tegilmen L3-S1 3-level ProDisc Aug. 2003

[mmglobal]

Originally Posted by Original Post Sept 8, 2003

SURGERY DATE: August 25, 2003

SURGEON: Dr. Rudolf Bertagnoli

SURGERY LOCATION/CLINIC: Straubing, Germany/St. Elisabeth hospital

LEVEL(s): L3-L4-L5

COST =
AMOUNT BILLED:28,560 Euros
INSURANCE ALLOWED: Not available yet
OUT OF POCKET:
TRAVEL: $2200
EXPLANATIONS?

ONSET OF LUMBAR PROBLEMS, DATE OF INJURY, CAUSE, ETC...: My back has been giving me problems for over ten years. The DDD set in three years ago. My MRI for Nov. 2000 showed a normal spine, with slight dessication at L4-L5. Things have gone downhill since then. I have not had any trauma to my spine to cause the rapid progression of the DDD.

PRIOR SPINE SURGERIES AND PROCEDURES (IDET, ESI, etc...): None

PRE-OP MEDICATIONS: OxyIR 40 mg/day; Topamax 200 mg/day; and Skelaxin as needed.

PRI-OP DIAGNOSTICS (discogram, nerve root blocks, etc...): My only discogram was done on October 4, 2002. It showed L5 as totally deranged, L4 was also deranged, and L3 had 2 annular tears. All three discs had concordant pain. I had an EMG in Jan. 2003, which revealed no nerve damage.

PRE-OP NEUROPATHIES: I had bilateral leg pain that hampered my ability to concentrate it was so bad. When I was put on Topamax, it took care of my leg pain.

PRE-OP CONDITION: I had 90% back pain once the Topamax kicked in. My back pain was manageable with the OxyIR and activity modification. At rest, my LBP was rated at 5. Most physical activities caused my pain level to shoot up. So, my life was not very full because I could not do the things that I enjoyed: gardening, yard work, roller blading, museum visits, etc.

I dealt with excruciating back pain whenever I slept because I could not always control my movements. Twisting was a very bad motion for me.
The stenosis had an effect in my sensation awareness for when I had to use the toilet.

I was able to work full time as a consultant. This was a real drain on my energy and I was useless at the end of the day. My desk job allowed me to move around as I needed.

TIME POST-OP AT ORIGINAL POST HERE: 2 weeks

DESCRIBE YOUR SURGICAL EXPERIENCE: The staff at St. Elisabeth are very nice and easy to get along with. I stayed in the advanced surgery ward and had consistent care immediately after surgery. The nurses would turn me over and rub my back with this soothing lotion during the days when I had not been able to get out of bed.

St. Elisabeth has their own protocol as to when a patient can get out of bed after ADR. I was not allowed to sit up on the day of surgery. I don't know that it mattered because I could not find a comfortable position. I was in so much pain, even with the PCA.

I had a discogram right before my surgery to confirm the levels that would be replaced. Originally, I was to have the discogram on the 25th and the ADR on the following day. Once out of surgery, I was on my way to recovery. I had very little abdominal pain. With the PCA, my pain level was an 8. This new pain was post-op pain and did not resemble my original pain. I woke up without any leg pain.

My one negative experience has to do with the pain medications that they administered. Once the PCA was removed on post-op day 3, they did not have me scheduled for any analgesics. Instead, they put me on 25 mg of Diflucan three times a day. I went into withdrawals on top of all the pain. Once I explained to them that I was going through withdrawals and that I was taking 50 mg of Oxycodone, they put me on Oxygesic, which I have since learned is Oxycontin. The 60 mg of Oxycontin put me at a pain level of 7. They also wanted me to use my medication that I had bought along with me.

RATE FUNCTIONALITY / SATISFACTION AT INTERVALS BELOW:

FUNCTIONALITY:
1. Very poor: much worse... disabled after surgery.
2. Poor: worse after surgery.
3. Neutral: No improvement, or improvements offset by new problems.
4. Fair, some improvment, limitations are still serious.
5. Good, substantial improvement, some limitations.
6. Excellent: no limitations.

SATISFACTION:
1. Very sorry I had the surgery.
2. Somewhat sorry I had the surgery.
3. Too soon to tell, or I'm ambivalent about the surgery.
4. I'm somewhat glad I did my surgery.
5. I'm very glad I did my surgery.

FUNCTIONALITY: 4 SATISFACTION: 5 [6 WEEKS POST-OP]

FUNCTIONALITY: 5 SATISFACTION: 5 [3 MONTHS POST-OP]

FUNCTIONALITY: 4 SATISFACTION: 5 [6 MONTHS POST-OP]

FUNCTIONALITY: 5 SATISFACTION: 6[1 YEAR POST-OP]
Explanation of decreased functionality below.
2-15-04: I am waiting to Hear from Dr. Bertagnoli and Dr. Fenk-Mayer regarding my CT Scans that I sent to them. I am experiencing progressively wore right thigh pain whenever I lay on my side. The pain is very sharp and radiates to my righ hip. I also experience right thigh pain whenever I climb stairs. I have lost my balance because my right leg was too weak and painful.
8-7-04: It has since been confirmed that I have facet arthritis. I have had the facet blocks done and the CT scans schow the arthritis. Considering how much I have gained from this ADR surgery, I consider it a total success. I have much more functionality of my spine and I don't walk so slow and deliberately, like I used to. I have a t-spine MRI pending because of ongoing symptoms. I will post any significant results.

FUNCTIONALITY: ___ SATISFACTION: ___ [2 YEARS POST-OP]

Thelma

I spoke to Thelma a few weeks ago too... update coming soon!