Consult with Dr. B.

treefrog · #1 (**permalink**) 04-13-2009, 02:58 PM

I finally got an email back from Dr. Bertagnoli's office, Dr. Fenk-Mayer specifically.

Quote from the email: "He firmly recommends Pro Disc L at L45 and L56 (with L6S1 is present as a variety, but hypoplastic non-functioning, and not generating any pain)."

No one here has ever specifically said that I have L6S1. It has been noted that I have a lumbarized S1. I assume that is what they are referring to. I trust that Dr. B will get the right discs though, when he does surgery.

I did write back, one because she said I needed a bone density test, and I wrote to say that test result is on my profile, but if she had trouble getting it I would fax it directly to her. The other reason was to ask how she and Dr. B. thought my facets looked, if they would cause future problems (I know they can't say for sure), and also to ask if because of the lumbarized S1, did Dr. B. think fusion at the lower level would be beneficial.

So, hopefully this week, I can get the quote from them and schedule surgery.

I am still waiting to hear from Dr. Regan too. I'd like to get another opinion, just to make sure I am doing the right thing, though I really do trust Dr. Bertagnoli's opinion.

You can't believe how happy I was, when I saw that email.

Maria · #2 (**permalink**) 04-13-2009, 03:24 PM

I was equally as happy to receive communication from Dr.Fenk-Mayer back around 2002/03 that helped me to get the ADR ball rolling here in the states altho I've always held out thinking I want the surgery done there w/Dr.B.

So congratulations I'm trying to say as I do know the joy of getting that communication what once again gives one great hope!!!!

Good luck with all and keep us posted

Justin · #3 (**permalink**) 04-13-2009, 03:38 PM

Quote:

Originally Posted by treefrog

I finally got an email back from Dr. Bertagnoli's office, Dr. Fenk-Mayer specifically.

Quote from the email: "He firmly recommends Pro Disc L at L45 and L56 (with L6S1 is present as a variety, but hypoplastic non-functioning, and not generating any pain)."

No one here has ever specifically said that I have L6S1. It has been noted that I have a lumbarized S1. I assume that is what they are referring to. I trust that Dr. B will get the right discs though, when he does surgery.

Cathy, glad you heard back from Drs. Fenk-Mayer and Bertagnoli. About the lumbarized S1 or L6--it's the same thing. I have countless reports, even my most recent MRI and CT/Myelogram, of "incorrect" labeling of my lumbar. It also depends on which way (from the cranial down or sacrum up) they start counting. In the end, though they mean the same thing.

Quote:

(with L6S1 is present as a variety, but hypoplastic non-functioning, and not generating any pain)

I have the "exact" same finding at L6/S1...during my discogram the needle could not gain access to this disc, as it is a "residual hypoplastic disc that has a bony ridge surrounding the disc."

Keep us posted...it is great to get a plan of action, isn't it?!?!? At the very least, it reaffirms that you are not crazy

and that surgery is, indeed, indicated.

Dr. Fenk-Mayer is incredible--she is extremely thorough in regards to answering questions via email and she is reassuring about the proposed plan. She works very hard as a surgeon and somehow keeps up with the inundating emails she/Pro-Spine receives.

treefrog · #4 (**permalink**) 04-13-2009, 04:25 PM

Thanks for that explanation Justin, it makes it much more clear. So, there is actually a disc there, but a non-functioning disc? I'll have to take a closer look at all my images, and see if I can spot that.

So, that was one of the things I was wondering. If this abnormal anatomy is in part the cause of my problems, would fusing that segment make sense? Of course, maybe it isn't the cause, and maybe it doesn't cause more movement, like I am envisioning. But, I thought it was worth discussion.

dshobbies · #5 (**permalink**) 04-13-2009, 05:53 PM

Cathy,

A lot of people have that 6th lumbar disc. Not a worry. Great news about Dr.s B & FM.

Can't say if that's part of the problem?

Keep us posted, Dale

treefrog · #6 (**permalink**) 04-13-2009, 06:24 PM

Yeah, if a lot of people with lumbar problems have that L6, then does it cause problems? Maybe, maybe not.

One of the surgeons that I talked to, did say that he does see a lot of people with back problems, have that lumbarized S1 (or L6). Could be coincidental, but he seemed to think that the people with L6 were more likely to have problems. But I don't know if it is because that segment then has more motion, if it does, then would fusing it help?

Cindylou · #7 (**permalink**) 04-14-2009, 02:35 AM

I was going to reiterate what Justin said treefrog, as I also have a lumbosacral transitional vertabrae (lstv). Some of the latest studies I have read lend strong support to the relationship between this anomoly of the lstv and low back pain. I have also read there is a higher incidence of lstv in males versus females. I guess you and I are the lucky females. I did have my lstv fused as it was impossible to put an artificial disc in the space. Just my 2 cents, but I would venture to say there is a high probability it is contributing to your problems. Hope you get the relief you need from Dr. B.

Regards,

Cindylou