New Member looking for help.
 

Hello,

Let me introduce myself:

36 male from Canada.
In 2009 I herniated my L4-L5 disc and have been having on off back pain since. Once a year I would hurt my back and would need a few days to recuperate. No leg pain, no meds or surgeries.
This past April was in great shape until I busted my back again while skying. This time the pain was different and had shooting pain down both legs so decided to obtain an MRI.
The report shows significant disc space narrowing and desiccation, a large extrusion in my L4-L5 on a previous chronic looking hernia (2009).
It also was showed in my L4-L5 disc : Mild facet arthrosis on the right and moderate on the left which is causing mild foraminal stenosis on the right and moderate stenosis on the left which is likely not clinically significant.

I am waiting to meet a spine surgeon but have done a lot of research and am expecting for him to either offer me a fusion or ADR. I have failed conservative treatment for the past 4 months and things are getting worse .

The question that i have :

Will this mild/moderate facet arthosis and foraminal stenosis exclude me from being a candidate for an ADR?
Im terrified of the idea of getting a fusion at my age :bawling:

Thanks!

Mike

People have had ADR with mild to moderate facet damage and had that damage halt, and sometimes even reverse to a degree, due to the improvements of the mechanics of the spine when the failed disk was replaced with an ADR. At the moderate arthrosis level, if you take the number of complaints vs. praise as a reasonable predictor of your odds, you're probably more likely to stay level or have your facets continue degenerate albeit much slower. At the mild level, you're probably more likely to stay level or improve.

You can also seek post-ADR conservative care routes to increase the likelihood of facet improvement. A lot of those options end up being snake oil but there are some that seem to help a large fraction of those who try them.

I would continue to pursue ADR and do it aggressively so that you can get to a decision point before your facets degenerate too much further. Once you get to a surgeon you trust to perform the ADR, have the conversation about our facets and know what you're getting into. Don't delay in getting to that conversation, though, or your facets will degenerate and you'll have the decision made for you.

It's also worth pointing out that, if things go bad and you end up with a fusion, people have used ADRs to bracket a fusion and halted the adjacent segment problems inherent with a fusion. No, it isn't a great option but simply getting a fusion isn't a guarantee of cascading degeneration in your later years.