To my knowledge, a framinotomy is much less invasive than an ADR. My husband had on on L5/S1 not long ago and he was practically waltzing out of the hospital the next morning after surgery. The ADR is a different story.
Maybe I'm missing something but why did they suggest ADR when there is an obvious bone spur they can just whittle away?
Don't know about the order but I think (simply intuitively) that I'd go for the major problem first to see if the other doesn't resolve, particularly if the elbow and shoulder problems are on the same side.
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Minimal DDD L4/L5
Minimal DDD L5/S1
Disco 4/07 : Large tear: @L5/S1
Idet 4/08 No improvement
Now looking at ADR vs. Fusion
ALIF Fusion 2/10 Stanford
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