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3 level ADR -Prodisc C- new Nova Model-C4/5,C5/6,C6/7

steve55ssteve55 Posts: 86
edited 10/19/2013 - 8:13 PM in Back Surgery and Neck Surgery
WOW! It seems Im perhaps the first patient on these message boards to have gotten the new Prodisc -Nova model. As posted my Mark at I spine, below is a brief description of the new Nova prodisc

"They changed the keel configuration to minimize the risk of adjacent keels in multi-level procedures becoming 'stress risers'. Instead of central keels on both the upper and lower plates, the new Nova version has a central keel on the upper plate and 2 smaller keels on the lower plate.
Most importantly, the new Nova is MRI compatible because instead of the metal components are primarily titanium instead of cobalt chrome. Titanium does not have the durability of cobalt chrome, so Synthes did it right and retained the cobalt chrome where it's needed. The wear partner in the joint are still UHMW Polyethylene and cobalt chrome, while the major portion of the metal is titanium to make the prosthesis much, much more MRI compatible."

Anyways, I had originally submitted my films to Dr B's team in Germany on Thursday 2/12 and my prognosis/surgical recommendation came back on Sunday 2/15 with a assigned surgery date of 2/26. It all happened very fast!! (thank God! Besides being in severe pain, my Aetna expired 2 days later on a Saturday 2/28!! I made it by 1 day!! I can now appeal for reimbursement of a multi level ADR)

I was originally scheduled for a 2 level but as my discogram done here in the US indicated that the C4/5 had a tear (but produced no pain at the time), Dr B was suspicious that it might be a bad disc also. He said he wanted to take a look at it interoperatively and asked me how I felt about replacing it also it it looks bad. I advised him to replace it if it looked bad as I really didnt want to have to return for another expensive surgery a year or two later. So, he did a discogram while he had me cut open and he witnessed the dye material leaking into the spinal channel and so he replaced it. Apparently the discogram done in the US showed it just had some tears but didnt cause pain. This is why Dr Z was only reccomending a 2 level. The day before, Mike(known as pizza man on this board? ) was supposed to get 4 levels done but Dr B said he only needed 3. So, this is good to know that DR B simply calls it as he sees it. Ive heard he is actually quite conservative about suggesting additional ADR's.

As it turned out, Surgery went well but I was really in alot of pain and discomfort for the first 24 hours. No matter what body/head position I layed in, I could not find a comfortable position to lay in. I was constantly turning and churning every 3 seconds trying to escape the agony. My heart was racing and a sort of panic started taking me over. The german patient I shared my room with spoke some english and he asked me if I was ok. I told him, "No, I think Im in shock". LOL. But I think I really was. Its AGoNY not being able to get comfortable and I started to panic. They gave me more pain killer and some valium and it did the trick. 4 days later I checked out of the hospital and pain level was only about a 4 (on a scale of 1-10). But it seemed to get worse during my week long stay at the hotel in Straumbing, oftentimes the pain level was more like 6 at times. I couldnt hardly go walk anywhere for more than 20 minutes (like going to eat) without having bad pain and having to lay down again. Some days it was agony just sitting at the dinner table with my friend. Even the smallest head movements could send pinched nerve sensations through my neck. I spent a week just laying in bed day and night. I could not sleep for more than an hour or two at a time so I just got whatever sleep I could get in small doses. But overall It wasnt too bad I guess.

The post op pain I have been referring to above and currently having now is only from about the a few inches below shoulder level on up, due to muscle stretching that occurs during surgery. The SEVERE old DULL pain between my shoulder blades and my below the waste symptoms are all gone!! I could feel that from day one after surgery! But one thing that still frustrates me is how badly the US doctors "missed" the call on my below the waste symptoms. In some ways these US doctors dont seem to know squat! I had gotten several second opinions from 2 well known top rated surgeons, one orthopedic and the other a neurologist. One sent me to a urologist for gods sake, I knew it was a waste of time but I did it anyways just to prove to him it wasnt anything related to a seperate urology issue. The US doctors kept telling me that it was "IMPOSSIBLE" that my below the waste symptoms were related to my cervical spine issues. They said so because the spinal cord doesnt go down that far. However, to his credit, my 3rd opinion, from Dr Z, was the only "US" doctor who said it was a possibility". Of course, as I suspsected, Dr B said it was not at all uncommon to have cervical patients have below the waste symptoms and he sees that quite often and that he expected mine to clear up with this surgery. And he was correct as it did resolve after the surgery. IMHO, these US doctors still have a long ways to to go to get to the level of EXPERTISE of the german doctors.

My 3 level surgery should have taken about 3 hours but Dr B says it took 6 hours because in his own exact words, ....my case was "technically complicated and challenging". He further stated "We had to do alot of remodeling and restructuring". He went on to explain that he checks every single nerve at each level to make sure there are no other compressions occuring. In my case it sounds like locating each individual nerve at every level was a bit tough and then he had to further decompress some of those nerves further ,....I guess that besides the bulging discs compressing the nerves, I probably had bone spurs and other structures that were pressuring my nerves that he had to "restructure" , or perhaps shave away some bone spurs to uncompress them. Im not exactly sure of the precise details but this is basically what I understood him to basically say. I do recall reading "stenosis" in my MRI reports, so yea, maybe he cut away some bony out growths or stuff like that? He sure went all the way for me by doing a 6 hour surgery. At our post op consultation, I looked him in the eye and gave him a heart felt "Thank you" for spending all that time on getting me done right, to which he replied "it was my pleasure". Ive heard (though dont know if its true or not) that not all doctors will spend that much time and go quite that far as they have other patients waiting for surgery behind you. Ive heard that many surgeons will just put in the discs and fix any obvious compression issues and not really get too involved in looking at every single nerve and check for any further deconpressions that might need doing. I know that in my case, this is what made my surgery a 6 hour surgery. My surgeon said "steve, I am never in a hurry when I do my surgeries. Some 3 level adr patients take 3 hours while others take up to 6 hours like yours". I wonder if there is any truth to the idea that not all surgeons are equal when it comes to the amount of time they are willing to go into in checking every single nerve and other details etc when doing a ADR?? Just curious.

Anyways, if I had done the 2 level here in the US with Dr Z, I bet we'd have never discovered the 3rd faulty level. Dr Z was just going off the discogram and saw that only 2 levels were causing pain. I really love dr B's approach. He visited at least 3 times in my patient room. It was real nice to be laying in the hospital bed watching TV and to have him just swing on by from time to time discussing things with me. Of course, the final meeting was more formal in his office and we had our picture taken together and he asked me if I was interested in serving as a reference for other patients which I am very happy to do. As we got up to leave, he again restated how much he is worried for patients who are getting multi level fusions here in the US. He seems to think that the risk of fusion gets exceedingly riskier the more levels that get done. The risk, of course, is needing more fusions done in the future due to a cascading effect if a stiffer and stiffer fused spine.

So, bottom line is that I am 100% "Old" pain free!! Just dealing with the post surgical pain. Dr B is an incredible person!! I chose him based on the fact that 99.9% of the patients who posted having surgery with him (and Dr Z also) all came out great.I didnt see quite as high of a success rate with US doctors. But I could be wrong, its simply my own personal observation that affected my decision making. I do know that many US doctors do a fine job also, but as mine is a multi level procedure, I really needed to go with experience in this case. And given that one of the best in the world said I was a technically complicated and challenging case, it sure felt good to know that I didnt go with a much less experienced US doctor, IMHO. Dr B has done more multi level surgeries than any other doctor in the world and that played a part in my decision also. My next step is to prepare for going to war with Aetna.

Please, if anyone can send me proof of their insurance carrier covering 2 or more level ADR's , or if you can direct me to someone who has, please contact me at Or PM me here at this forum. Besides getting copies of insurance approvals, Im willing to take any other info you can email or fax me or refer me to that you believe was helpful in winning your appeal(i.e. such as studies showing how ADR is cheaper or has better outcomes than fusion etc). BUt my most valuable ammunition is proof of other insurance carriers covering these, especially Aetna as I had Aetna coverage at the time of surgery.

Here is my X r ay. Ill post a few more in the next day or two.



  • You sound great. I hope you continue to post so we can see your recovery.

    You posted that this new disc helps the ajacent disc. That's great. But what about the facet joints. What type of improvement has this disc made for the facet joints? Multi level disc have had bad results for facet joints. I hope this has been corrected with this new disc. If you have any info on the outcome of the facet joints with this new disc please let me know.
  • Congratulations on your successful surgery! I've read several of your old posts about ADR and I am glad to see you were able to get to Germany to have your surgery. It sounds like you are doing great for having 3 levels. I had two levels of what I am assuming is the old pro-disc on Feb 3, 2009. Mine looks different than yours, so mine is probably the old one. I am amazed at how great I feel. A day after I came home from the hospital I was forgetting several times a day that I'd had surgery. I think most of the success of ADR has to do with the surgeon. Good luck!


    PS Don't know if this helps, but Worker's Comp (California) paid for my surgery. If they are paying, then other insurance companies must be paying.
  • I'm jealous. But I'm also glad that you seem so happy with the outcome. I'm trying to persuade my doctor to use the prodisc c but so far I'm not a candidate. Bummer.
  • cla_gua said:
    You sound great. I hope you continue to post so we can see your recovery.

    You posted that this new disc helps the ajacent disc. That's great. But what about the facet joints. What type of improvement has this disc made for the facet joints? Multi level disc have had bad results for facet joints. I hope this has been corrected with this new disc. If you have any info on the outcome of the facet joints with this new disc please let me know.
    I do not believe it has been changed to reduce stress on facet joints. :( The f acet joint risk continues to be the potential downside with ADR's. But Ive been told by several doctors that my facet joints are really strong and I shouldnt have to worry about those. We'll see down the road I guess. :)
  • steve55ssteve55 Posts: 86
    edited 10/19/2013 - 8:12 PM
    For those of you who have had multi level "cervical" ADR insurance approvals, please email or fax those to me if you wouldnt mind so I can use it to prove prescedence in my appeals

    fax 972-267-7977

  • It's so sad that this great technology is out there to be had but because of our bass ackwards medical system we can't have it. I hope for the best for you and good luck on your reimbursement from insurance. If you don't mind me asking, what was the total cost out of pocket? I'd go have surgery today if I could get ADR without batting an eye, especially since I'm going to end up getting ACDF sooner than later anyway.
  • Cost was $40,000.

    Few more photos



    Me and Dr B
  • nantynannie said:
    I am amazed at how great I feel. A day after I came home from the hospital I was forgetting several times a day that I'd had surgery. I think most of the success of ADR has to do with the surgeon. Good luck!

    The fact that you where forgetting that you had surgery dys after is great...

    Unless it was the drugs...
  • Hey Steve,

    Thanks so much for your posts, and for being so brave to go for three level ADR. I've got a 3 level problem myself (C4-7) and the MDs are wringing their hands. So far I have two recs for 3 level ACDF, one for 2 level ACDF, and one hybrid (fuse C-6/7 and Prodisc-C for C5/6 leaving C4/5 alone). I've asked about multi-level ADR and all I'm told is that it might actually be "too unstable." (Besides that insurance won't cover it !!)

    Question is did you notice any instability at all ?

    Also - I see that you've had problems now at C6/7 - what's up there ? Now they are recommending revision (fusion) ?
  • To: Steve55

    I just signed up to find testimonials of satisfied ADR patients because I am in urgent need of repair from C3-C7. Your posting sounded positive until I read the last date 9/22/09 where Dr. B came from Germany to Wisconsin to remove the implants and revise with fusion. Is that right? Good God, now I am really unsure of proceeding with ADR.

    Hopefully, there are others to counter this good-gone-bad. Was this infection a rare mishap or a common occurence; especially by who appears to be the most experienced surgeon in the world!

    I am impressed by the Spinal Kinetics M6 and the Synthes AxioMed discs because they best replicate the original disc. Although, they must be too new for approval or testimony. Mark suggested they are too flexible and create too much unstability, especially for multilevel operations. Personally, they look to me to be the most advanced and suitable artificial discs on the market. Any opinions?

    I hope you reply with your current situation Steve and let us all know what 3 stack fixation is like. No offense, but isn't fusion the old standard? One would think Dr. B would have given you what you paid for or somewhat of refund.
  • To cragar59

    I am just starting my research into 4 level ADR or 3 level depending on what Dr. B says. It also distresses me that Steve55 had revision surgery and fused his vertebrae after all of original work done. I am anxious to hear from him. I noticed his last update was 1 year ago, so wonder if he even comes on here anymore. I hope so because i wonder if he got Aetna to pay.

    I want to know more about the prodisc C Nova and it's pros and cons.

    For anyone else out there like cragar59,, I am interested in successful ADR surgeries, especially with Dr. B in Germany. As well as successful reimbursement thru Aetna. I have problems with C4-C7 Please see impression below.

    C3-4 moderate to sever bilateral formaninal narrowing.
    C4-5 moderate to sever right foraminal narrrowing and mild to moderate central canal stenosis which has mildly progressed when compared to prior
    C5-6 Moderate to sever bilateral formaninal narrowing
    C6-7 Left paracentral disc protrusion which is slightly less prominent than on the prior examination but continues to cause mild deformity of the left anterior cervical cord. There is also moderate to severe bilateral foraminal narrowing which is unchanged.
  • Hi. Did you ever hear from Cragar59 about his scary experience? I am researching ADR myself. I already have a proposal for a 3-level and maybe 4-level(!) from a European Dr. who has not yet even seen all my documents and images.

    It is so hard to find credible or informed info on ADR, whether anecdotal or clinical. And yet alternatives are even less appealing.

    And there are so few up to date positing on any of te blogs. Makes one wonder.

    Thanks and good luck.
  • Yes they will offer you all the adr you are willing to pay for in american dollars,

    Why would they refuse to take your money? Dont you think itsa red flag from the get go when they never even seen your documents yet and they say come on down how many would you like?

    You want some fries with that? If you have a half million dollars to take to germany cash up front they will give you as many adr as you can buy,

    But once you return to the U.S.A and surgery failed. Good luck finding a dr here who will touch you, I hope you have another 500.000 dollars to take back to germany,

    Read some of the failed adr websites who had failed surgery from germany with adr,

    I have family in europe and lot of countries stoped using adr for the lower back because of its complicarions,

    For every person the adr helped you can find 10 who had failed adr in germany just as here in the U.S.A
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • That's good feedback. Hopefully this will reignite a discussion here. I'm a scientist at core and want proof on all sides. We need to go beyond mere assertions. Agree?

    You sound like you're on to something. Can you please provide the links to " ... some of the failed adr websites who had failed surgery from germany with adr".

    Would you please help us back up what you said about "lot of countries stopped using adr for the lower back because of its complications". Can you get us a verifiable list of countries. Are desperate (gullible) Americans being preyed on?

    Also,"For every person the adr helped you can find 10 who had failed adr in germany just as here in the U.S.A."

    We need to gather more and better info one way or another. You may be 110% right but let's get the proof - or at least the data - and then we can confront the Drs. and our serve own needs.

    Cool? And thanks for the great response.

    I will also list a couple sites I've found with complaints.

    But I have to be honest and say that I have not made a decision against or for ADR, or fusion or just taking painkillers until I'm a total cripple. I think we want to move ahead the truth and the research

  • I agree on dont assume anything is as simple as it sounds, and there are complications that are many all around the world with every surgery,

    But it would be fear to assume anyone offering adr to anyone without knowing there full spine issues without there full medical file mri ct xray and so on is all about the money,

    There are many websites with patients horror stories about failed surgery from germany with adr , But sadly same goes for the U..S.A.

    Mine was done here in the states in 2004 with the flexicore clinical trial on l4l5"
    My dr was already doing triple adr for lumbar also as a clinical trial so in my view at the time i felt i was safe with a 1 level by my dr,

    You are never safe no mater how many levels,

    In 2006 after having many complications with nerve damage pain caused by the adr surgery and consulting with many dr,s in the Chicago land area, having multiple test done to view for study the motion of the disc is also in no way a narural movement causing more stress to the joints,

    This study was done do to another dr along with other dr,s to prove adr is not advanced as they claim and in no way a beter solution for fusion, Adr has beter sucess rate on the cervical then on lower lumbar because of the weight distributed on the adr on the lumbar region,

    From 2004 all i been doing is talking to at around 10 dr,s in the area with about 8 out of 10 who are collecting the data on this and working on dissaproving the adr for lower lumbar, as a replacement for fusion,

    So to your question about me providing proof! I am not a dr and i of course dont have the records on the data the dr,s have, I am simply sharing what my findings are on the informarmation i was given by my dr,s on this adr and its complications,

    Because i have family in europe i also mailed my medical records to a family member who knows many in the medical comunity in europe, They reviewed my mri images with the adr and they had nothing good to say about it other then they stoped doing the adr on lumbar procedures because too many complications such as mine has occured,

    So i am not here to aprove or dissaprove adr, i am simply here the share what experience i have had with adr and its complications personaly,

    In todays economy i am sure even the hospital in germany is hard up for the mighty dollar and not as many Americans are able to afford going there for there procedure,

    And with insurance not covering the procedure in out of network such as the hospital in germany you are dealing in cash and carry,

    You bring the cash and you carry the adr home back to the states with you, but you are prety much on your own after that,

    Many good findings come out of europe which i would never deny, and i hope further advancement is made for beter outcomes for everyone for spine complications and Germany along with the U.S.A join forces to work together to find the best adr with some serious advancements to preserve natural motion within our spine,

    I am just not sure we are there yet, and by now we should be way ahead of the game but we are not,

    The screening process for who is the best candidate for the adr i think is over looked many times clouded by the dollar involved and profit,

    Best of luck to all and as everyone knows surgery is a personal decision and for it can have its benefits. You always have to know the good and bad of it,
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • Hi, Ann. Still feeling/doing OK? I am considering a 3-level ADR in Germany. Probably an M6.

    Ca you give me more info on who your surgeon or the facility was?

  • Hi, your post on Spine health is pretty old but could you please tell us what your current status is? Since then, the M6 and the ProDisc-C Nova purportedly provides a more stable configuration.

    What did you finally decide? I am told I a also a candidate for 3-level.
  • Steve55, who in September'09 had revision of 3-level ADR because of a staph infection, has responded to an email I sent him about it. I asked him how it happened and if he'd still go through ADR. He OK'd me posting it here. I wrote to him:

    Re: Your 3-level ADR experience.

    Thanks, Steve.

    Sorry to hear of the trouble you went through and hope your fused neck functions well enough and without pain.

    I would like to post our exchange about this on the Spine Health blog. I know there were several other people who were concerned and had great doubts raised about Dr. B and ADR from your posting about the revision.

    On 10/27/11 11:02 PM, "Steve Nees" wrote:

    Dr B is the best. I think my staph is likely a result of my severe psoriasis that often slightly bleeds. They really should exclude implanting anything artificial with anyone who has severe psoriasis. That's why they recommend antibiotics before getting teeth worked on by a dentist. Any break in the skin can cause germs to latch on to the implants where they form a bio shield which makes the antibiotics ineffective.

    And yes, I would do it over again if I had the choice. I currently am fused at 3 levels which is a lot and the more levels you have ADR on, the more levels you will have to have fused should you happne to get an infection on the hardware. The chances are exteremely small but its possible.

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