Letter from Peachtree City, Georgia, USA
Approximately ten years ago, just shy of my 51st birthday, I began to experience increasingly protracted episodes of pain shooting down my left arm, slight but increasing numbness in the 4th and 5th fingers on both hands, and occasionally severe muscle cramping between the shoulder blades. An MRI showed significant disc ruptures at C5-C6 and C6-C7. The radiologist suggested the discs appeared to have been damaged for a long period of time and the damage was consistent with what I thought were minor injuries during my collegiate soccer days.
At the time of this initial diagnosis, artificial cervical disc replacement (ADR) at two levels was still experimental in the U.S. as no ADR devices were approved for such a procedure. Not wanting to undergo a two-level fusion (the recommended treatment), I instead chose a regimen of exercise and stretching to mitigate the symptoms with the hope that two-level ADR would be approved by the FDA within a reasonable time frame. It would seem my hope of the FDA moving expediently was more than a bit optimistic.
Eighteen months ago, despite remaining in excellent physical condition, the muscle spasms between my shoulders suddenly increased in frequency and intensity, numbness in both hands increased, and jolts of intense pain shot down my left arm. I was spending 3 to 4 nights per week sleeping in a recliner as it was the only position in which the pain would cease. A second MRI indicated the original disc ruptures were nearly in total collapse with only about 20% of the original disc space remaining and, because of the impaired mobility at the discs between C5-C7, there were now significant disc ruptures at C3-C4 and C4-C5, both of which were pressing on the spinal cord. The recommended treatment was a four level fusion because, although two-level ADRs were now possible in the U.S., four level ADRs were not permissible and two-level ADRs were not permitted adjacent to a two-level fusion. Additionally, the surgeon indicated there was insufficient space between C5-C6 and C6-C7 to even attempt an ADR.
Being an avid golfer, hunter and outdoorsman, the four level fusion was not an acceptable option and so I resumed research into the latest ADR technology. During the course of this research I came across Dr. Bertagnoli’s website, a website that is probably one of, if the not the best, source of information on cervical and lumbar disc pathologies, treatment and artificial disc technology. After conducting all of the research, as enlightening as it was, the decision to go with Dr. Bertagnoli ultimately came down to testimonial letters written by surgeons and doctors who had undergone ADR surgery by Dr. Bertagnoli.
I underwent a four level ADR at the capable hands of Dr. B using the Pro-Disc C Nova on April 12th, 2016. Sufficient accolades cannot be offered about the professionalism and friendliness of the Dr. B’s staff and the nursing staff at the hospital in Bogen. My wife stayed with me in the room, and on this point, I would strongly suggest anyone going to Bogen for surgery be accompanied. Yes, it does cost more in travel and such, but you will be thankful you did in general. Language differences are no more than a minor issue as most of the staff speaks passable English and the cleanliness of the hospital is outstanding. My only complaint was the food, but then, I have yet to be in a hospital where the food was acceptable. My surgery was on a Tuesday and I was released from the hospital that Saturday morning and we moved to the Hotel Theresientor in Straubing. The hotel staff was incredibly helpful and responsive to our requests; they were in a word - outstanding. We spent ten days in Straubing before returning to the U.S., more than anything else as a general precaution against infection or unforeseen complications. As it turned out, other than a bout of unusually high blood pressure, I had no serious complications and, other than the lack of stamina one would expect after surgery, we were nonetheless able to take in the sights around Straubing and take several day trips by train to other cities in Bavaria.
I am now one year post surgery and could not be more pleased with the overall outcome. All of the pre-surgical symptoms have been eliminated and, despite low probability, much of the numbness in my hands has receded. Full motion has been restored and I gained ½” inch in height due to the restored disc spacing. The increase in height led to some pain and stiffness in the muscles and connective tissue around the spine, but this has been greatly eased over the intervening months through physical therapy and daily stretching and strengthening exercises. The only persistent artifacts from the surgery are a small area of numbness under my chin (there is a nerve that is typically difficult to avoid severing during the surgery) and my speaking voice which emerged weaker from the surgery; however, it has improved noticeably over the past several months and is nearly normal again. The incision scar is barely noticeable so I had no need to make up a good story as to how I received the scar.
In conclusion, would I do it again, absolutely! Would I recommend it, yes, without reservation; and I have.
Mark F. Friedlein
Peachtree City, GA