Hybrid vs All ADR-Opposing opinions from Dr.s-Help!

[TamiN]

Hey everyone,

I'm researching a 3 level ADR vs Hybrid from L3-S1. In the states it would be a hybrid while in Germany it would be ADR.

I'm getting opposing recommendations at L5/S1. US doc says a fusion (hybrid) while Germany says ADR. I've been told that a fusion at l5s1 will not affect my movement much at all but could, it instead, offer more stability. What have you learned?

Here is my question: DOES IT MATTER? I have severe DD at L5-S1 but if my facets are good, which procedure is really better? At the base of the spine does ADR have more benefit or would the fusion be just as effective? If they are equal, great! I just need a straight answer...

Tami

[brian mccarthy]

Hello Tami
I had a 3 level Hybrid Charite ADR at L3/L4, L4/L5 and ALIF Fusion at L5/S1. I was very concerned about the possible lack of flexibilty with the L5/S1 fusion but it was explained to me that there is very little movement at that level anyway. Prior to my recent revision fusion I could still touch my toes without too much trouble, once I had recovered of course.
That was a fusion without instrumentation but my recent surgery was a revision fusion at L5/S1, but this time with instrumentation, plus a full SIJ fusion so not sure if I'll be still as flexible just yet.
Best of luck with your research.
Regards
Brian

[Harrison]

We've discussed this so many times in the past four years and the comments are always interesting, perhaps being somewhat inconclusive. There is small (but crucial) movement at L5-S1. Please also search this forum for related topics. If anyone can dig up and post these topic links, I'd be most grateful.

[Maddie]

I've been told the same thing, except in my case I would need three instead of two lumbar discs worked on. I then had a third opinion that said if I had three ADR, I would be worse off than before the surgery, and he was VERY adamant about that. He were not opposed to mulit-level ADR overall, as he wanted to do two levels in my neck.

That scared me, despite all the people I knew who had successful multi-level ADR, and I've decided on the hybrid route. The reputation and good feeling I got from the doctor involved made the decision for me.

That wasn't very scientific, but I hope it helped somewhat. Sometimes you just go with your gut feelings.