Hi Beaverc,

Overall I thought both Dr. Clavel and Dr. Blumenthal (TBI) inspire confidence. They are both very well known and I am confident either would perform the surgery well. I had a virtual meeting with Dr. Clavel and an in person meeting with Dr Blumenthal. I do like that Dr. Clavel has a more lengthy post surgery process. They recommend two weeks in Barcelona with lots of rehab included. With TBI, once out of the hospital I would fly home and be on my own. Nice to be home, and I am good at rehab, but feel like having some dedicated work right after might help. Both want to do the same procedure (ADR 4/5 and ALIF 5/1).

Now I have to decide if I want to do this conservative approach or the more aggressive 3 level ADR. Bertagnoli recommends this. Although I have not spoken to him, based on all the information I have reviewed, I think he would also have the same ability to have a successful surgery. Once you have the right surgeons it really seems like it is just how your body responds to it. Obviously working on two vs three would have less likelihood of issues since less work is being done. However, the liability of having a degenerating disk at ¾ that could cause problems later.

If Clavel still uses Lila for PT (she came to my hotel on her motorcycle a few times to do PT), I wouldn't put too much emphasis on that if you are diligent in doing your own. Even better if you have good and very gentle massage therapist. Lila is very good at what she does, and is certainly a very kind and professional woman and I really liked her (even had snacks and beverages . But it isn't magic for someone like you who can, and will, do it on their own. What ADR's are proposed? Good luck

I had an epidural on Friday and it seems to have aggravated the nerve. Back on the couch not able to stand, sit or walk. Time to make a decision about surgery. The two primary things I am struggling with are:

1. Intervention at l3/l4 or not. I am not experiencing symptoms but the imaging shows ddd. I've attached the image. I am leaning toward leaving it alone but would hate for it to be another problem. Anyone else get info that helped them make this decision?

2. ADR vs ALIF at l5/s1. I've been down the path of ADR so the fusion opinion is hard for me to accept. The reasons given for ALIF are slight spondy and already collapsing disk. When I asked the drs that recommended ADR they said I have a very minor spondylolisthesis, less than a full grade 1. No fusion is necessary. I also don’t see how ADR would have a larger impact on height. The two devices seem similar size? Anyone get any good info to help make this decision?

Thanks in advance for any input.

Looks like I am headed to Texas! Dr. Blumenthal will be doing a hybrid ADR4/5 ALIF5/1 during the later part of April. Just a few weeks, can't wait! My last epidural has left me unable to stand, walk, or sit so basically immobile. The pain down my leg is at a 4-5 at best 9 at worst (always have to imagine there can be something worse at a 10 but not sure what). This helped me make the decision as I can’t imagine making the trip to Europe in this condition. I’ll start posting my experience in the other section when I’m on the other side!