[carls]

Hi Everyone!

Thank you for sharing your information. This forum has been very helpful as I am navigating the Lumber ADR process.

I’ve outlined my information in the signature. I am currently experiencing back and leg pain. Cortisone shot helped a little so I am able to control the pain with diclofenac and gabapentin. Not able to do most things I like to do so I need to find some type of solution. I have had 3 different opinions and am waiting on 1-2 more. I’m more confused than ever in terms of direction. I am leaning towards Dr. Blumenthal's approach but would love to hear any feedback from those that got the muli level disk replacement vs ALIF/ADR.

1. Illerhaus (ONZ/Spineconnection) - Recommended 3 disks (L3-S1) with either prodisk or ESP. Some of the recent bad results have me a little worried about this place. It is also the most aggressive approach. I do like the idea of getting it all done so I don’t have the possibility of needing more ADR surgeries in the future.

2. Paul Schwaegler (Seattle Spine Institute) - Recommends another microdiscectomy with mesh insert and remove disk protrusion that is affecting my L5 nerve and causing leg/foot pain. Does not think he can get the piece from the anterior approach and thinks I should wait on any more aggressive approaches. Don’t know if I am up for another microdiscectomy.

3. Blumenthal (TBI) - Flew to Texas for an evaluation. Recommends ADR L4/L5 and ALIF L5/S1 due to minor instability (Grade 1 anterolisthesis). He doesn't think I have a disk protrusion. But said if I do have a protrusion he can get it from the front. He didn't think I needed disk replacement at L3/L4 because it isn’t giving me symptoms and looks like normal wear and tear. I would hate to do the surgery and then need another one in a few years though.

Bertagnoli - Sent all of the information to the liaison but have not heard back.
Clavel - Submitted the online form but have not heard back.




Current (January 2023) MRI Notes:
L3-L4: Mild disc height loss with disc desiccation. Mild diffuse disc bulge without significant spinal canal stenosis. Mild bilateral neural foraminal stenoses. L4-L5: Mild disc height loss as well as disc desiccation. Compared to 1/11/2023 exam, there is marked decrease in size of right subarticular zone disc extrusion. There appears to be a 6 mm focus of extruded disc, possibly sequestered, in the right subarticular zone (7/14, 4/67) with impingement of the traversing right L5 nerve root, as well as similar mild diffuse disc bulge with mild central and right extraforaminal disc protrusion. Mild bilateral neural foraminal stenoses. L5-S1: Moderate disc loss as well as disc desiccation. Mild diffuse disc bulge without significant spinal stenosis. Mild bilateral neural foraminal stenosis.

Any recomendations on other directions to look at is much aprecated.

Thanks,
Carl