Intro..

[Alastair]

Well thought out David - -- I hope this goes well for you
Best
Alastair

[David]

Thanks.

At this point in time, it is pretty much a waiting game.

Either Dr. Y can get me into a study of some kind, or I wait for the FDA to approve prodisc and then go that route....

David

[Juli]

If I just had issues at L5/S1, I would probably take fusion, as it can be quite successful. I have been told that I have L5-S1 congenitally fused and have never had movement there. I have always been less flexible than most people I know, but lived a very active life, raquetball, softball, biking, jogging. I was active duty navy for 16 years with this condition. But the deteriorating discs at that level and the two above it put a stop to my activities by the time I was in my late 20s. With ADR still being relatively new in the U.S and the fight with insurance, I would jump on fusion if it was just that one level. But, I do not want fusion at three levels, I think that is too much range of motion lost.

Anywho, that was my thought process, just to share with you. I do believe there are many who disagree and would never choose fusion over ADR. But I have even had many well known doctors who do ADR indicate that fusion at L5-S1 can be a good option.

Well, here is the other mystery. My problem disc has always been refered to as L4/L5 up until an x-ray report from early this year. It is now being refered to as L5/S1. A couple reports have indicated a transitional segment (?)which I think is where the confusion began. The NS seems to be sure it's L5/S1.
But it is causing major problems as my comp carrier fighting that it's a new injury. Needless to say, they are becoming difficult to deal with. They don't want to take responsibility.

[David]

I personally would be more apt to believe a MRI, discogram, or CT scan than I would a X-ray when it comes to potentially diagnose DDD.

If you don't mind me asking:

--Which level(s) do your recent MRI indicate as DDD?
--Have you had a recent discogram?

David

The x-ray is actually where the confusion began. An MRI a few months later refer to L5/S1. So between the MRI and the NS, I'm inclined to think it is L5/S1.

I've actually never had a discogram nor was it ever suggested.

[David]

I apologize, because now I think that I am a bit confused....

Are you saying that you had a laminectomy in 2002 on the L4-L5 level, and now you have issues with L5-S1, or are you saying that your issues have pretty much always been with L5-S1?

Thanks.

David

I'm a bit confused as well.

I did have the lami on L4/L5 in 2002. Which it has been. Now it's being called L5/S1. What I was told by the NS is that no matter what it's being called, the prior surgery and new problems are the same area. It's a natural progression. It just depends on who's reading the films and how they count the vertebrae. All surrounding discs are healthy. It all stems from this "transitional segment".

[David]

I agree. I am still confused.

But.... I am not a neurosurgeon nor an orthopedic surgeon.

Perhaps someone like Mark / Alastair / Juli will show up again shortly and have something else to add to the conversation...

David

Me too. So far, no matter who explains this to me, I can't quite understand it.
All I know is that this confusion is giving the comp carrier ammo to dispute it.