[Cynlite]

The L5/S1 is a tricky level and some do choose to fuse it instead of an ADR because it is the base of the spine and takes a beating. You might want to PM Drewrad about it or read his threads. He is also a sports person and had to figure this out too. From what I've read, tall men often have an issue at this level and when it gets bad, sitting is a real problem for them so, it sounds like you have time still to figure this out.

You might want to read ozphysician's threads. He has been getting stem cell injections followed up by images to chart his progress. (It's hard to find any solid proof like this from stem cell patients or centers that do this type of treatment.) He's been growing his lumbar facets back! I've read that the stem cells can re hydrate discs so, that's why I mentioned it to you.

I've had seven spine surgeries now. I was desperate to get out of very extreme pain so, six of them (all within 3 very hard years) ultimately caused more deterioration of my spine after 5 to 8 years post-op. My options were much more limited 10 years ago. Just look at my signature and you can see what I had done. So, in the beginning, while the surgeries stopped paralysis, they did not get rid of much of my pain at the time and in the end made matters worse. These were so called minimally invasive procedures where the surgeon did not fuse and just removed the obstruction. My point is that spine surgery is a big decision to make because there are no guarantees. It is good you are here and can do the research necessary to make the best decision possible for you.

I don't know of one person that is 100% out of pain after having a spine fusion. Sure wish some of the lumbar folks would chime in here!!!! This is why I have avoided it so far for my L3/L4. However, someone here mentioned recently that Dr. Clavel said that it's better to get an ADR earlier than later, probably, because of the contraindications for the surgery. I can't get an ADR at my L3/L4 so, I'm waiting it out.

I remember reading of people going to the Hospital for Special Surgery (NYC) for ADR but, don't know if they are any good at it or still doing it. I don't think the Mayo is doing it and only one surgeon that I know of out here at Barrow is implanting the Mobi-C but, is cherry picking his patients. Several surgeon profiles at Barrow say they do it but, I know from spending a lot of time calling them, most seemed to have stopped. One of their top surgeons that I saw had implanted the Prodisc but, didn't like it so, he recommended fusion. The big guns are staying out of the game probably because of insurance problems.

Many surgeons in the U.S. seem to still be using the Prodisc (with the really huge keel design) and the insurance companies are still really slow to get on board with the ADR surgery. Then of course, we have our FDA that is slow on the go for disc approvals. So sadly, we are about 10 to 15 years behind Europe still when it comes to spine surgery IMO. I just shook my head when I talked to Dr. Clavel about the Coflex that a surgeon here had recommended for my L3/L4. It's new here and he already quit using it because of the problems it causes. Sigh.... So, some people are afraid to go to Europe because they can't get follow up care in the U.S. very easily. IMO, this is because the surgeons here just don't have the knowledge or experience to be in the same league as some of the best in Europe. But, the same is true if you have multiple failed surgeries in the U.S. You get very limited in finding the surgeons that will be willing to correct a failed surgery for you. So, it's really important to choose the right surgeon the first time! After everything I have experienced, I will probably go see Dr. Clavel again if I need to have a lumbar fusion even if my insurance would cover surgery in the U.S. I'd definitely talk to him about the technology he is using compared to the U.S. Dr. Bertagnoli in Europe was not my choice but, he sure is doing some cutting edge stuff with his Prodisc in a hybrid surgery technique he developed. It's a whole different world in Europe when it comes to spine surgery compared to the U.S.

The two surgeons at TBI are Dr. Blumenthal and Dr. Zigler. I think they may have the most experience in the United States because they were in on many of the trials. If you stay in the U.S., best to go with the surgeons that have been doing it the longest here so, ask the question "how many have you done?"