New Member: Cervical ADR 2 / 3 level

[LauraMary]

Hi, I have been perusing through your forum trying to glean information about surgeons, ADR devices, and surgical outcomes in hope of affirming my most recent decision to have ADR surgery at 2 (possibly 3) cervical levels.

In 2006, I had C5/6 discectomy and fusion (anterior). In 2008, after a car accident, I began having symptoms of burning between my shoulder blades, arm pain, shakes and tremors, tingling, and horrific migraines along with neck pain. So be it, I returned to have further diagnostic tests; only to find that I had damaged discs both above and DDD below my fusion. US doctors only suggested multi-level fusion (insurance dictated), and I decided to abstain.

Well after five years, I finally digressed and was ready to fuse when I learned about ADR as an alternative. After doing much research regarding physicians, I had narrowed my physician search down to Dr. Bertagnoli (ProSpine, Straubing, Germany) or Dr. Bierstedt (Hattingen, Germany). I feel both surgeons had vast experience with multi-level and would be a good choice either way. The difference is the use of ADR device. Dr. Bertagnoli suggests the PRO DISC C Nova while Dr. Bierstedt recommends the M6.

At this point, I had made a preliminary decision to see Dr. Bertagnoli (ProSpine). I am nervous about the choice of ADR. I have been hearing both positive and negative outcomes pertaining to "keeled" devices, and the possibility of resurgery. Help me out here. I am not an engineer, but I want to make the most informed decision. Most surgeons have a personal stake in their device. The M6 (being new) seems to have a flood of great responses - but again....not sure?????

[mmglobal]

IMHO, properly implanted in a properly selected patient, any of the current crop of ADR's will likely be a success. The opposite is also true... improperly implanted or in an improperly selected patient, any will fail.

Because of what what I've seen in handling over 1,000 cases now, I have been converted to a 'stationary core' guy. There are trade offs with all the significant features of all the devices, but I've seen too many 'mobile core' problems and the impact of these issues are magnified and complicated in multi-level procedures.

Also, in my travels, I've also seen more m6's needing to be removed than I have of any of the other discs. This is remarkable because the number of m6 cases is small compared to the others. Having said that, I don't lay that on the doorstep of the device, most of the explant revisions I know of are not device issues, but either implantation errors or unique complications related to other health issues of the patient.

There are also trade offs between the maturity of or the experience with the designs and materials providing a huge unknown.

Just my 2 cents, but I'll reiterate... properly implanted in a properly selected patient (this is quite a large caveat!), they are all good.

[LauraMary]

Thank you for responding. I agree with you that the effectiveness and success of the device largely depends upon the physiology of the patient and expertise of the surgeon. I am running every possible test while waiting for my surgery (9/24/13) so that I can insure as much possibility for a successful implementation as possible; i.e. metal allergy, bone density, etc. At least it keeps me proactive while I'm anxiously waiting. Dr. Bertagnoli's office did a great job addressing my concerns and answering my inquiries. I feel more confident about my choice. It seems that there is a lot to be concerned about with mobile devices and hope that their longevity outlives me. For me, fusion wasn't the answer. I'm such an active person that the chances of reinjury, subsequent DDD, herniation, disc bulges, are too likely.

I haven't read about recent patients (past year) that have seen Dr. Bertagnoli. If there are (and I just can't locate), please redirect. I am always interested in hearing others opinions and experiences. Otherwise, I anticipate posting my positive experience 8 weeks from today.