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Old 06-11-2015, 11:10 PM
bwink23 bwink23 is offline
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Join Date: Nov 2013
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Quote:
Originally Posted by Mrbaozi View Post
In mid May I received a reply from Dr.Bierstedt regarding my scans and this is what he recommended:

Drs Bierstedt and Illerhaus comment after reciewing your data :

Diagnosis

degenerative disc disease L4/5 and L5/S1 – spondylolisthesis (slippage of vertebrae)


Dr. Bierstedt:
ADVISE:

disc replacement L4/5: ROI-S cage and stabilization at L5/S1 (APLIF)

The advised surgery by senior neurosurgeon Drs Thomas Bierstedt or Dr Illerhaus includes

· M6 implant technology

. Nuvasive implant, Globus spine

· fluroscopic guidance for accurate placement of implant

I then contacted Dr.Clavel and received this:

“At L5-S1 only a fusion can be done due to the spondylolisthesis
It cannot be done from the front due to the steep sacral slope.
He then needs a fusión from the back.
What can be done is a lumbar arthroplasty at L4-L5, this one coming from an anterior approach, as we always do”


So, Dr. Bierstedt is saying he would do the fusion from the front (L5-S1), then put the ADR in at L4-L5. Malte called me to answer a few questions and said it would be a fusion from the front, then 2 tiny keyhole sized incisions in the back to put the screws in.

Dr. Clavel is saying due to my sacral slope, a fusion from the front can't be done, so it would be a PLIF and then flip me over and ADR it up from the front...

This is fairly confusing as one is saying it can be done and the other is saying it can't...

From what I've read, isn't the posterior approach bound to increase recovery time, as they'd be hacking through my back muscles to gain access?

Has anyone on here heard of anything like this before?

Thanks!

Do you know the grade level, 1 thru 4, of your spondylolithesis? What caused it, do you know? Any fractures in your spine? I too have a small Spondy, grade 1 at 2mm. I have a pars defect on my left side, L5 vertebra. Depending on how bad your slip is, its not uncommoon at all to do a 360 fusion. The posterior approach is an attempt to bring the vertebra into a more correct alignment. You have to do that to be able to correct the slip as much as it can be done. An anterior approach will not correct slip. I had an anterior fusion done without posterior instrumentation by Dr. Clavel, i presume cuz my slip is minor as far as spondy goes. He wasn't concerned with correcting my slip, more with stopping movement of the vertebra.
__________________
2013 - MRI and CT scan....DDD L4-S1
left side (where my pain is) interarticularis pars fracture/defect with Spondylolithesis L5 over S1 with 2MM anterior displacement

Feb. 2014 - Hybrid lumbar fusion(l5/S1), ADR(L4/L5)...2-level cervical ADR (C5/C6, C6/C7). Dr. Pablo Clavel of Quiron Hospital in Barcelona, Spain. All M6 implants (PEEK cage and plate from Medtronic at fusion level in lumbar.) SAME DAY OPERATION for both areas of the spine.
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