This is a discussion on Have to do fusion, not a candidate for ADR within the Spinal Fusion (Including Discectomy & Laminectomy Procedures) forums, part of the Spine Surgery Support category; I have gotten some good news and bad news. Bad news first: Dr. Carl Lauryssen, down in LA, told me ...
Have to do fusion, not a candidate for ADR I have gotten some good news and bad news.
Bad news first: Dr. Carl Lauryssen, down in LA, told me emphatically that I was not a suitable candidate for ADR. The reasons are that I have loss of normal curvature in my neck at C6-7, lots of bone spurs, and ostopenia in the cervical spine. Since he told me he was too expensive to be worth my while for fusion surgery, his opinion carries the extra weight of being disinterested.
Dr Lauryssen warned me against surgeons abroad willing to do ADR, citing their financial stake in getting cash up front.
The good news is that fusion surgery can be confined to C6-7.
Since Dr. Lauryssen is down in LA & does not contract with any insurance, I am going with a surgeon who is closer to home and on my insurance network. I am scheduled for a fusion at C6-7 with Dr James Zucherman, head of the St Mary's Spine Center in San Francisco, on 12/21. I am still awaiting insurance approval.
A herniated and serverely degenerated cervical disc C6-7 seems to cause all my symptoms. In the past year, the disc immediately below C6-7 also began showing up as some 90% degenerated. But it does not appear to be causing any symptoms as yet.
My surgeon recommended replacing both discs with 2 Prodiscs. My insurance refused coverage.
Should I do surgery? Pay cash for replacement? In Germany? Which surgeon and artificial disc? One level or two?
Re: Have to do fusion, not a candidate for ADR It's great that you are moving forward with surgery. With your level of degeneration and associated compensation (bone spurs), fusion does sound like the best route forward.Originally Posted by herniated C6-7
I've heard great things about Dr. Zucherman over the years. Good luck with the insurance approval. We'll be thinking about you on 12/21--it's a "gift" for the New Year.
Justin Averna
Founder & President, Spine Patient Society™
www.SpinePatientSociety.org
A 501(c)(3) Tax-Exempt Nonprofit & Charitable Organization
I'm here to help.
- 1994: Football Injury, Severe Hyperextension
- 1997: Snow Skiing Injury
- 3/7/1997: Laminotomy L4/L5
- 1999 & 2003: Motor Vehicle Accidents (not at fault both times) --> Grade V Annular Tears L4/L5 & L5/L6
- 11/15/2003: 2-Level ProDisc® L4/L5 & L5/L6*, *lumbosacral transitional vertebra --> Dr. Rudolf Bertagnoli
- 4/2008: 4.5 years pain-free before "new" leg pain
- 5/14/2009: Dynamic Stabilization System L4/L5, Dr. Rudolf Bertagnoli
Questions? Suggestions? Need help with registering, creating a signature, etc.?
justin (at) spinepatientsociety.org
Disclosure: I have no financial relationships with any surgeons, spine clinics, device manufacturers, pharmaceutical companies, hospitals, etc. -- the SPS Board of Directors serve without compensation.
Re: Have to do fusion, not a candidate for ADR I would think you should receive coverage for a cervical fusion. Pretty standard procedure. Your surgery is right around the corner.....so my best wishes to you for a successful procedure, and a blessed holiday too!CL
• January 2000 MVA passenger, used jaws of life to retrieve me, neck injury and months of PT
• June 2001 Bicycle accident, 2 compression fractures at T12/L1, Vertebroplasty Sept. 2001
• April 2006 right hip, labral tear and repair
• April 2007 3 level ProDisc @ L3/4, L4/5 & L5/6✷ ✷Lumbosacral transitional vertebra; Dr. Rudolph Bertagnoli
• July 2, 2008 ALIF & Laminectomy @ L6/S1
• July 30, 2008 re-opened 28 days later to remove bone cement that had leaked onto S1 nerve root
• August 2008 Pulmonary embolism, double pneumonia, collapsed left lung, re-hospitalized 1 week
• March 10, 2009 Right SI Joint Fusion
• April 27, 2010 2nd right hip arthroscopy to remove adhesions and release psoas muscle
• September 30, 2010 lumbar facet rhizotomy
• December 9, 2010 12 bilateral lumbar trigger point and steroid injections
• December 23, 2010 12 more bilateral trigger point injections w/o steroid
• February 15, 2011 ESI bilaterally in lower lumbar...relief only for few days. Considering 1 more.
Did Spinal Cord Stimulator trial from 5/11/11-5/17/11 with excellent results; Spinal Cord Stimulator surgery is Monday,
July 18, 2011
Re: Have to do fusion, not a candidate for ADR I'm glad you have your surgery scheduled and your new life can start. I agree it sounds like you would not be an ADR candidate and would live to regret it if you had one. I think you will be more than happy with your fusion and have many pain free days ahead!
31 years old- 1/06- In wreck with 18 wheeler at 25 years old; 6/06- Head on collision on Interstate, both wrecks other drivers fault. Numerous MRI's, PT, chiropractic, acupuncture, TENS therapy, massage therapy, facet injections, epidural injections, Nerve study, Discogram, confirms pain in L4/5, IDET, decompression, Bi-lateral neurotomy L3/4/5, denied by insurance twice, in Active L clinical trial, had surgery March 17, 2009 in Miami, FL- received Active L disc at 29 years old. Pain and medication free as of October 2010!Mommy to Emma- 8 years, Ava- 6 years & had baby Eli after ADR, via c-section on March 25, 2011, completely pain free still!
Re: Have to do fusion, not a candidate for ADR Sorry to hear the news, but it sounds like you got some great advice from Dr. L and are moving in the right direction with your neck. I was going to send my films to him to get his analysis, but for some reason forgot to do it -- and now wish that I had given the honest recommendation he provided relative to whether or not ADR is right approach for you. Best of luck with your upcoming surgery and recovery -- I wish you all the best!!
Scott
Diagnosed 6 years ago (at age 30) with multi-level DDD of the C-spine
Have had numerous epidurals, nerve root injections, PT, etc.
Severe stenosis and cord compression at C5-6 and C6-7 -- also have herniations and stenosis at levels above
After much deliberation, decided to have a two-level fusion (5/6 and 6/7) on 1/25/11
Recovery has been rough so far, but trying to stay positive
Re: Have to do fusion, not a candidate for ADR After having L5-S1 fusion last December with good results, my C-spine decided to act up. I have talked to several people who have had as many as three C-spine fusions who were quite happy. They all had good range of motion except were not quite able to put their chin on their chest but no trouble seeing turns to drive. One lady who also has L spine disease had her lower three cervical levels fused in 1991 and still has good range of motion and is pain free. It seems the top three levels are the most important in ROM. One lady had the lower three levels fused this past April and went home 48 hours after surgery. Most of my sources come from me being such a blabber mouth in the waiting room of my neurosurgeon. It's amazing what you find out. If I were having surgery I would make sure they don't take donor bone from your pelvis. There are still a few that do this.
Low back pain became somewhat dehabilitating in 2005
Have had 11 steroid injections, IDET, Trial for nerve stimulator, PT, chiropractic trial, practically every med known to mankind. Discogram indicated three diseased levels with L5-S1 being the most likely pain generator. Post minimally invasive PLIF with internal fixation (titanium) on 12-28-09 of L5-S1. Doing better than expected. Last opioid 7/9/10. Five months pain free, then my neck turned against me. MRI on 12/1/10-- disease at C2 to C7. Only surgical alternative is to fuse entire C-spine. Diagnosed now with Aggressive Relapsing-Remitting Multiple Sclerosis with cord & brainstem active lesions
Re: Have to do fusion, not a candidate for ADR I agree, my uncle has had fusions in L and C spine, he has at least 3 or 4 in a row in the L spine, is in his early 60's and can bend forward and touch his toes (I can't even do that).
31 years old- 1/06- In wreck with 18 wheeler at 25 years old; 6/06- Head on collision on Interstate, both wrecks other drivers fault. Numerous MRI's, PT, chiropractic, acupuncture, TENS therapy, massage therapy, facet injections, epidural injections, Nerve study, Discogram, confirms pain in L4/5, IDET, decompression, Bi-lateral neurotomy L3/4/5, denied by insurance twice, in Active L clinical trial, had surgery March 17, 2009 in Miami, FL- received Active L disc at 29 years old. Pain and medication free as of October 2010!Mommy to Emma- 8 years, Ava- 6 years & had baby Eli after ADR, via c-section on March 25, 2011
Re: Have to do fusion, not a candidate for ADR Ok, quick question... Jack, I know you mentioned to make sure that the surgeon doesn't take donor bone from your pelvis for the fusion surgery. I always thought that was a more favorable apporach (despite the harvest site morbidity risk) because theoretically it gives the fusion a better chance of taking place. Am I wrong in thinking that? Most of the fusion guys I saw were looking to harvest bone from my hip for the surgery.
Any thoughts on this one would be greatly appreciated!
Scott
Diagnosed 6 years ago (at age 30) with multi-level DDD of the C-spine
Have had numerous epidurals, nerve root injections, PT, etc.
Severe stenosis and cord compression at C5-6 and C6-7 -- also have herniations and stenosis at levels above
After much deliberation, decided to have a two-level fusion (5/6 and 6/7) on 1/25/11
Recovery has been rough so far, but trying to stay positive
Re: Have to do fusion, not a candidate for ADR There are multiple sources available now without going through the possibility of months of recovery from the donor site. There are lattice inserts, bone harvested from the facet joints at the surgical site, cadiver bone that has been sterilized and prepared, cage inserts, and I'm sure others. If this is what your surgeon is comfortable with then do it. You might ask if he/she has ever used anything else or is comfortable using anything else but I wouldn't want them to learn a new product they are not comfortable with on me. I don't really buy the excuse of giving fusion a better chance. It is old technology. My surgeon agrees. You might be able to get a better explanation on
spine universe - Google Search
Low back pain became somewhat dehabilitating in 2005
Have had 11 steroid injections, IDET, Trial for nerve stimulator, PT, chiropractic trial, practically every med known to mankind. Discogram indicated three diseased levels with L5-S1 being the most likely pain generator. Post minimally invasive PLIF with internal fixation (titanium) on 12-28-09 of L5-S1. Doing better than expected. Last opioid 7/9/10. Five months pain free, then my neck turned against me. MRI on 12/1/10-- disease at C2 to C7. Only surgical alternative is to fuse entire C-spine. Diagnosed now with Aggressive Relapsing-Remitting Multiple Sclerosis with cord & brainstem active lesions
Re: Have to do fusion, not a candidate for ADR Jack,
How did your consultation/ MRI go?
04/06 L5/S1 Rupture
05/06 MRI shows DDD @ L2-S1
06/06 Diskectomy/ Laminotomy L5/S1
04/07 Recurrent Disc L5/S1
4 Ortho and 1 Neuro Surgeon, 5 MRIs, 1 EGM, 1 Myleogram & 11 EDIs later:
03/27/09 L4/5 & L5/S1 Maverick discs at Stenum (www.dr-ritter-lang.com)
11/9/11 C6/7 Herniation with Nerve Impingement. Another journey begins.
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