Does a wait and see approach hurt ?

[JeffR]

Originally Posted by bruceminer

I've also read that fusion is a reliable option to ADR for the L5/S1 level as this disc level does not provide much movement. Any thoughts?

Bruce,

My understanding is that a fusion for L5-S1 is a viable option IF L4-L5 IS BEING REPLACED WITH AN ADR ALSO, e.g. this option was offered to me at the Texas Back Institute (I opted to get M6s for all three of my discs with Dr. Clavel). AFAIK just getting a fusion at L5-S1 would leave you susceptible to adjacent disc disease but I am not a doctor. You probably want to get the opinions of some ADR surgeons who do both (e.g. Clavel) on that.

-Jeff

[annapurna]

Originally Posted by bruceminer

I've also read that fusion is a reliable option to ADR for the L5/S1 level as this disc level does not provide much movement. Any thoughts?

This is an unproven comment that's been debated for years. Certainly, people have done well with ADRs at L5S1. That's a proven fact. It is, however, a proven fact that it's not the motion at a given point that leads to failure; it's the forces across the structures at that point that does it. L5S1 is likely one of the most heavily loaded structures; the most if you simply count how much of the body is above it compared to other levels. I haven't seen anything done to analyze this but I'd really love to see someone show whether or not the large forces outweigh the very small movements at the level.