[annapurna]

Typically, the hybrids that you'll find discussed here take place when the surgeon places both ADR and fusion at the same time. Less often is the ADR followed by fusion, and even less often than that are situations like yours where a fusion was first. That said, I wouldn't be surprised if you found a similar case if you searched the board.


You asked about recommended device types. I'd approach that by choosing surgeons you're willing to pursue and whether the devices they use are suitable. The reason I'd prioritize the selection of the surgeon is that placement of the ADR above a fused level will stress the device, even if it's been optimized for that kind of use. Getting it placed as close to perfectly will have a huge effect on long term success or failure of the device. My suggestion is to look for surgeons who've done multiple levels, and multiple levels over multiple surgeries, and are old hands at such work. Don't consider someone who's got a lot of experience with single level work and sells an optimized ADR over someone who's done hundreds of multilevel surgeries.