Newbie - Hybrid ADR/STALIF vs 2 Level ADR?
 

Hi everybody, I'm Dave! This is my first post so please be kind :) I have been reading your boards but didn't want to post until I had more knowledge. As you can see from my signature, over the past 3 years since my accident I had conservative treatments including a micro-discectomy at L4-L5 and S1-51 but I am still experiencing constant right-sided low back pain, secondary facet area pain and tingling on the soles of my feet. My facets are normal and did not respond to treatment and every surgeon now concludes it is secondary pain that may resolve with ADR surgery. I'm a young-ish guy :) in great shape, don't smoke and no health problems; also I'm a musician (who wishes he could sit down without pain!).

I am considering ADR and sent my scans for diagnosis to several ADR surgeons both in the U.S. and in Europe.

Instead of 2 level ADR, 3 surgeons recommended: Hybrid ADR/STALIF (ADR at L4-L5 and single-level fusion at S1-51). One surgeon said 2 level Prodisc ADR. Another surgeon uses Activ-L which seems to have a better outcome than Prodisc. I live in Florida so going to Europe for surgery is a big deal but I am considering it since they are more experienced with ADR.

As the S1-L5 disc moves very little compared to your other discs, over the years I guess these surgeons saw facet problems from too much movement with S1-L5 ADR, and concluded that if you need to replace L4-L5 and S1-L5, then depending on the patient, they may do a L4-L5 ADR and single-level fusion at S1-L5 instead of 2 level ADR...or am I wrong about the reason?

Please reply with your experiences and any studies comparing hybrid ADR/STALIF vs 2 level ADR.

I would like to hear from any 2 level Activ-L ADR or ADR/STALIF hybrid patients, what surgeon they used, especially if surgery got rid of your back and facet pain. Or just say hi :)

Hi Dave, sorry you are here, but I hope we can help. I met a few experienced ADR docs in Miami a few years ago, Dr. Garcia comes to mind.

In the meantime, you may want to search for patients with the STALIF, If indeed that is the right corrective procedure for you:

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When you can, pls create a signature (see first topic in this forum).

Thanks Dave.

Seeing Dr Zeegers next week for lumbar ADR
 

I'm seeing Dr Zeegers next week for his recommendation for 2 level lumbar ADR with Activ-L.

When I'm on Percocet and lidocaine topical patch I'm a 2/10 pain scale, and when I stop my meds I'm a 4/10 pain scale, mostly when sitting with pain mostly in my upper butt area and some lumbar. I've been this way for a few years, and though physical therapy helped a bit to get my pain to this level this is the best I'll get, but unfortunately I am a musician and need to sit for long periods which isn't possible without meds right now which leave me foggy and tired.

Dr Zeegers reviewed my scans and it is definitely discogenic pain in L4/L5 & S1/51 and could get rid of at least half my pain so I could get off meds.

I've talked with some of Dr Zeegers patients who had ADR at the same levels of which many had lumbar and facet pain eliminated.

Would you proceed with the 2 level ADR with my pain levels?

I would go for the two-level. Actually, that is what I did! Since your original post was in 2012, I think you have already suffered long enough... Just make sure that the diagnosis indication is clear. Once you know for sure that the discs are the sole reason for your pain, you know that the decision is right.