Pro disc surgery. Dr. Bertagnoli

[haris]

hello everyone, My name is Suad and I am from Bosnia. 50 days ago I had a surgery at Bogen, Germany L4/L5 and L5/S1 pro disc. Dr Bertagnoli performed the surgery. First Spine surgery that I had was microdiscetomia L4/L5 back in 2000. After that surgery I had no problems until 2007. MRI showed discus hernia L5/S1. My symptoms back then were as follows: I could not stand up for more then one hour, and I coud not sit down for more then half an hour. After that time I had back pain which goes down towards my both legs. I had a same feelings in the both legs, I never had "dropped" foot, and I never had problems when I had to go to toillet (I always had control over my blodder). Hoping that I will solve these problems with sitting down and standing up I underwent new surgery L5/S1 microdiscetomia. However, after that surgery my problems become worse. After surgery I could both walk and sit down less then before the surgery. After I had consultations with many doctors, I went to Bogen, Germany at dr. Bertagnoli where I had a surgery on 15 of September 2011. They implanted two pro disc at the levels L4/L5 and L5/S1. They told me that surgery was successful. Dr. F. Mayer told me that after 6 months I could continue with my sport life style. However today, 50 days after the surgery I still can't sit down for more then 10 minutes, I can't walk for more then 20 minutes. I also feel very insecure when I want to get up when sitting down. New symptoms are: My left foot is more red then the right one. My right foot hurts during my short walks. Also when I am walking and sitting down I have a feeling that my both feet are kind of burning, I feel heat in my feet. I became very scared. I feel psyhologicly very bad. I am also worried because no one from the Pro spine clinic in Bogen Germany does not reply my emails. They did reply at the begining but they do not reply any more. I am begging all members of the forum who had similar surgery to give me their experience and to help me in any way shape or form so I can feel better. Any advice is welcome. You can also write me at my personal email suad.hadzic@bihnet.ba THANK YOU ALL.

[Keano16]

Pozdrav, da li si ti isti Suad koji je bio kod nas na pregledima u Hrvatskoj kod dr. Saftica? Bilo kako bilo, zao mi je sto imate i dalje probleme. Nemojte slati e-mailove u Njemacku, najbolje Vam je zvati. Drzim fige.... Javite ako mogu kako pomoci.

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Hello, are you the Suad who visited us in Croatia (dr. Saftic)? I am sorry for your ongoing problems. I suggest you stop sending emails to Bertagnoli, and pick up the phone and call then and explain your situation. Fingers crossed... LEt me know if I can be of any help.

[dshobbies]

Hi Haris and welcome,

I too had surgery with Dr. B and sustained nerve damage as a result. It does sound like some of your pain is nerve related but not being able to sit? doesn't sound right.

If they have stopped returning your emails, I back up Keano's suggestion. Call them and don't stop pestering them for answers.

Are you under the care of a follow up surgeon where you live? If not, you should look for someone who can also help.

Good luck, Dale

[mmglobal]

Suad, I'm so sorry that you find yourself in this situation.

The current symptom, not being able to sit; is this the same as before the ADR surgery or is this new?

Perhaps the problem is not in the discs??? I have seen people with SI (sacroiliac) joint dysfunction that causes such symptoms.

Some times during anterior spine surgery, the sympathetic nerve chain is disrupted causing the discoloration of the foot and temperature or sweat issues. My wife had 'warm leg' following her ADR surgery, but for her, this was not a serious symptom and is a complete non-issue.

Again, I'm so sorry that you have not realized improvement from your surgery. It can improve still.

Regarding your feeling 'psycologically very bad', can you get some help for that? In the US, the very easily prescribe antidepressant drugs that can help. I don't know what your access may be in Bosnia.

Good luck.

Mark

[ADR seeker]

I suspect that Bertognali or maybe I read it is a POD Physician Owned Distributor of spine hardware. Please correct me if I am wrong.

I also think (correct me) that ProDisc is a Johnson & Johnson product that has been a disaster. I think J&J bought the company Synthis that developed the disk.



The FDA approved the ProDisk-L that alone makes me wary.

The disk is a ball and socket. There are many problems with a ball and socket design. It will be the first spinal segment to move and it will move further than it should. That will cause a myriad of problems. IMO the best disk is one that acts like a real disk. Currently the only lumbar disk that acts like the real thing is the M6 made in Sunnyvale CA by a small company called Spinal Kenetics.



What is going to stop a segment from rotating too far? Think about it.

I am not a mechanical engineer but common sense tells me that when you repair a machine you need to use the correct part. We can theorize and discuss the many possible factors but we and most surgeons would be guessing.

Maybe a motion X ray would show what is going wrong. I suspect that due to over rotation nerves are being pinched but that is a guess. The implant may have migrated or Dr B was sloppy. I hear that he is. An Xray would show that.

[mmglobal]

J & J have nothing to do with ProDisc.

Suggesting that an individual case like this has to do with the design of the disc seems silly to me. I know hundreds of successful ProDisc patients. I know many failures of all device types. The ProDisc does not have a failure rate that is substantially different than the others.

I have never seen sloppy work from Dr. Bertagnoli. I have hundreds of clients who have been to him, and hundreds more that have been elsewhere. His output is uniformly excellent. Sadly, all spine surgeries come with substantial chance of failure. Unnecessary failures come from technical issues related to incorrect implantation. More unnecessary failures come from failed diagnoses that might have been avoided with more appropriate patient selection. There will still be a substantial percentage of failures that we don't understand. Many of the surgeons I now suspect that many or most of these failures would have failed regardless of the implant or type of surgery. I believe that is true. I have seen so many unexplained failed spine surgeries of all types.

Gotta go now... more later.

[ADR seeker]

Originally Posted by mmglobal

J & J have nothing to do with ProDisc.

Suggesting that an individual case like this has to do with the design of the disc seems silly to me. I know hundreds of successful ProDisc patients. I know many failures of all device types. The ProDisc does not have a failure rate that is substantially different than the others.

I have never seen sloppy work from Dr. Bertagnoli. I have hundreds of clients who have been to him, and hundreds more that have been elsewhere. His output is uniformly excellent. Sadly, all spine surgeries come with substantial chance of failure. Unnecessary failures come from technical issues related to incorrect implantation. More unnecessary failures come from failed diagnoses that might have been avoided with more appropriate patient selection. There will still be a substantial percentage of failures that we don't understand. Many of the surgeons I now suspect that many or most of these failures would have failed regardless of the implant or type of surgery. I believe that is true. I have seen so many unexplained failed spine surgeries of all types.

Gotta go now... more later.

No two spines are alike. I am not just talking about the bones. The muscles, tendons and ligaments may be different. Some spines can compensate for fusions and ADRs and in the case of chronic over rotation hyper extension and hyper flexion in some spines nerves will get pinched, tendons and ligaments will be stretched and instability will occur. It is and it isn't rocket science. The fact that "they" can look at diagnostic studies and not see why something is failing tells me that they have a lot to learn. I apply commonsense. If the spine was working properly before there was a disk problem then there is a good chance that if the disk were to become normal the problem would go away. If a ball and socket were the best way do provide articulation for a spinal joint that is how God/Nature/Evolution would have made all the spine of the invertebrates. What we have is a flexible spacer that modulates movement and works in concert with all the other joints so that there is an even regulated articulation in all 6 axis.

IMO, based on commonsense, replacing a disk with a ball and socket is asking for trouble. I would ask surgeons why they would use what seems to me a Frankenstein when a virtual disk...the M6 is available. Simply put, why is a non shock absorbing disk that is unable to modulate motion better for me and my spine than a disk that acts like the real thing. If Dr B is reading this I would love to hear him explain it. He certainly did not explain it to Saud.

So Dr B if you happen to read this can you explain why you put to ball and sockets into this patient and can you explain why you are ignoring him?

Put another way, in your best medical judgement please justify the use of a B&S style ProDisc when the M6 was available.

I don't know the condition of this patient's spine pre or post surgery but you do Dr B. That being said can you explain under what conditions a ball and socket ProDisk is a better choice than the M6?

[Rob Wilson]

ADR Seeker - I totally agree with you that the ball and socket does not mimic what God gave us. However, when I was deciding which disc to get, it mad sense that the simple 2 piece all steel disc seemed the best choice to last without issues. I have the Maverick and I am sure it puts extra strain on my body vs. the M6. However, the M6 has many different parts and materials. More for there to go wrong in the M6? See below story of a Mobi disc that attempts to mimic the human disc but has had issues.

LDR Mobidisc

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In 2005 my husband had single level ADR (L5/S1) at Alpha Klinik w/ Dr. Zeegers. An LDR Mobidisc was used. The surgery was successful at the time. Early this year, Tommy began to have severe, debilitating pain in his back. After MRIs, CT scans, and Xrays we found the problem. LDR used a titanium pin as a "marker" for the polyethylene core of the Mobidisc. That pin has become dislodged and is sticking Tommy in the back every time he moves. LDR has tried to shift the blame to Zeegers stating that Dr Z put the disc in backwards. But regardless, the pin should never have come out of the core. None of the doctors in Dallas will help due to liability issues. Oddly, earlier this year we sent Tommy's Xrays and MRIs to Dr Zeegers who never mentioned the pin sticking out of the disc into Tommy's back until we called him to say we found the problem. When we told him what we found, he said yes he had seen that too but did not believe it was the source of pain. The new discogram says that 100% of Tommy's pain in coming from L5/S1. Tommy is in horrible pain and very depressed. Tommy is not the first Mobidisc recipient to have this issue. - there are 12. I adore Dr Zeegers but think it is odd he didn't mention the pin. And, I have asked LDR to provide contact info for the surgeons who had the same problem and they continue to be evasive. What do you think we should do????

[ADR seeker]

The Neo Disk is the simplest motion modulating shock absorbing disk. It makes the most sense to me. I suspect that the M6 and the Neo Disk are more durable than the ball and socket designs that use nylon bushing or metal on metal.

[Maria]

Back to you Suad vs. which disc is better ...

Have you contacted a doctor and been seen for the complaints you currently have? I do hope so. I would urge you to be seen sooner than later so that hopefully you can get a diagnosis and also treatment plan and some relief from the discomforts/pain that you are experiencing.

As Mark stated sometimes spine surgeries just don't work out the way they were intended no matter how well everything is done. I would not bother yourself with the negativity of wondering if the right disc was used or not rather just finding out what is going on now and how to make things better.

I believe while churning out negative feelings our bodies respond to this with muscular tension and creating more pain so please as best you are able try to not let the negativity get you totally down and try to move forward with your care even if you aren't getting a response from Dr.B. See someone if you've not already. Please let us know how you're doing if you've time.

[Aaron]

The statement that God made our bodies the best design they could be. I am an engineer and from an biological standpoint the body is an amazing piece of work but from an engineering standpoint the body is an flawed design, when it works it works great, but one flaw can break the entire chain, one injury can have a domino effect. As engineers you design things with safety factors and secondary protection factors that protect things in the event of a small failure, the body often does not have the ability to do that. First of all just the act of making us upright beings causes an enormous amount of stress on the body. And evolution/nature often takes millions of years to perfect a design.

[mmglobal]

Maybe our bodies were only designed to last until we were expected to die... say 30-40 years?