(1) One eminent spine surgeon told me that I am not a candidate for a two-level fusion. He didn't say it's b/c of my DDD but that's my guess. If correct, does this make sense?
(2) The reason I ask is b/c my MRI and CT scan (with dye) indicate "moderate" facet damage and the thought of an ADR at such levels frankly gives me the creeps - even if my forthcoming facet injections do not cause relief, is there some cause for concern - regardless? I suspect the answer to (2) is anyone's guess. Best - Allan |
Allan, this is a question that also applies to me and I have no answer either. My disc replacement was deemed suitable as although that level (L4/5) was bone on bone it apparently showed no facet degeneration. However my L3/4 did show degeneration and instability hence the fusion there. It wasn't suitable for ADR.
I thought ADR wasn't indicated with DDD and fusion was the ony option so you've confused me now. I'm still having pain at both levels and had facet injections a few months back. While effective, they only lasted 8 weeks. |
ADR is indicated for DDD, in fact it was at least in part intended for DDD with no other damage to the vertebral structures. As for why Allan's doc doesn't want to use fusion, which was the gold standard, I can only guess. Is he making judgements based on Allan's age and deciding that the likelihood of adjacent level problems is far too high to justify fusion at his two worst levels? If so, he might be willing to pursue fusion if you would later puruse ADR at other levels, but there aren't many that are willing to use a mix of fusion and ADR.
Allan, if your facet injections show your facets are a pain generator in themselves, your odds are poor for ADR at that/those levels. Some here did have their facet pain diminish with ADR but most seem to have either held steady or gotten worse if they were compromised to start. |
Thanks for your responses and insights. I agree with you Annapurna that this is probably why a several level fusion is out but I'll certainly look into it. W/get a fresh opinion re: facets as this confuses me, even if there's no response on the facet injections. Best - Allan
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