[Deborah]

For those who feel strongly 2 level TDR is what they need... remember FDA approval shouldn't be far off if you can wait (within one year). I agree totally with ans about considering hybrid; many doctors and some of us individuals actually find it preferable for L4-5 TDR and L5-S1 fusion. (It turned out in my husband's case that L4-5 could have a well seated and placed TDR, but the L5-S1 level skews just enough, which apparently isn't unusual, that a TDR wouldn't be perfectly aligned... not fully visible until exposed by surgery.) There's the consideration that for most people L5-S1 has very little movement naturally.

ans: You know you can make this happen. Get a few doctor consults from docs you trust and go for it... there's a lot of data out there now that makes hybrid a much more winnable fight. (I'll be glad to share the particular studies used to convince CMS, but I'd guess most docs can get a pre approval in their own way.) The biggest issue if docs consulted find you an 'appropriate candidate' given your specific back condition. For that, I'd see at least 2 docs you really have reason to trust.

Debi