR encourages me to see Nick Boerhee instead. She had heard there was a doctor who was more like a "sausage factory," though she did not think it was Dr. Bertagnoli.

I have sent my discs to, been in contact with, and spoken with Dr. Fenk-Mayer from Dr. Bertagnoli's office. They use the Prodisc-C Nova and are experienced in 4-level ADRs. When speaking with them they were concerned that my discogram only covered C4-5 through T1 and asked that I get additional x-rays of C3-4, which could mean a 5 disc ADR.

Mr. Boerhee's office wants to charge about $400 for a phone consultation. He is on vacation now and his assistant isn't even sure he does a 4 level ADR. Her lack of knowledge is not too comforting. The only reason I hesitate is due to the recommendation for Boerhee, although if he does not do a 4 disc level I guess that's a moot point. I know he also uses a newer disc with no long-term track record.

I need the ADR due to weakening and pain in the arms, some tingling in the right hand, minimal neck range of motion due to pain, and pain in my neck, mid-back, shoulders and shoulder blades.

Any insight from your experiences would be greatly appreciated

**Katie** · 08-03-2011, 01:51 PM

Welcome Pam. You will find a wealth of information here, and it has helped me and many others immensely.

I can only go on personal experience, and others will probably come onboard with theirs as well. There have been a number here who have had surgery with Dr. Bertagnoli with great success, as well as Dr. Boerhee I believe.

My experience has been with Dr. Luiz Pimenta who did surgery on me in Brazil (I am in Canada), but who also has an office in San Diego. He does not charge for evaluating your images. I suspect that the 'sausage factory' that you speak of is Stenum Hospital in Germany. While there are numerous stories floating around, I personally know of at least a dozen people here in Canada, as well as others on this forum who have had very successful surgeries there. They also do not charge to look at your case and give their opinion.

I sent my images to several of these doctors before settling on Dr. P. He was the best for my personal case. I might recommend that you send yours out to as many as you can to get numerous opinions before settling on one. You will get a feel of who you are most comfortable with, who offers what you need after a while.

**spinches** · 08-04-2011, 02:02 AM

I am scheduled for surgery with Nick Boeree this month. I invite you to look at my other posts regarding my search for a surgeon. I am happy to share my experience if it would be helpful to you.

Several others who have posted on this site have expressed dismay about Mr Boeree charging for his consults. He actually charges considerably less than the U.S. surgeons. The other overseas doctors who offer "free opinions" just give you a few sentences in an email from an assistant. Several people including myself have chosen Mr Boeree as a doctor because of how he communicated his understanding of our medical situation during the phone consult. I think it would be great if all the overseas doctors offered the option of a phone consult for a normal professional fee. It provides a much better feel for who the doctor is and how he would approach your case. The consult with Mr Boeree was well worth the money I spent on it.

Keep in touch with the members here. I could never have done this without the information and support available on this site.

**pamela51661** · 08-04-2011, 02:32 AM

Interesting that my doctor is also in San Diego and did not mention Dr. P. Maybe he has more of a relationship with Dr. Bertagnoli. He also recommended a surgeon in France whose name I cannot recall. I emailed their office and never received a response. Does Dr. P do 4-5 level disc replacements?

**pamela51661** · 08-04-2011, 02:32 AM

Originally Posted by spinches

I am scheduled for surgery with Nick Boeree this month. I invite you to look at my other posts regarding my search for a surgeon. I am happy to share my experience if it would be helpful to you.

Several others who have posted on this site have expressed dismay about Mr Boeree charging for his consults. He actually charges considerably less than the U.S. surgeons. The other overseas doctors who offer "free opinions" just give you a few sentences in an email from an assistant. Several people including myself have chosen Mr Boeree as a doctor because of how he communicated his understanding of our medical situation during the phone consult. I think it would be great if all the overseas doctors offered the option of a phone consult for a normal professional fee. It provides a much better feel for who the doctor is and how he would approach your case. The consult with Mr Boeree was well worth the money I spent on it.

Keep in touch with the members here. I could never have done this without the information and support available on this site.

Thank you. I will check out your posts

**Katie** · 08-04-2011, 09:13 AM

The other overseas doctors who offer "free opinions" just give you a few sentences in an email from an assistant.

I have to strongly disagree with this. Both Stenum and Dr. Pimenta gave me very detailed feedback to my images that I mailed to them.

Stenum emailed me a two page diagnosis and surgical plan, with reasons why they were doing what they were doing all at no cost. I spoke to several people at the hospital over several months.

Dr. P. called me and spent a great deal of time over numerous emails and phone calls trying to deal with a solution best suited for me. Yes, I also communicated with his assistant, and yes, the emails were often short, but in the end the communication was more than satisfactory and again, free.

Does Dr. P do 4-5 level disc replacements?

I honestly don't know. I do know that he has done numerous revision surgeries for patients who had ADRs done elsewhere. He did fewer levels on me than other surgeons recommended, and so far it has worked out well. I am just over a year out and doing as well or better than I could have imagined.

He does believe in less is more, from our conversations, and said in my case that the adjacent discs that were less than satisfactory would sort themselves out without intervention. I am happy to have fewer spare parts if they are not necessary.

I always recommend that patients send out their images to several surgeons to see how the feedback compares.

**julesd** · 09-07-2011, 11:31 PM

Mr. Boeree has called me twice in the last week and spent over an hour total on the phone for no fee.

**phillyjoe** · 09-08-2011, 05:56 PM

Originally Posted by julesd

Mr. Boeree has called me twice in the last week and spent over an hour total on the phone for no fee.

you mention that you have spondy; would boree consider ADR in spite of that ? what degree do you have? both levels? thanks for the info

**KanRunMo** · 09-10-2011, 01:05 PM

As you will find in many of the posts, Dr. Bergtagnoli in Germany, Mr. (Dr.) Boeree in England, Dr. Pimenta in Brazil, Dr. Clavel in Spain and Dr. Ritter-Lang of the German Stenum clinic all have many success stories on the website. They are all internationally known spine doctors. The Stenum Clinic probably does the most back surgeries and has it down to a fine-tuned procedure. That does not mean it is necessarily bad or a "sausage factory". If they know what they are doing and can do it efficiently and quickly, that's good. I haven't seen any 5 level disc surgeries and I'm not sure there are any 4-level disc surgeries.

**julesd** · 09-10-2011, 04:10 PM

Originally Posted by phillyjoe

you mention that you have spondy; would boree consider ADR in spite of that ? what degree do you have? both levels? thanks for the info

Mr. Boeree is considering 1-2 level ADR since the degree of spondylolisthesis is 1-2mm, very slight. Of greater concern is the Pars fracture. Since it is one-sided only and spinal stability is good as indicated by standing MRI, he has not ruled out the possibility of a 2 level. I keep meaning to ask this question: after a hybrid procedure, do you rehab more for the fusion segment or the ADR? I am exceedingly impressed with Mr. Boeree. I have not encountered such a high level of knowledge and compassion in my US travels - 20 doctors in 4 states over the last 3 years.