[bwink23]

Brattigans,

It's nice that you found a doc who gave you his honest opinions..it's amazing you see the same docs for the same issues and they come up with different treatments. Did the other docs recommend multi-level fusion?? Is your L4/L5 degenerated or just bulging? My L4/L5 is degenerated...one doc i saw also mentioned fusion also at L5/S1, which seems to be common practice with Spondies who have stress fractures at the same segment. But, he did not want to tell me multi-level fusion, even though he knew my l4/5 was bad. All this guy does is fusions, what does that tell you about the outcomes of multi-level fusions when he doesn't even want to perform his bread-and-butter on you? (Not like i would go for that if i couldn't help it)

I'm interested to know what the other proposals were that the different doctors gave you. You seem like a cut-n-dry type of case that doesn't leave room for many options. Is 7mm slippage still in the grade 1 level of Spondy? Did inquire about the different types of fusions they could perform? Did you ask about the need to realign the vertebra ? Fusions raise a few questions just as ADR does. I'm more concerned with the fusion aspect of my issues than the ADR. I would bet there is a breaking point in the amount of slippage as whether you'll need a to have a anterior/posterior combo to properly align the segment again and keep it there to encourage a strong fuse.

From what i've read, a posterior fusion is more risky for nerve damage as opposed to anterior. I don't know how much disc space you've lost, but you will regain some alignment through an anterior approach when they open the space back up to normal. How much i don't know. 7mm slip is quite a bit more than mine comparatively, but i have just one pars defect, so the other side must be keeping it from getting much worse. But still, it seems on the low end of the spectrum, you may be able to get away with having just an anterior or posterior fusion. If the slip is too bad, for sure they will brace it from both ends. Let me know what the options they gave you were.

I've recently had a "pars defect injection" performed on the area to see if the fracture was causing my pain...it did no good at all. Most likely it is not the pain generator. i've had several injections in different areas in my spine, and none of them did any good. The one i had at L5/S1 though did not take away the pain, BUT it did make it worse. Possibly the slight slippage is putting excessive pressure on the innervated disc.

The fusion doc told me i had to have 2 pars defects for slippage to occur. Until he looked at my CT scan, which report states i have one. The scan shows one side. Maybe i had 2 at some point and only one side healed properly, i don't know. I do know he wasn't gonna let "2-level" fusion fly out of his mouth despite the DDD above the Spondy. He just wanted to fix the Spondy really. If i had to choose, i would take my chances with the Spondy and just have the DDD at L4/L5 replaced. Unfortunately, that's not possible, is all or none. What worries me even more, is the bulging at L3/l4 that i can feel. It doesn't cause significant issues that i know of, but i do feel it bulge out if i slump in my chair a little....don't know if Dr. Clavel will find it necessary to address that issue. Imagine that, hybrid fusion with 2-level ADR? ugh

At this point, i'm waiting for Clavel's response and see what he recommends and ask the necessary questions about whatever he proposes. It's time to take a leap of faith and hope for the best.