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  #11  
Old 01-20-2017, 10:46 PM
drewrad drewrad is offline
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Join Date: Jan 2014
Posts: 629
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I'm a three level hybrid. Clavel fused my L5/S1 and inserted two M6s above that. That was 2.5 years ago.

He said my sacral slope was too steep.
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Weightlifter since 12 years old, now mid-40's and figuring out this wasn't such a good idea.

Chronic back pain started in 2010 while shrugging weights that a 40 yr. old shouldn't even try.

MRI in 2012 showing L4/L5, L5/S1 herniations and L2/L3 bulge.

L5/S1 taking on new shape, chronic sciatica, etc.

DEXA bone scan performed 5/7/14 showing mild osteopenia.

Surgery performed July 9th, 2014, Dr Clavel, hybrid three level lumbar.
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  #12  
Old 01-21-2017, 03:07 PM
WakesurfMike WakesurfMike is offline
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Join Date: Nov 2016
Posts: 37
Default Just curious but how does the doc deal with spurring and facet arthrosis from an ante

When they put something solid in to fuse it, they restore to the height of what a normal disk would be. This takes the pressure off the nerves and the facet joints . The facet Joints will no longer be supporting the weight it should reduce inflammation and pain from the facet joints. Sometimes they also fuse the facets as well but not always.
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WakesurfMike
2007 Herniated L5/S1 Lifting changing X-ray tube at work. MRI PT/ Steroid shots/med
2009 switched to Remote/phone support
2010 workman’s comp lawsuit
2011 Microdiscectomy approved 80% pain relief
2011-2016 few flare ups but would always get beter after a few days.
6/2016 Pain is not going way
07/2016 MRI, tramodol, Nucynta, Celebrex
08/2016 Regenerxx PL-Disc shot- didn’t work at all
10/2016 can't even stand or sit for work for 30 minutes before pain gets worse
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  #13  
Old 01-23-2017, 07:10 AM
hanshan hanshan is offline
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Join Date: Jun 2014
Posts: 64
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Fusion at L5-S1 will always put you at risk of wearing out your SI joints, something to be aware of.
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2009: Injure lower back while doing deadlifts
March 2014: MRI shows moderate degeneration at L5-S1
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  #14  
Old 01-23-2017, 10:46 AM
annapurna annapurna is offline
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Join Date: Dec 2004
Posts: 1,573
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Quote:
Originally Posted by hanshan View Post
Fusion at L5-S1 will always put you at risk of wearing out your SI joints, something to be aware of.
SI and hip and there's little you can do with the SI joints other than fuse them when they become problematic.
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Laura - L5S1 Charitee
C5/6 and 6/7 Prodisc C
Facet problems L4-S1
Knee, Shoulder, Toe, Finger, Elbow Problems

Jim - no spine problem but lots of other fun medical challenges

"There are many Annapurnas in the lives of men" Maurice Herzog
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  #15  
Old 01-29-2017, 02:29 PM
Blizzaga Blizzaga is offline
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Join Date: Nov 2016
Posts: 128
Exclamation

Quote:
Originally Posted by jgvesely View Post
I have only heard back from the Texas Back Institute. They recommended that I get an ADR at L4/L5 and a ALIF fusion at L5/S1 (a hybrid). When I asked why fusion was recommended at L5/S1 rather than an ADR, I was told it was because I did not have much disk space left at this level. (I have only been corresponding with Christine, the doctor's representative). Do any of you know the reason why a fusion would be recommended at L5/S1 for people with a lot of disc degeneration at that level? I know there is not much movement to begin with at the L5/S1 level and it's my understanding that since there is no disc below L5/S1 and I would be having an ADR at the level above it, that there's not much risk of hurting adjacent discs. Still, fusion is a lot more expensive, and I've heard that the surgery takes longer and that the recovery is longer. I definitely trust the Texas Back Institute and I've heard many great things about them. I'm just curious to know what other people's thoughts are on the question of doing ADR vs. fusion at L5/S1.

Quote from Dr. Rischke et al. in "Preclinical and clinical experience with a viscoelastic total disc replacement" published 2011 in the International Journal of Spine Surgery:

"Some investigators advocate fusing the L5-S1 segment rather than implanting a TDR because of lower reported ROMs at this level. Although the ROM has been reported to be lower in some loading modes at L5-S1 compared with L4–5,ROM should not be the important factor in deciding between fusion and TDR. The compressibility of the L5-S1 segment is vital in the transition to the relatively stiffer segments of the pelvis below. Thus, in the degenerative state, the resistance to compressibility is lost, leading to clinical symptoms. This study shows that restoring stability and compressibility results in excellent clinical relief of symptoms. We therefore advocate the use of VTDR in this segment over fusion wherever possible."

I wanted to bring this up, since I heard some parties use the range of motion (ROM) argument for fusing L5-S1. Even if ROM may be small in flexion and extension, the L5-S1 may play a vital role in compression!

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2015 Lost ability to sit
2016 Gradually worsening despite conservative treatment
2016 L4-L5, L5-S1 activ L success!
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  #16  
Old 03-06-2017, 04:10 AM
jgvesely jgvesely is offline
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Join Date: Nov 2016
Posts: 32
Default Thank you!

Dear Blizzaga, Annapurna, Hanshan, Drewrad, and Pittipete,

This is a very belated thank you for the information that you shared on this thread I started a while back! I am sorry that my appreciation is so belated....I have been experiencing some pain when using the mouse and typing the past few weeks. I am now switching to voice activation.

I will be getting ADR on levels L4-L5 and L5-S1 with Dr. Clavel on March 22nd. I am excited and a little nervous. At some point in the future, I will probably get my neck worked on too.

I hope you are all doing well!
__________________
Juliette
1992 Neck injured in bad car accident
For many years taught & choreographed dance & injured lower back in 1997
Loads of conservative treatment
2000, IDET procedure L4/L5 & L5/S1,
2001, orthoscopic laminectomies L4/L5 & L5/S1 & orthoscopic discectomy L4/L5.
Surgeries didn't help
Recent years- stem cell & PRP injections- helped a little.
Recent MRI & x-rays show DDD & facet arthrosis in lower back & DDD & bone spurs in cervical spine.
3/22/17 L4-S1 ADR with Dr. Clavel
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  #17  
Old 03-08-2017, 07:27 AM
donmas2000 donmas2000 is offline
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Join Date: Dec 2016
Posts: 58
Default

Quote:
Originally Posted by jgvesely View Post
Dear Blizzaga, Annapurna, Hanshan, Drewrad, and Pittipete,

This is a very belated thank you for the information that you shared on this thread I started a while back! I am sorry that my appreciation is so belated....I have been experiencing some pain when using the mouse and typing the past few weeks. I am now switching to voice activation.

I will be getting ADR on levels L4-L5 and L5-S1 with Dr. Clavel on March 22nd. I am excited and a little nervous. At some point in the future, I will probably get my neck worked on too.

I hope you are all doing well!
Hi, so you decide to do ADR on your L5S1 not fusion?
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  #18  
Old 03-13-2017, 02:50 AM
jgvesely jgvesely is offline
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Join Date: Nov 2016
Posts: 32
Default ADR instead of fusion on L5-S1

Quote:
Originally Posted by donmas2000 View Post
Hi, so you decide to do ADR on your L5S1 not fusion?
Yes. From everything I have read, it seems like the better choice. And it is what Dr. Clavel recommended. Also, I have heard from several different sources that surgeons in America are starting to recommend hybrid surgeries because it is more easily covered by insurance.

All the best to you!
__________________
Juliette
1992 Neck injured in bad car accident
For many years taught & choreographed dance & injured lower back in 1997
Loads of conservative treatment
2000, IDET procedure L4/L5 & L5/S1,
2001, orthoscopic laminectomies L4/L5 & L5/S1 & orthoscopic discectomy L4/L5.
Surgeries didn't help
Recent years- stem cell & PRP injections- helped a little.
Recent MRI & x-rays show DDD & facet arthrosis in lower back & DDD & bone spurs in cervical spine.
3/22/17 L4-S1 ADR with Dr. Clavel
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  #19  
Old 03-28-2017, 02:15 AM
donmas2000 donmas2000 is offline
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Join Date: Dec 2016
Posts: 58
Default

Hi WakesurfMike, are you going down the surgery path? It seem like i have the same level problem with you L5S1. I am doing conservative treatment for almost 1 year and i am better with sitting and standing but not bending and lifting with more 3 kg. What do you think about surgery?
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  #20  
Old 04-24-2017, 09:17 PM
FutureRobot FutureRobot is offline
Senior Member
 
Join Date: Jan 2016
Posts: 104
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I find it incredibly interesting that Tiger Woods went to TBI for his l5-s1 issues and went with a fusion over ADR. TBI is definitely a pioneer when it comes to ADR in the US, and Tiger Woods is arguably one of the most famous athletes of our generation. I wonder why they didn't choose ADR at the l5-s1? To me it's a bit telling.
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HIZ tear at l5 s1 with mild disc height reduction and mild dehydration.
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