23 Years old planning a surgery C4-C5/ L5-S1 need help

[Dema]

Hi Hesham, sorry to hear about your accident, and wish you relief from the pain soon. I like Dr. Lauryssen here in the US, and while looking for top spine specialists in Europe I cam across Professor Max Aebi (Bern, Switzerland), though I have not contacted him yet, but thought he might be good for 2nd opinion given the proximity.
Best of luck
Dema

[hanshan]

Originally Posted by drewrad

The reason I ask is because L5/S1 is an increasingly contested level for ADR depending on issues referred to as pelvic incidence/degree of sacral slope.

Would be curious what he says in your case.

Dreward, do you know of a publication where the L5-S1 controversy is spelled out?

[henry4956]

Hanshan, I think the 1st thing you can do is read your mri report. It should mention something about the degree of facet degeneration at L5-S1. If moderate to severe (or grade 3 to 4) then fusion is the optimal option. That is probably the 1st criteria. Beyond that, I also concur with Drew in that right around the time I had my surgery (April this year) I heard of a spine conference in which many of the top spine surgeons world wide attended, adr at L5-S1 was being re-evaluated. It seems that the majority of adr failures do take place at that particular level, L5-S1. Look at yours or any mri and you can see the obvious angle it has as compared to those levels above. From all my research, the majority of successful fusions are at that level, probably because it is not considered a motion segment like those above. I do think based on what I know that the surgeons are being more selective for adr at L5-S1.

If you want a comprehensive understanding, Dr. Zeegers will be happy to explain it. Also, the Activ-L which Dr Zeegers uses has a uniquely designed disc specifically for L5-S1.

Hen

[hanshan]

Thanks Henry, didn't mean to get this thread off track. Typically if there is a scholarly consensus on a particular topic, such as the viability of ADR at L5-S1, there will be at least one publication out there spelling it out. Hopefully such a publication will come our way sooner rather than later.

[henry4956]

Actually I intended the post for Hesham. Hanshan, Hesham I messed up. Please Accept my apology Hesham

Regards,
Henshem, I couldn't resist

[drewrad]

Dr Clavel mailed me journal articles re the sacral slope. Pelvic incidence is another one you could use on a search engine. I had to get a second X ray for Clavel that included the tops of my exposed femoral heads since that is the data point used in relation to L5/S1 to determine if you are too steep for ADR at that level.

Lots of interesting and rare journal archives that may or may not have been exclusive, but it's something any of these consults can forward to you I am sure.

I was steep at a grade > 70 degrees which made Clavel choose that particular route. Dr Laurryson said the same exact thing, as did my Kaiser neurosurgeon. At that point, consensus had been earned and Clavel was first to being the issue up.

[Jerry5]

Sorry for your injury, and at this age, I have seen personally, people about a decade older than you...
However, if you believe you can go back to work, after 3 weeks, this is not realistic.
The ADR has a coating, and this looks like sandpaper, this is called hydroxyapatite, varies, but this will take several weeks, to grow and become strong. You may be able to work for periods, maybe an hour here and there, depends how you respond to the surgery, and how fast you heal.
I was to have two M6, but the surgeon could only place one, therefore I had a fusion at the L5-S1 level.
Still healing and this has been three months, but I am twice your age.
You may consider the MobiC for the Cervical, and go with the M6L, but remember, this is NOT the original, if you catch my drift, it will be much better, but a fall, car accident or other, can damage the disc.
Me, I hope they can come up with a better option, or at least, if in 20 years, if need be, they can remove the 'middle', leave the endplates and be done.
If you want my surgeon, in Germany, send me a PM, I have not been here in awhile, but will try to get back here.