Finally. . .got the green light (L4/L5 ADR)

[Chad]

Hi all,
After a consult with Dr. Balderston at 3B orthopedic following a recent discogram (results showed l4/l5 pain 7 of 10, disk showing tear; l3/l4 "atypical" pain 7 of 10, disc intact; l2/l3 disk intact no pain; l5/s1 partially sacrilized), the recommendations are either:

Replace l4/l5: procedure considered "very reasonable" with a "body of literature" showing that l3/l4 atypical pain will likely remit (1 level covered by my insurance)

Hybrid l4/l5 ADR & l3/l4 fusion: "What I would recommend if you were my brother" (covered by insurance, but do not have the time to take off of work for lengthier recovery)

Two level ADR: No dice per insurance, but probably the best option were it available

I plan to move forward with the first recommendation tomorrow unless there is any compelling suggestions as to why I should wait or consider otherwise.

Been having problems in what appears to be my thoracic area and I wondered if anyone had any thoughts about how to manage this pain. Also wondered what people's thoughts are about starting physical therapy prior to surgery to get conditioned for the recovery process. Looks like surgery will be in the next 3-4 months per his scheduler.

Any thoughts would be greatly appreciated

-Chad

[Harrison]

Chad, sorry for the delayed welcome to our community. Your multi-level lumbar issues must be very taxing on your energy and quality of life. We've all been there, it's brutal indeed.

A few questions for you:

- to what do you attribute the multi-segment disease?
- how descriptive are the radiology reports about the degree of disease, specifically stenosis or arthritis?

The condition of your facet joints are really critical, particularly the stage of any facet arthritis.

[Chad]

To what do you attribute the multi-segment disease?
*There was a herniation in 97 that led to microdisctectomy shortly thereafter. Repeated injury led to annular tear that is creating pain at l4/l5. As I have a partially sacrilized l5/s1 and the l4/l5 is as good as fused, my doc thinks that the l3/l4 might be affected because of the lack of motion/flexibility. Shown to be anatomically intact per discogram, but exhibiting "atypical pain".

How descriptive are the radiology reports about the degree of disease, specifically stenosis or arthritis?
At l4/l5 I don't remember

The condition of your facet joints are really critical, particularly the stage of any facet arthritis.
*My doc thinks that the facet joints are in relatively good condition with mild arthritis

Are there any questions that you think might be important to ask him given this limited information?

Best regards and thanks in advance
-C