[Gil Denis]

Dear Mr. Denis,

your x-rays arrived and were reviewed. So good to have the full info now.

the scoliotic curvature is more than expected from the MRIs – but apparently fully due to the degeneration.

So Prof. Dr. Bertagnoli expects to correct this along with eliminating the disc pain and realigning facets by:

a) ADR into your l23 l34 l45 and l5s1 (this is maximum surgery already, app 5-6 h OR time, bu feasible in very experienced hands
b) dorsal removal of the present implants, re-instrumentation with a dynamic pedicle screw system (DPI), at L2-l5


a) and b) can and should be done in separate anestehsias, app 1 week apart, to give your systems time to recover. Primary stability is there after the ventral procedure, so you can be mobilized.

Prof. Dr. Bertagnoli wants to point out, that the “standard” solution for your constellation is a (min) l2-s1 fusion, expectedly to be widend to thoracic for better alignement. In his eyes and experience this would however sacrifice mobility without need (even if a dorsoventral combination is not as mobile as a virgin disc would be or once was). And he has gone to use this hybrid construct for comparable cases since several years, if feasible. It is in your case..

Pro-spine will send you a preliminary cost-estimate for the proposed surgical plan. Be back to me via this e-mail account, if you wish to be scheduled. Of course our staff will be here to support you with local travel arrangements like airport pick-up and hotel etc. I am here to answer your further medical questions. We thank you for the honor of your inquiry. Feel free to be back with any questions you might have.


Well this is huge all the options in this country none had offered and help except a Spinial Cord Stimulator or a four level fusion and fusing my S Joint
Now how to come up with the money arround $100 grand