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Old 05-10-2017, 12:59 AM
LumbarSpine LumbarSpine is offline
Join Date: May 2017
Posts: 44
Default Greetings! Lurking for a while, just introducing myself!

Hi Everyone,

First, let me say that although you don't know me, I feel like I know some of you. I've read quite a few lengthy threads on this site, and it has been very educational. I really appreciate all the information that people, often over the course of multiple years, have posted here.

I won't bother to repeat what's in my sig block, but I'll expand a bit by saying that I have to sit for my job, and of course, driving requires sitting. So, my lower back pain is pretty disruptive, and I'm in some level of pain nearly 24/7, although it is normally a level of pain I can deal with. I used to have a flare up where the pain would get bad enough that I essentially couldn't move maybe once a year or less. Lately it's been more like every couple months that I end up bedridden for a few days. And that's already with accommodating it more than I would like (e.g., by avoiding sitting -- which isn't easy).

I know what I'm describing isn't as bad as some of you have it. In fact, after seeing many doctors for this, probably the most frequent opinion I get is that I shouldn't do anything (I'm in the US -- I think this attitude is pretty typical here). They say that my symptoms aren't severe enough and point out that with surgery things can go wrong. When I asked one doctor why he didn't think I should do anything when I'm in pain on a daily basis, he said "Well, you can walk now. What if you can't after the surgery?" OK... that's scary. But is that really useful input? I don't know. Of course I know that anything can happen, but if horrible outcomes are, e.g., 0.1% of the time, personally, I'd risk it. Many doctors don't seem to agree.

Incidentally, I'm here because I'm interested in ADR pretty much exclusively (I know some of you have had fusions or hybrid surgeries). I did see one doctor (in the US) who said if he did anything, it would be fusion, not ADR. I had already done quite a bit of research at that point, and so I said "If I had a fusion done, my understanding is that it greatly increases the chances of problems in the adjacent levels down the road." He said "Oh yeah, if you get a fusion done, you'll be back to see me for the other levels." What?!? And yet he is still pushing fusions... At least he was honest, I guess.

It wasn't until I started reading this site that I realized that there seems to be a big dichotomy between doctors' attitudes in the US versus other countries. I've now had my situation assessed by Dr. Bertagnoli, Dr. Ritter-Lang, and Dr. Clavel (among other doctors who I don't see mentioned on this site, such as Dr. Bae at Cedars Sinai in Los Angeles). Without fail, anyone who is an ADR expert (and so isn't pushing fusions) says the same basic thing: Replace L4/L5.

Of course, the details aren't the same. In the US, or with Dr. Bertagnoli, it would be a ProDisc-L. With Ritter-Lang or Clavel, it would be an M6-L. And, while most say they would use an anterior approach, Bertagnoli said he would go posterolateral (which is interesting in that other doctors, even experts at ADR, seem firmly convinced that posterolateral for these discs is impossible due to not providing enough access).

So, that's pretty much it. Where I am now is having largely decided that no, I'm not going to put up with this pain in perpetuity, even though some doctors say that is exactly what I should do (and with the narcotic scare that is currently going on in the US, doctors don't want to prescribe them, I've never found muscle relaxers or NSAIDS to do anything, and so in essence the doctors here are truly saying "I can't do anything for you. Deal with it."). Assuming I do have ADR done, I'm more hazy on traveling abroad versus not. That really boils down to how much I want an M6 instead of a ProDisc. (I don't want to start any religious wars, but I'll probably be posting questions on that topic, just in case anyone has new insights or statistics I haven't seen).

Thanks for listening, and thanks for the great community.
* 40's, otherwise healthy, back pain for many years.
* DDD at L4/L5. Facet pain at same level.
* Multiple RF ablations, with inconsistent/marginal results.
* Single-level disc replacement with Dr. Clavel, Sept. 2017. Went well, recovery MUCH faster and less painful than anticipated. Now need to get active again and keep back in shape!
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