Stenum - My story

[cp7959]

I thought I would join your board and share my experience at Stenum Hospital. My intent is not to dicredit or promote Stenum. I believe sharing my experience might help others with their ADR decision. I believe before anyone jumps into surgery anywhere, they should gather as much information as possible.

I am several months post op from a 2 level cervical ADR surgery. The hospital and nursing staff is incredible. They have done a top notch job at making you feel comfortable and welcomed. The ward is all English speaking and I was there with several other Americans, so it felt as if I where in a ward back home.

My surgery was with Dr. Ritter Lang. The morning of the surgery was my first meeting with him. He came to my room with other Stenum staff. He did not look like a DR., nor did he have any paper work, films or other information pertaining to my situation. It was if he just walked off the street. So prior to surgery the only thing that was discussed was me telling him my problem.

From the time I left my room till the end of surgery was 1 hour and 10 minutes. Assuming it took about 20 minutes to be wheeled to the OR positioned in what I would call a "prestaging" area for surgery and then put under, the surgery itself was probably in the 50 minute time frame.

When I awoke I was in much more discomfort than prior to surgery. I am not refering to distraction pain, the pain was nerve related. The same nerve that was impinged prior to surgery. I explained the pain to the Dr. Michael (he is what I would describe as a non surgical Spine Dr.) and he said it was not unusual and would settle in time.

The stay in the hospital after surgery again was top notch. The nurses where wonderful and the other Americans where great people. When I left Germany I was still in pain, but tried to remain optimistic.

Now several months later and reflecting on my experience here's is my situation. I still have radicular symptoms. I have met with an orthopedic surgeon here and have had a CT. I have osteophytes at each of the operated levels. It appears some level of decompression was performed but not as complete as should be. Now I will proceed with steroid injections to see if things can calm down. If not I am probably looking at removal of a least one of the ADR's if not both. So not a very good situation.

My opinion is the Stenum hospital staff is outstanding and impressed with the facility. However I am very disappointed in Dr. Ritter Lang. He could have taken more time to do a proper decompression and take better care of me. Is there a chance that I could of had a nerve problem if I had a 2 hour surgery? Of course there is. However the speed at which my operation was performed increased the chance of failure. And the level of decompression is very disappointing. So now my life is spent trying to fix my problems and I hope to be on the other side soon, it's been to long.

I know that many have had good outcomes at Stenum. There situation may have been different. Maybe they had a different surgeon, or Ritter Lang was more careful. But all I can say is 6 surgeries where done on my day. The first left his room at 10:30am, the last came in the recovery room at about 7:30pm. Thats 9 hours that it took to do 3 lumbar and 3 cervical. All where multi level, but 1 single level lumbar. Todate I understand at least 3 are still having issues.

I am not trying to convince anyone to choose Stenum or not. But if I was asked I would not recommend Ritter Lang. In fact I would ask Stenums US contact Sue Hart about the speed in which surgeries are performed, just to get their opinion. I feel lucky I got an ADR and not fusion from Ritter Lang. Not because of the obvious benefits of ADR. But if I was fused and a proper decompression wasn't done, instead of removing a ADR, I would be looking at a laminectomy or corpectomy to clean things up.

Ritter Lang is probably a great surgeon if he took his time and would probably have a better success rate. On my day he was faster than I would expect, which to me opens up the opportunity for increased failure.

I should have done more home work in picking my surgeon. I did read many good Stenum outsomes on boards. But I also read many bad ones. I should have paid more attention to the bad ones. I should have stayed in the US and got several price quotes for surgery. I should have contacted the approved ADR reps in the US and asked for their help. And if I failed I should have got a fusion. So many things I could have done to give me a better chance.

I hope this information can be helpful to someone. And remember a wrong choice on our part can change the lives of our families and ourselves. Mine has. I love my wife and kids, but I spend all my time trying to be fixed. I have put their life on hold and filled my home with a level of sadness and depression. I am not the man I was prior to Surgery.

I don't blame anyone but myself.

[Gil Denis]

Hi Cp

I am sorry for your outcome. I wish you find a solution for your pain. Finding the right surgern it very hard to do.
All Surgery have good and bad outcomes Its a crap shoot

Please keep us posted

Gil

[Maria]

cp,
Back in '92 I had my 2nd spine surgery which was a percutaneous discectomy.
It failed very miserably with horrendous nerve related symptoms/radicular and for the longest time I blamed myself.

I said some of the very same things I saw that you posted and I can only imagine what you're feeling with regard to your decision but you thought the surgeon would do his job, you thought you were going to a world class surgical center, and you had faith.

We never know the outcome with spine surgery we only hope for the best and that's what you did.

I know I kept thinking is hindsight is so useful it should be foresight tho still again with spine surgery~ who knows..

Thanks for your input re your experience and let's hope that what you have reported might help others with the surgical inquiries and quest.

[wilsonrob]

I had a similar experience as you. The surgery went so fast that Ritter Lang cut the major iliac vein resulting in major blood loss and multiple DVT's. In addtition I continued to have leg pain. I ended up having many more micro type posterior decompressions and now my leg pain is mostly gone (I recently had my piriformis muscle removed that was also causing some sciatica). Why can't you get some micro surgery to decompress the nerves and open the foramen posteriorly?

[JKDE302]

O my, thats very, very bad news....can I ask which disc was used? M6? Pro-Disc?

[steve55]

This makes me feel fortunate that I went to dr bertagnoli. My 3 level ADR should have taken 3 hours but took 6 hours. When I asked Dr B why it took so long he said mine was a technically challenging surgery due to all the nerve decompressions that he had to do one at a time at each level. So, it was interesting that he did not go into mentioning the ADR's as being difficult to place, his answer focused on the decompression of the nerves. Though, as many here know my 3 ADR's had to come out due to staph infection, the 3 level ADR removal conversion to fusion also took 6 hours.

I wonder if you could remove the ADR's, have the doc decompress those levels and simply put them back in??

[dshobbies]

Hi cp and welcome to the forum,

I am so sorry for pain that continues to rule your life. You put your hopes and dreams into one basket and that basket broke. There has been some heated discussion on Stenum and we thought their stats had improved over the years. Thank you for sharing because this too is important information.

I believe the single most important decision in back surgery, and I suppose any surgery, is your surgeon. Good luck and I hope you find the relief you so need.

Dale

[Joe56]

I did speak with someone at Stenum and brought up these issues, first, nerve pain; it seems the nerves don't always respond or recover quickly and sometimes never do, each persons situation is unique. Too much decompression may be as risky as too little. I spoke with several cervical ADR patients and the results vary. The key seems to be don't rush to conclusions or second surgeries, give it time. Regarding the number of surgeries done at Stenum in one day. They tell me that there are other surgeons involved in the process, while Ritter-Lang is the surgeon that does the implant, a vascular surgeon is always involved and their cheif of surgery may also scrub in, They may do most of the access and closing, and Ritter-Lang may only do the implant process. His experience, thousands of ADR procedures, combined wirh an improved implantation process he was involved in developing, has shortened the ADR process, reduced blood loss and improved overall success. Still researching but this M6 looks like the best option.

[cp7959]

Thanks everyone for the support.

Maria - Do you still if have nerve pain from 2nd surgery. If not how long till it resolved.

Rob - Micro surgery is a very viable option if need be. The struggle will be the time it takes to identify the source of my irritation. Is it one level or two, left side or right, or is it complete inflammation from the disks themselves.

JKD - I have the M6

Steve - I guess I could look into removing and reinstalling ADR's if it came to that. Then you have all kinds of insurance issues. I could go to Stenum, but it wouldn't be something I would look into at this point. My gut feeling right now is if the disks have to come out, I should probably fuse, the joints may become painful.

Joe - I hope your right and time may resolve my problem.

Looks like your doing research for surgery, good luck and I hope the best for you.

[cp7959]

Joe,

In your research talking to other patients did you find nerve related problems? If so did they resolve and what kind of time did it take?

[JKDE302]

My mom had sent my MRI to stenum last week and I had already made up my mind that I want the M6 because of shock absorbtion...

Then I read this and now I dont want surgery anymore...

I even played basketball today for the first time in over a year and had a dunk in a game which is suprising because I just turned 30 years old...I have no nerve pain all the pain is in my neck because of stenosis or fibromyalgia...Thank you for posting I dont know what to do...I need to really think things over...I have manic energy for some reason today I think because I took some packet of pills my brother had called BSN Astro-Phex...

[Bill1961]

An improper decompression is one of the biggest issues with ADR surgery for success or failure. I'm not suggesting CP had an improper decompression. I just stating that if one wasn't performed it could be a problem.

JDK there are many successes and unfortunately to many failures regardless of where you get your surgery. If I where you I would get a local neurosurgeon opinion of what your problem is and their recommendation before I jump on a plane.

[New-disc]

CP,

The nerve going down my leg was compressed for 6-7 years before having surgery.

It took me over six months to feel the surgery was worth it.

(95% of my nerve pain is gone now)

I do still have flear ups from time to time.

Best of luck with your recovery!!

Todd

[fuzzy]

I am now 2 years post op lumbar surgery and it took this long for my leg pain to continually improve. This spring I had another strong relapse bout but I ramped my activity level way up this summer even at the risk of more problems with my neck and my nerve pain in my legs improved over last year. If the images show an improvement post surgery I would not rush to another surgery but give it time time time exercise activity give it time don't rush back to another surgery. Nerves take time to heal, years it seems. At least many months.

The only reason I myself now have another surgery is that I have waited years and my neck is getting steadily worse I have to take the risk. I do agree all the best surgeons have a risk. Even having read bad outcomes from Ritter Lang I would still consider to have him do a surgery as there is a reason they are still there. I do know for a fact that they have been trying to learn from past cases rather then simply go on no matter what the outcomes but to make improvements based on experience. I feel it is safe to go there unless you do have a difficult case then maybe worth to consider some one like Bertagnoli, Zeegers or even staying with a US doctor for easier or better follow up.

[Maria]

cp,
after my percutaneous discectomy that failed in '92 I had horrendous burning pain in my low back, glutes/piraformis area, quads, and calves and some burning in soles of feet tho the most intense pain was buttocks and legs and this was bilateral.

The pain was BRUTAL. It lasted nearly 5 years and started to fade. In '98 I started taking Neurontin (Gabapentin) 1800mg daily and have been on that dose since which helped greatly.

Right around '98 my low back started really caving on me and giving me horrible pain for which I had to stop working in 2000 as I was missing more work than attending and had long periods of bed ridden low back pain (4-8 weeks at a time).

Was offered a 3 level global fusion in 2001 and then various surgeries later on but it seems that sometime after starting pain medication and ESIs my pain became less pronounced and esp. the tailbone type of pain I would have seems to have pretty much vanished except with prolonged sitting.

It appears my L5S1 finally fused on it's own and I think that helped with much of my pain. Still have probs with L4 tho so all isn't completely good but I do feel the difference for the better most definately.

So it took a long time for nerve pain to calm down for me but back in the early '90's there wasn't much out there in terms of *working with it* or even investigating the pain generators/causes.

I wish you the best and not a prolonged course of pain like my own. I did however make my choices re not having several surgeries offered since 2001 including 2 level ADR and later ADR at L4 and fusion at L5S1.

Then again~ never say never re more spine surgery even tho one might wish that to be so.

[JKDE302]

Originally Posted by cp7959

My suggestion would be is to get the best surgeon possible and don't worry so much about the disk type. However if it's multi level and it's the Pro Disk with center keels, I would probably not go with that one.

I would also question getting more than 2 disks.

Good luck and pick your surgeon wiseley.

cp7959 you left this on Spinehealth.com what does that mean about keels?

[JKDE302]

Originally Posted by steve55

This makes me feel fortunate that I went to dr bertagnoli. My 3 level ADR should have taken 3 hours but took 6 hours.

Steve do you think being opened up for 6 hours is the reason you got the staff infection? just a thought...

[cp7959]

JKD myself I wouldn't use the center Keel Pro Disc that's FDA approved in the states. In a multi level configuration the keels sit right on top of each other providing a greater risk for fracture. I know the M6 keels are staggered as well as the Pro Disc Nova.

[JKDE302]

cp7975 did the surgery help with the pain in your Neck? I have to ask b/c I have terrible neck pain without nerve pain...


.

[Karger]

So I've been reading this thread now, I had a apt booked with DR ritter-lang but after doing alot of research and hearing about his muck ups I am afraid to even consider them.

Now these are very old post and I can't find any negative reviewes for him within the past few years.

Who is a good surgon that I should consider?

[Maria]

a good person to contact re other surgeons you might want to consider is mmglobal (Mark).. the contact info is on this site.

Are you looking to go specifically to Germany or would there be other countries you'd consider?

I think there are surgeons with better all around track records than Ritter-Lang but every surgeon has some failures. It just seems R-L had some major huge screw ups that just shouldn't have been (at least from what I've read).

Good luck and hope you will find the right surgeon for your situation.
Maria

[Karger]

Hi Maria,

Thanks for your response. Yes, the major screw ups scare me, and the fact that the surgery i only 45 min also scares me. It almost feels like he is treating me as an image and not a person. Due to the horror stories i am very afraid to go to him. I was thinking about staying in Germany as they seem to to be the leaders in this field. Unless I find other surgeons who are just as good.

I was looking at Dr Zeegers, I have seen some glowing reviews of him and could not find any bad press on him. He seems to be pretty honest, and caring from what i can find.

I was more looking for some suggestions form people who have had the ADR surgery and their exp and thoughts on the doc.

[Maria]

I think there are plenty of people that have had surgery with him and/or Dr. Bertagnoli and then others in other countries.


I don't know if you checked out the surgical outcome part of the forum that has some of the information about people reporting back on their surgeries. Persons that have been thru this a while back might not be checking the forum too frequently and then there are plenty of people that had surgery in the US when ADR surgery was approved/authorized for at least one level and those that paid to have more levels done cash (without insurance).

Again I'd suggest contacting mmglobal (contact info on this site) so that you might gain much more info/insight with regard to surgeons for your situation that you might want to consider and more details/info.

Good luck. I'm rather out of the loop since I stopped wanting to have more surgery at least lumbar after about 2006. Well actually I'm probably not an ADR candidate anymore nor are my current lumbar symptoms as severe at least at the time. Wishing you all the best with your information gathering and decision making stage. Maria