No Surgery... Yet

[drewrad]

Originally Posted by pittpete

My L4-L5 disco was in 1996.
Im just saying i don't like the Costco approach.
We're talking about your spine here bud.

No, I know. I'm just wanting to make the most responsible choice I can with the knowledge I can with the money I have. I don't want to go over the top(ADRs), but in your opinion, when looking at my MRI, what would you do? I guess you're saying, in my case if you look at my MRI, that you'd go for the micro at L3/4, L4/5 and L5/S1 and get the posterior disc/protrusion scraped?

I hear you.

Money is not the problem, although that would suck to spend so much. I'm much more interested in taking the best possible care I can for the long haul. I'm only 44.

OTOH, I am worried that if I only get a micro, that arthritis will be even more painful years down the road but no one can know that for sure. I guess if I don't go to Europe, my L5/S1 would attempt to autofuse(who knows how long) and then as long as I don't spur too bad, I'd be good. If I had a crystal ball...

Share your thoughts. That's what I'm looking for. I'm getting tired of doctors' opinions. I'm starting to feel much more comfortable getting the opinion of fellow back wonks. So... if my MRI was PittPete's, you'd .... (fill in the blank here).

Sorry to be so long winded.

[drewrad]

One thing I notice looking at your MRI is how sketchy your L5/S1 looks. Other than that, you're canal looks real bright and open down the entire length. Wish that was my case.

After looking at my own images again several times on this thread, one thing I notice is how bad my L3/4 is. I always assumed my L4/5 and L5/S1 were bad due to the herniations, but the L3/4 bulge looks real discouraging. I'm all for conservative care/treatment before all else, but I'm getting to the point where I don't know what to do anymore. Even if I have work done, I doubt I'll ever be someone who sits down much anymore anyway, but I'd still like my goal with a procedure to be able to at least sit down once in awhile. I don't need to climb Mt. Everest or run a marathon. I just want to be able to go to the movies ocassionally, maybe sit my *** down in church once in awhile.

[pittpete]

Dre IMO any surgeon who told you he would do 3 microd's on you, i would run the other way.
I have to go to a Football Board meeting right now.
I will respond more later tonight or tomorrow.
Hang in there bro

That white spot(High Intensity Zone) in L4-L5 is a tear

[Wraspondy]

You MRI looks alot like mine and I had a tear at l4/5. I had a fusion for spondy at L5/S1 a few years ago. Gave me some relief for a few years, then l4/5 blew with a 18mm herniation. I have the same symptoms as you. I am hoping they make some rapid progress in stem cells to get some relief. I am also only 43. Feel free to ask me any questions.

[drewrad]

The hits just keep coming with Kaiser. They are becoming absolutely worthless. I asked about implant sensitivity and Orthopedic Analysis for metals.

Got this from my doc today in email(that's all they do BTW to communicate with their patients):

Regarding metal sensitivity:

"Hello,

I would advise the patient to discuss this issue with the orthopedist who plans the implant.

The Orthopedic Analysis kit does not appear to have FDA approval, and the web site disclaimer states that the results have not been shown to have any clinical value. The company is asking for doctor permission for billing purposes and because they need a doctor to draw the blood.

In general, if a patient wishes to know about contact metal sensitivity, dermatology can do patch testing to some metals. Skin sensitivity is different than implant sensitivity, and there is no test with proven value that is a good predictor of implant metal problems. From a Medscape review (http://www.medscape.com/viewarticle/742801_5)--

"It is hoped that our knowledge about the associations between metal allergy, allergic contact dermatitis, and device failure will expand. At present, it is unknown whether the risk of device failure and allergic contact dermatitis is increased in metal-allergic persons."

Thanks,

Bruce
BRUCE T. RYHAL MD"

[drewrad]

What in the hell am I supposed to do with that?

And when I call Orthopedic Analysis they tell me I need my doctor's permission/signature in order to get the kit.

Where do I go from here?

[jss]

I don't know what's involved in appealing this cop-out, I mean non-decision, I mean denial. Before you pay for the test out of pocket, I would encourage you to contact the doctor and lab and negotiate a cash price. You'd be amazed what is possible. On a similar situation my wife had a blood test go from $185 to $13.

[drewrad]

So, Dr. Bierstedt called me yesterday. We talked for a long while. I really like him.

He is recommending a two level L4-S1 as opposed to Dr. Clavel who is recommending a three level L3-S1.

Dr. B says the lower two are what are causing my main symptoms. I think he is correct. He said he could always come back later for the top two lumbar laterally if he had to, but that I might make it just fine.

I'm wondering why Dr. Clavel wants a 3 level as opposed to a two.

If anyone can take a second guess on that for me by looking at my MRIs I posted, tell me what you think. I'd be open to hearing your thoughts.

My images are on the 2nd or 3rd page of this thread.

[FranklySir]

D,

What I can say for me is I avoided MLD's like the plague. I know its difficult to get to the final decision but for me reading all those that tried MLD they never seem to last and now you are stuck with scar tissue and bone buildup that is all close to the nerve roots. Read other posters herein that finally have made the choice to get ADR done and it seemed to me unfortunately for them they have issues even after ADR. I went whole hog on both neck and lumbar. Clavel did both per my sig line. My L5S1 is also bad but close to being naturally fused. It was Clavel's choice to not touch it due to that. I am very happy I left it in his hands since I am 3 months right now and I am fantastic. I read also same results from Dr. B.

Look at this way. you see a truck with a loose piece of tread, they clip off the tread, DO you think the tire will last another 10 miles? No it won't. It will blow out right up the road.

For me I help off for 14 years to get done and am 47. Waiting actually helped in that L5S1 fused on its own.

I feel for you in trying to make the choices. You have two great surgeons looking. Clavel was hosting an Int symposium this week for Cerv and lumbar ADR.
If I were you I would pay him and Dr. B to review your stuff again. It;s your back and you have to live with it the rest of your life and hopefully without nerve damage and pain. I had wonderful experiences on both occasions but that was me.

I wish you calmness of mind and unfettered thought in making your choices. As always feel free to PM me and I can make myself available if you would like to talk.
Frank

[Jerry5]

Yea, your spine looks bad, but you got more stuff than I do.

If I figure out how to post, I will send mine to you in a private.

At any rate, I may be looking at 3 level, I submitted my BC international, 10 Mar, have not heard from them yet.