Greetings from a new L4-L5-S1 buddy
 

Hello Everyone,

I am 43 y.o. and have L4-L5-S1 DDD. Hernia microdiscectomy of l4-l5 in August 2014, 7 steroid shots in the past 12 months. Still hurting. Fusing 2 levels (with L2-L3 is also a little messed up, but not much yet) is a scary prospect. Considering ADR of L4-S1. Obviously I am very scared and anxious. Currently I am looking at all your posts and learning, learning. Thank you all so much for the information you have shared. From what I understand, ADR on L5-S1 level does not have as much of a successful history as other levels. I would appreciate any feedback on this very much.

I am recovering from a fusion at the L5/S1 and so far very happy with the anterior fusion my surgeon performed on me. No more Charlie horses in my legs, spasms in my feet and the sciatica is gone. I can sleep at least 10 hours a night and that means so much to me. I have 95 percent mobility so don't rule out that their all not successful. I highly suggest that you research your surgeons and once you find one that you feel confident in, then do it.

I hope you are planning to go to Europe for an ADR in the Lumbar? I was going to do the Pro-disc but after much research chose to do a fusion. Good luck!

2 level fusion scares me. The problem is that if I fuse l5-s1, it makes sense to fuse l4-l5 at the same time. If I do ADR, l5-s1 seems to have many negative outcomes. Doing two separate surgeries is obviously a not a welcome scenareo.... My US doctor is great, but he does not do ADR...

How about Hybrid Surgery
 

First of all, 2 level fusion is not necessarily bad. I had lumbar fusion at L3/L4 and L4/L5 in Dec, 2010. I haven't had any lumbar issues since then. My neck is another story. However, why not consider Hybrid surgery? It's one surgery where they do ADR on one level and then fusion on the adjacent one. In your case, they could do ADR at L4/L5 and then fusion at L5/S1.

As you read these boards you'll see many people who have had hybrid surgery, both here in the U.S. and abroad. In the U.S., you have a good chance of getting insurance to pay for this.

Good luck with whatever you decide to do!!

Gene

I'm not sure where you got ADR on L5-S1 level does not have as much of a successful history as other levels. First time i heard that.

I've seen plenty success stories. I had l5/s1 adr disc and no issues there.

I think it all comes down to the Dr you go with and the disc that is selected.

Feel free to PM me if you have questions.

Cheers,


Karger

Karger,

Just to clarify, 95% of people who have ADR at L5/S1 do very well (at least according to what I've read). It does tend to have a higher rate of failure as compared to some of the other levels. It also happens to be a level where fusion is less likely to cause Adjacent Segment Disease.

Note, I am not a doctor, but I've spent a lot of time reading these boards and have learned this from others. I do know from reading these boards and speaking to a couple people who had failed ADR at L5/S1 how debilitating it can be.

If it were me and I had to do the levels L4/L5 and L5/S1 and insurance only covered one level of ADR, I would opt to have L4/L5 done by ADR and L5/S1 fused. That's just me. I'm sure many others will have something to say on this.

Gene

I would only do fusion as a last resort. Studies show that most fusion is failure. Although there has been success stories with fusion. It may depend on your doc/surgeon and how good/caring they are. I'd do ADR all the way and leave fusion as a very very last resort due to it's high failure rate.

Part of the issue is that people are banking on insurance. Insurance will do as little as possible. In NA doc's have only been doing it since 2008 and are also bound to FDA regulations and years behind the current disc's.

I wouldn't have it done in North America, I would go to Germany where they have been doing it since 89 and are the world leaders in this field. Even Spain or England over NA IMO.

Don't get me wrong, I am sure there are good doc's in the NA and helped alot of people.. but I would rather find the the most experienced ADR surgeon that has been doing it for 20+ years then someone that only has 7 years under their belt.

I am sure other people have their own opinions, the above is just my 2 cent :)

It's also crazy that in NA only one level is covered. They have been doing multi levels for years in Europe.

It is just an impression I got after reading many stories on this website and others that L5-S1 ADR tends to cause some problems, albeit rarely. I also got a feeling that some doctors are apprehensive about this level ADR. Dr. Zeegers for example mentioned a hybrid option right away. I am not a doctor, but looking at the angle of L5-S1 it does look like the disk could have more potential to slip.

O i didn't realize you already had a diagnosis with Dr. Zeegers. Again, I am not sure of your spine pathology and it's possible that 2 adr's may not be possible in your case. It's really left up to the experts to decide if you need 2, or 1, or hybrid.

In any event, I wish you the best of luck and do a ton of research prior to making your decision :)

Cheers,

Karger