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Old 08-12-2019, 11:24 AM
annapurna annapurna is offline
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Quote:
Originally Posted by Owain View Post
Maybe fusion on L5-S1 is a good idea, though? Maybe at this level it is too big bone angle and it will fall apart in a dozen or so years? Maybe after 40 L5-S1 is not so mobile anymore? Maybe that's why many doctors make a hybrid if it concerns L4-S1?

L5-S1 doesn't move that much, which prompts many doctors to recommend fusion instead of ADR. The forces generated by fusing L5-S1, though, are high and prone to mess up your SI joints and hips as well as risking L4-5.


That said, spondy changes things. If you have a joint that isn't moving correctly to begin with, putting in a high degree of freedom prosthetic might cause more problems. With that, I can see Bertagnoli's argument. I can also see why fusion might be the best bet.


If you didn't have spondy, the argument for fusion over ADR isn't very good. Any of the arguments that I've heard about limited motion at L5-S1 depend on a faulty understanding of mechanics and the effect of locking that joint. As you do have spondy, you're into a situation where you have to pick the lesser of two evils. I would suggest, though, if you chose ADR, especially a elastomer disk, you need to plan on limited lifting and lots and lots of core strengthening as that core strength will be what controls your hypermobility.
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Laura - L5S1 Charitee
C5/6 and 6/7 Prodisc C
Facet problems L4-S1
General joint hypermobility

Jim - C4/5, C5/6, L4/5 disk bulges and facet damage, L4/5 disk tears, currently using regenerative medicine to address

"There are many Annapurnas in the lives of men" Maurice Herzog
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