L5S1 Revsion on Subsided Disc; need advice

jamie5136 · #1 (**permalink**) 02-21-2010, 03:01 PM

After all of my opinions and finding out a bone density was not done on my spine prior to my three level ADR with the Pro-Disc L in Germany with Dr. Bertagnoli, I have had a few doctors say in order for a full fusion to take place, the disc must come out and then the others say leave it in to fuse it, but, I have not heard one good story with this configuration. My level is L5S1, so the entry is easier and the disc is severely subsided (not sure if it is the cause of my sitting/laying/leg pain) so, indeed it would be ideal to do it this way, but I have also heard good/bad about this from not fusing to cutting veins, but again, mine is the lowest level and not close to the great vein.... Dr. B said to "start" with a a fusion over the ADR and "if" that does not work, then do an anterior approach, but from what I understand, if the posterior is a failure, trying to go in and remove the posterior hardware again to put a new system in and trying to remove a perhaps partially fused disc, is MUCH harder. I have friends in Germany/Norway where they have their own forums, such as this, and I have heard many failure stories of fusing on top of a failed ADR. Does anyone have any experience with this or know anyone? Also, if I do choose an extraction doctor, I know of only a couple, Dr. Leary and Dr. Regan. One is young and supposedly good, but has never removed a sunken pro-disc and one has a bit of a reputation. Ideas? I need to do something soon, but am super afraid I will end up worse than I am now. Finding someone thorough and kind would be nice.

I have a friend who did some Fibrin sealant with success, but that is more of a patch job, but she had success with it. So, minimally invasive is the best.

Thanks!

Mark has been very helpful on this journey, but real life experience would help! I live in Dallas, but would travel anywhere in the USA... just not out of the country. I can't afford it anymore after the first surgery.

Ideas?

dshobbies · #2 (**permalink**) 02-21-2010, 07:08 PM

Jamie,

I'm really sorry for your circumstances. While I have no experience with revision surgery post ADR, my own little voice says to remove the disc before fusing. I know nothing about Dr. Leary but Dr. Regan has excellent hands and experience, which is what you need. You're not looking for a friend so any 'reputation' you might have heard about should not be too much of a consideration. We all want a doctor to pat our knee saying everything will be just fine but given a choice between expertise or that pat on the knee, choose expertise.

Again, Mark can help you with a consultation with Dr. R is you decide to go that route.

Good luck, Dale

jamie5136 · #3 (**permalink**) 02-22-2010, 02:37 AM

I guess after a few failed stories about Regan and his bad rating on all the rate md sites, I fear him, but all the doctors that are alternatives, trained under Regan, so yes, that does say something. It is just that I have a few friends who had surgery by him with bad luck and I hate to hear that... now granted, what they had done is different than what I need, but still a failure is a failure... and yes, I hear he can be untruthful and disrespectful, but again, I have never spoken to him, but I am going to California soon to visit about 3-4 doctors about removal. Yes, leaving in does not sound good to me. I can't envision a full fusion taking place around a subsided discs.... I will probably see Regan as well... might as well if I am in Cally. I wish TBI could remove and fuse, but they don't like failed patients from over-seas... they are five minutes away. I also hope I have no insurance issues. My three level Germany trip left me broke and of course now with massive back pain and leg pain.... argghhhh... Yes, Mark is trying to help and is being patient, which I appreciate.. I am not an easy one to deal with all the time. I ask alot of questions....but, IMHO, you can't ask too many. I did not ask enough before Germany. I should have. Thanks!!!!

Quote:

Originally Posted by dshobbies

Jamie,

I'm really sorry for your circumstances. While I have no experience with revision surgery post ADR, my own little voice says to remove the disc before fusing. I know nothing about Dr. Leary but Dr. Regan has excellent hands and experience, which is what you need. You're not looking for a friend so any 'reputation' you might have heard about should not be too much of a consideration. We all want a doctor to pat our knee saying everything will be just fine but given a choice between expertise or that pat on the knee, choose expertise.

Again, Mark can help you with a consultation with Dr. R is you decide to go that route.

Good luck, Dale

Maria · #4 (**permalink**) 02-25-2010, 03:01 PM

I think you should see Regan while out here in CA. I've mentioned before he was a consult for me and I really had a good visit with him where upon he answered far more questions than did the surgeon that I had originally pushed WC to authorize my surgery (still an excellent surgeon just don't care much for his personality and the way the office is run). That's another thing.. Dr.Regan's office staff was truly nice.

There are always failures in spine surgery and I'm one as well. I too didn't ask enough questions for my 2nd surgery and lived to regret the fact I had it but it's been long ago still left me scared to have more surgery no matter how many surgeons gave an opinion to have surgery and there must have been at least 6 that all concurred on the same surgery.

You are so right about your surgery being different as well as you being different when it comes to what you need and how your body will respond as well as skill in surgical technique with prescribed surgery.

Wishing you the best with your consultations out here in CA.

jamie5136 · #5 (**permalink**) 02-27-2010, 05:24 PM

Yes, I think i will go see Regan.... I will try to look past what has been done and see what he says about my case.

Quote:

Originally Posted by Maria

I think you should see Regan while out here in CA. I've mentioned before he was a consult for me and I really had a good visit with him where upon he answered far more questions than did the surgeon that I had originally pushed WC to authorize my surgery (still an excellent surgeon just don't care much for his personality and the way the office is run). That's another thing.. Dr.Regan's office staff was truly nice.

There are always failures in spine surgery and I'm one as well. I too didn't ask enough questions for my 2nd surgery and lived to regret the fact I had it but it's been long ago still left me scared to have more surgery no matter how many surgeons gave an opinion to have surgery and there must have been at least 6 that all concurred on the same surgery.

You are so right about your surgery being different as well as you being different when it comes to what you need and how your body will respond as well as skill in surgical technique with prescribed surgery.

Wishing you the best with your consultations out here in CA.

grantwb1 · #6 (**permalink**) 02-27-2010, 10:25 PM

I think what needs to be said is that some surgeons are in it for their record and when they see something that they could fail on they find a way out of it cause they do not want a failure on their record. Spine surgery is already tough odds. Then there are surgeons that don't care about their record and really want to help and look at it as a challenge and truly are trying to help the patient. Where this is just two scenarios of possibly millions of personality types of surgeons my point is in my dealings with and my knowledge of Regan (he was going to do my surgery until a major financial change at the last second) is that he has and will deal with these really complex spinal surgeries. I researched him a lot. He also has a ton of experience dealing with all different types of devices and situations.

I really wish the best for you Jamie, I just had my second spine surgery with hardware removal and fusion. I spent a year here in southern California seeing a bunch of the really big name surgeons before choosing Dr. Coufal so if you have any questions you would like to ask fire away via PM or this post.

Minnesota · #7 (**permalink**) 02-28-2010, 07:03 AM

Hi, could you please define subside.....did the disc fail or has the vertebrae failed? I am wanting to understand as I am in need of some sort of surgery due to advanced disc degeneration at multiple levels in both the lumbar and cervical. Subside by definition means to sink?

ans · #8 (**permalink**) 02-28-2010, 09:14 AM

Unfortunately, you need a doctor who does heroic surgeries. I would trust Regan in your challenging surgery as I think for revisions, he's the best. But this is my opinion. Maybe Dr. Pimenta has more experience; I think that he is in Brazil. My very best - ans

jamie5136 · #9 (**permalink**) 03-04-2010, 01:07 AM

Yes, my case is complex and the pain in my legs is worsening....heavy legs... I just want the disc out and Regan could do it, but yes, finances could be an issue and Dr. B already took my life savings, so we will see. I called Dr. Coufal, but he would fuse the disc in and I am not sure about that. They seem nice though.

Quote:

Originally Posted by grantwb1

I think what needs to be said is that some surgeons are in it for their record and when they see something that they could fail on they find a way out of it cause they do not want a failure on their record. Spine surgery is already tough odds. Then there are surgeons that don't care about their record and really want to help and look at it as a challenge and truly are trying to help the patient. Where this is just two scenarios of possibly millions of personality types of surgeons my point is in my dealings with and my knowledge of Regan (he was going to do my surgery until a major financial change at the last second) is that he has and will deal with these really complex spinal surgeries. I researched him a lot. He also has a ton of experience dealing with all different types of devices and situations.

I really wish the best for you Jamie, I just had my second spine surgery with hardware removal and fusion. I spent a year here in southern California seeing a bunch of the really big name surgeons before choosing Dr. Coufal so if you have any questions you would like to ask fire away via PM or this post.

jamie5136 · #10 (**permalink**) 03-04-2010, 01:09 AM

Well, basically the disc sinks downwards or upwards into your bones. Could be from an infection, wrong size disc, osteoporosis... etc. etc. Mine is not bacteria and Dr. B did not do a bone density on my spine, so softer bones could be an issue or maybe the disc was the wrong size. At this point, I don't know and I am sure there are other reasons.

Quote:

Originally Posted by Minnesota

Hi, could you please define subside.....did the disc fail or has the vertebrae failed? I am wanting to understand as I am in need of some sort of surgery due to advanced disc degeneration at multiple levels in both the lumbar and cervical. Subside by definition means to sink?

jamie5136 · #11 (**permalink**) 03-04-2010, 01:10 AM

I have been talking to Pimenta and he said he could do in Mexico, but I don't get solid communication with him... it is on/off. I sent my discs to Regan. My advocate wants me to see Scott Leary, but I am unsure of his experience.

Quote:

Originally Posted by ans

Unfortunately, you need a doctor who does heroic surgeries. I would trust Regan in your challenging surgery as I think for revisions, he's the best. But this is my opinion. Maybe Dr. Pimenta has more experience; I think that he is in Brazil. My very best - ans