Clavel did 2-level on me - I will never regret it, he is great guy and doctor!

A two level lumbar ADR is not approved in the US. Therefore, we must look to Europe for this procedure.

have you looked at xiomed freedom lumbar disc?
 

http://www.axiomed.com/pdf/WPaperSWISSSpineReg.

The Freedom Lumbar disk outperformed all other disk.

The Freedom lumbar disk has completed the 5 year study and will hopfully get Fda approval soon. (later part of 201?)

The results for the Freedom disc look very promising. Not enough long term results, but still may be a good candidate to succeed the 1st generation tdrs. Note that here the Freedom was compared against all historical implants collectively, so it is not really "fair". It may still be better though.

Appendix 1 first case is a bit strange. I am surprised they did not do l4l5 as it is clearly degenerated. But maybe it did not cause symptoms for that particular patient.

Exactly! It look terrible.

Ten years ago, at a spine conference in the US, Zeeger's threw up a slide with an MRI showing two clearly dessicated and collapsed disks and asked the audience which was the pain generator. Then, when everyone had pointed to one of the two obviously damaged disks, explained that the pain was from the torn and leaking but radiographically sound disk above those two. Can't trust imaging to tell the whole story.

I guess you are correct. Maybe they removed the bulge from L4L5 in the case I mentioned. It wouldn't show on the x-ray.

I can imagine the surprise of the audience at that conference :eek2: I wonder if Zeegers makes speeches at conferences nowadays. I guess he has really seen it all!

And of course the sad thing about this is that docs often want to do discograms in the hope of finding the pain generator. This was the case for me with respect to my L4-5 and L5-S1. The former was shifted to the rear, a real spondy, and the latter was about gone. Foolishly I agreed to the disco. Result.....inconclusive. I still have pain down both legs and haven't made a decision on the next step, since like everyone else here, I can't get any two docs to agree to anything.

Why Patients travel out of country
 

Many have asked why patients travel out of country for lumbar disc arthroplasty. The answer is pretty easy: Insurance still considers the procedure experimental/investigational.

Well I was all scheduled for surgery with Dr. Garcia - Lumbar ActivL on February 15th and Florida Blue denied at the last minute. I then quickly filed an expedited internal review which Florida Blue denied. Then On February 13th, I filed an expedited external review.
My frustration has continued, as the expedited external appeal that was filed through Florida Blue was denied. This has exhausted all of my insurance options in the United States. Therefore, I will be headed to Barcelona on March 13th to have a lumbar ADR with Dr. Clavel. I have thoroughly researched the neurosurgeons in Germany and Spain and based on patient outcome and insurance provided by Dr. Clavel's office for the surgery, the decision was easy. Also, I have researched the activL and M6L and discussed both discs with several US and European surgeons. In the end, I will go with the M6L. This disc has an 80 year lifespan vs. the activL that has a 30 year lifespan. I feel at peace with the decision and look forward to feeling better in the near future!

I am hoping for at least half of that 80 year lifespan for M6. But really, how do they know? the testing is not in vitro. I wonder what the lab testing life of a typical implanted 20 year knee replacement is?
Good luck. I have nothing but good things to say about my Spanish team. In fact, and maybe it was just luck, but as a solo traveler with no language skills, the kindness of the Spanish people toward me was remarkable. Gave new meaning to phrase to be thankful for the 'kindness of strangers".