Back Institute Ditsworth,Atlantic Back Liu

[MB123]

Hi All,
I've been a lurking around the site on and off for some time and this is my first post.
After reading many of your posts I feel fortunate that at a this time from what the doctors tell me I only need a lumbar discectomy for a HNP @ L5 S1( knock on wood).

Like most, my current state was proceeded with chronic LBP which eventually lead to a HNP in 2005. I was to scared to undergo any spinal surgery or injections and did nothing but chiro and PT. It left me with numbness of my left foot and perminent weakness of my calf. 3 months ago I reinjured my back and the numbness and weakness has significantly increased and am lossing my push off when I walk.

I've seen 3 highly respected docs in NY 2 orthopods and 1 neuro surgeons all of which want to perform the laminectomy discectomy proceedure all of which they propose is minimally invasive.
I am trying to avoid that traumatic approach and would prefer a full endoscopic discectomy.

I have consulted with Dr. K. Liu from Atlantic Spine Institute in NJ and recently with Dr David Ditsworth of Back institute in CA. Both consider me a good candidate. But considering I have a significant herniation and migrated fragment I wonder if this proceedure can gain access to and remove the inferiorly migrated fragment and result in this miracle cure they propose. I am also considering consulting Dr. A. Yeung as well
Doing nothing the first time left me with permanent weakness and here I am again in the same situation only worse and still having a difficult time making a decision.
Any personal experiences, outcomes , recommendations or general thoughts regarding those mentioned would be greatly appreciated

Wishing everyone good luck and future health

Thanks
Mitch

[mmglobal]

It sounds like you are going through a discovery process similar to what we did for my wife in 2007. She had a large, centrally located disc herniation at L5-S1 that was too difficult for many of the most experienced endoscopic surgeons around. She was 50 and never had the slightest hint of a back problem until suddenly having significant LBP followed days later with leg pain and numbness.

She had an MRI on a wednesday and by Thursday night I had spoken to 1/2 dozen of the world's leading surgeons... all saying that it behooves us to go with a discectomy for her first surgery. About a week later, I got a call from Bertagnoli. He had been reviewing her films again and was changing his opinion. He said that because her disc was compromised in nearly every sagittal slice, "the disc will not survive". This was one of the few cases like this in which he'd recommending going straight to ADR.

Even though his is one of the very few opinions we respect the most, we believe that with spine surgery, less is better and still elected to have an endoscopic discectomy with Tom Hoogland, then at the AlphaKlinik. He did a wonderful job and Diane recovered very nicely. She was up and around the same day, enjoying Munich in the days that followed. I worked the following week then we did several days in Prague. Hoogland's work was perfect and she was great for 3 months. Then she started having leg pain on the other side. Onset was May 2007, surgery in July, then went bad in October. In March 2008, she had ADR and is still doing well, working full time as an RN (in an office, not on a surgical floor as she feels it's too risky for a spiney.)

Her case really showed me something about the decision making process. A more critical eye towards the condition of the disc may yield a more appropriate decision. We all understand that less is better. I'll bet that the same discovery process with the same situation as Diane's will generate 99% of opinions for discectomy. In retrospect, it would have been nice to have avoided the costs (physical, time, financial...) of the first surgery. I'm not sure how we would decide again, because ADR is a big step that should be avoided if possible. But, I would definitely consider the overall condition of the disc and other factors.

Let me know if you'd like to discuss this in more detail. Good luck! Welcome to the forum... I'm sorry that you find yourself in this situation. All the best,

Mark

[MB123]

Hi Mark,
Regarding your wife going straight to the ADR you know what they say hind site is 20/20. Glad to here your wife had a good outcome.
I'm really getting frustated with myself and the decision making process. I ask myself how many consultations will be enough?
I feel like just biting the bullet, getting it over with doing the tried and true laminectomy /discectomy but am still hopefull I can find a doc I am confident in to perform a full mini endoscopic discectomy.
I'm still hoping that less is more and have sent my films to a pain Doc in N.J. Jasper.
I've heard the name Bitan mentioned several times with good outcomes but I believe he specilizes in more structural deformities/ scoliosis, disc replacement and fusions and dont believe that endoscopic is his expertise. Interesting enough he practices out of Atlantic Spine in NJ along with Dr. Liu who I went to see for consulation before having my MRI. I wonder if the Dr. Batin association increases the credibility of Dr. Liu who I liked and specializes in endoscopic but unfortunately I haven't herd any recommendations or outcomes other than those on his web site.
Any insite into any of those mentioned or others would be appreciated.
Feel free to send me a PM if more appropriate

Thanks for the reply
Mitch

[mmglobal]

Mitch, just about a week ago, a client of mine had a new style of lumbar decompression surgery (after ADR at the same level) that seems to have gone very well. It's an open surgery, but does not come with the typical removal of bone from the facets in order to gain access to the canal area. I can't write more... too much on my plate. Contact me via PM or messages from the GPN website and I'll put you in touch with him. He's an engineer and loves to discuss the intricacies of these procedures and technologies.

All the best,

Mark