Dr. Jean-Jacques Abitbol

California Spine Group
meeting to discuss options

I told Abitbol that he was recommended by two PT women at US HealthWorks. I then told him I was scheduled for disc replacement surgery with Delamarter in November. I also briefly detailed my insurance dilemma. He repeated a comment which my podiatrist had first brought to my attention, namely that paying for this surgery out of pocket is risky because if something were to go wrong, then a 5-figure cost could easily become 6-figures. And if Blue Cross won't pay initially for the ADR, then they very well might balk at paying to address any complications resulting from the surgery (which was unauthorized in their eyes). Scary thought!

We then discussed ADR vs. fusion, and he felt that ADR had not been proven to be better than fusion. I told him I thought that ADR reduced wear on the adjacent level by preserving mobility, and he stated that studies were inconclusive on this supposed benefit. He also asserted that no one knows the long-term results from disc replacement since they haven't been performed for more than a dozen years or so. Abitbol therefore does not do ADRs. He said that he knew Rick Delamarter and was familiar with his work, but he said they simply had a difference of opinion regarding the efficacy of ADR. Abitbol simply felt it was too risky at this time.

He suggested that if I was dead-set on a disc replacement, that I get a fusion at L5/S1 and an ADR at L4/L5. I told him that I was not dead-set on anything, and I asked for his professional recommendation. He said that he would recommend a two-level fusion with a "dynamic rod" at L4/L5 which would provide some increased flexibility and more closely mimic the spine's natural motion. I asked him who he would recommend to do the surgery and he (not surprisingly) said himself at Scripps Mercy Hospital.

All in all, I was impressed by Abitbol's confidence and forthrightness, but I felt that perhaps he was applying a bit too much pressure in pushing me towards a fusion. His last comment to me was for me to stop seeing different doctors for second opinions as I would just become more confused. I disagree with that train of thought. I think more medical opinions can be quite helpful indeed.


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