Thank you so much for your input and your good vibes!! This is such valuable advice that one can't get anywhere else.
In regards to artificial disc choice I believe the ActivL has some advantages over the M6L. First I think spikes are better than keels - they both appear to be effective methods of fixation but I prefer not to have my bones chiseled into. Second is the ActivL's wide choice of end-plates specifically designed for the S1 vertebra. Third, is the 8.5 mm height option. Fourth, is their solution for revision surgery and the thought that if something goes wrong it might be easier to remove the ActivL than the M6-L. Needless to say the M6 has it's own set of advantages!
It would be ideal to have the surgery here in New York but I'm willing to go anywhere in the world to ensure I get the best possible care and thus maximize my chances of a successful outcome.
Doctor Clavel is the best with the M6 but does that extend to the ActivL? Here in New York I've heard good things about The Spine Hospital at Mount Sinai in NYC. But doctors at the TBI appear to have the most experience. More research on my part is required. I'm guessing doctors will want to see and MRI as well as X-Rays. Since I haven't done X-Rays post microdiscectomy my plan is to take a set in the next couple months and then get multiple opinions: 1. Dr. Clavel. 2. TBI. 3. Mount Sinai. 4. My local orthopedist.
I also need to perform more research on the option of Fusion - I'm not yet completely convinced that it's not a good option for me. The adjacent disc (L4-L5) looks in perfect shape so if I take good care of my back post surgery maybe it will hold just fine. Having said that, I fully intend to run again - it's the fire that keeps me going. Please keep in mind that I've spent countless hours improving my running technique and making it flawless: Light on my toes, Short strides, Low vertical oscillation, Mid foot strike. I feel I put more pressure on my back sitting down than running. It amazes me that most amateur runners have terrible running techniques and it's no wonder why they injure ankles, knees, hips, and discs!
Then there is the question of timing. My symptoms are bad enough that the situation is unsustainable and I need to do everything within my power to try and fix it. Everyday I feel that I'm chewing into my L5 nerve root while waiting. I can get a new disc, I can even fuse the vertebras. But sadly I can not get a new nerve. At the same time the pain in my legs is not chronic and I am not taking pain medications. I do not have back pain and still fully control my legs. They are constantly tingly and painful from glute to calf, but I can feel them and control them. Maybe it's a gray zone. In my case DDD feels like a losing battle were it gets worse bit by bit and the advantage of simply waiting is not so clear. It has not been easy for me to decide when to have surgery. I think about it every day and have not been able to make up my mind. So I am using this time to do research, and develop a plan that I can live with even if something goes wrong. I also plan to use this time to strengthen my core as it needs to be rock solid if the best option is the less-constrained ActivL disc.
Thank you for reading. Feedback is much appreciated.
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"Permanence, perseverance and persistence in spite of all obstacles, discouragements, and impossibilities: It is this, that in all things distinguishes the strong soul from the weak." -Thomas Carlyle
"We fall, but we get up because the ground is no place for a champion." -Dustin Poirier
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