Needing to make some decisions..
 

Hi all,
I just discovered this site and like many others, am considering a fusion vs. adr. It is difficult to find objective information on the web. Also, hard to find success stories not related to selling some procedure or product. I have an degenerated L5/S1 after experiencing a severe rupture 7yrs ago leaving my right leg with nerve pain, weakness and disc pain that is more and more becoming debilitating. I am not able to work very well, hike, bike, golf or ski and I live in Colorado! Am only 49 and fit but losing it more and more everyday. I want to be superactive in the future. I see Dr. Corenman at Steadman Clinic in Vail which is very progressive and treats many professional athletes. He is still not a proponent of ADR, believing fusions are still treatment of choice. Does anyone have any feedback for me? Need to decide in next month or so. I could go to Europe for ADR or even to Boulder where I hear there are some good surgeons.

P.S.
 

All other discs are healthy so far. Had several injections with no relief but injecting the facets on Monday for further diagnostic information.

Thank you in advance for your advice!

kbrooks,

Yes, many of us have experienced being active and in great shape; then suffer an injury and watch the body atrophy into a blob of jelly because we're in too much pain to move. Condolences and welcome.

I think that getting an opinion from a doctor that is pro-ADR would be prudent. If you decide to pursue ADR, then getting opinions from multiple ADR doctors would be wise. If their prescriptions converge, you can proceed with confidence that you are making a good decision.

A note about fusion at L5/S1 ... ADR doctors seem to be less likely to do ADR at that level than they were in the past; opting for fusion with increasing frequency. So I'd encourage you to remain open to fusion, especially at that level. I am acquainted with a woman that has completed multiple marathons and an Ironman with an L5/S1 fusion; so it's not necessarily going to prevent you from doing what you love to do.

Good luck!

JSS,
Thank you for your reply. I had sworn not to have a fusion because of so many complications I had heard of. So often medical professionals say DON'T have a fusion. I even had a very busy MD that did my pain injections say NOT to do fusion. But they are not in pain. The problem is that you rarely hear about the successes. I have a surgeon in my area that I really respect and is very well respected advise against all lumbar ADR. But now with so many improvements in ADR products, I don't know what I would do. I will consult with several ADR doctors first. If anyone has recommendations in Colorado or London, I would love to know. Other international locales are not out of the question either just want a kind and caring experience.

I am glad to hear of your friend running marathons, I want to climb Kilimanjaro some day!

Hi kbrooks, I second Jeff's message, as I am seeing a shift toward fusion for the lumbar area, even insurance companies here in US seem to cover ADR's for Cervical more than for lumbar, though not without an appeal or two!
I was scheduled for surgery with a surgeon in London (Mr. Adrian Casey) for M6 ADR for C4-C6.
For lumbar issues my mother in-law (a surgeon herself) saw Mr. David Harrison and loved him. If my problem was lumbar, I was going to Mr. Harrison too, but he does not do cervical, so I went to someone else.
Best of luck here in US or abroad,
Dema

The Activ-L seems to be the artificial disc of choice for indications in the L5-S1 area. There are a few folks on this forum have had it implanted with excellent results. Do a search for Activ-L and compile a list of surgeons that use this device.

One name that comes across this forum periodically for a Colorado surgeon is Kenneth Pettine; he's somewhere north of Denver. "colorado babe", who actively posts on this site had surgery with him last year.

There are a number of British ADR surgeons that are occasionally mentioned. The only one I can name is Chris Dare.

Good luck!

KBrooks,

I believe that what JSS said about L5/S1 is correct. One of the biggest problems with fusion is Adjacent Segment Disease. In other words, the pressure of the fusion on adjacent healthy discs often cause them to weaken over time and require additional surgery, thus creating a domino effect. From what I understand, this issue is very unlikely to happen at level L5/S1.

Most of my issues have been with the neck, which is why I'm on this forum. However, I did have a fusion at L3/L5 in 2010. I felt better after waking up from the surgery and haven't had any lumbar issues since.

The neck is another story. About two months ago, I started to do some weightlifting. Just a few exercises. I lost about 10 pounds and felt great. However, I hurt my shoulder and have some small tears in the rotator cuff. I also feel some stiffness in my neck. I hope to get an MRI of neck soon to rule out further injury. I've had 4 surgeries on my neck and hope not to need anymore. However, if it's between fusion or ADR, I'll definitely do ADR up there.

Good luck!!

Gene

Hi There! I had a fusion in the L5/S1 on Oct 20, 2014 by Dr. Kenneth Pettine and Dr. Fernando Techy and am doing awesome. Please feel free to pm me and I would be happy to discuss with you. These two incredible surgeons gave me my life back. I have 95 percent mobility and no more Charlie horses, sciatica and feet cramps. My average amount of sleep per night is 10 hours. Prior to surgery about 3-4 hours. I am a poster child at my Physical Therapy appointments and my therapists have never seen a patient do so well.

Thank you all for taking the time to respond. I am touched and it does feel good to know there are those who understand. I just had my facet joints injected today by Dr. Karli at Steadman and feeling pretty good, will see in the next week. Colorado Babe, I would love to hear more of your story too and will PM you after I get a feeling for how this injection is going. It looks like there is somewhat of a consensus about the fusion at this level. The Activ L disc sounds promising though and will research on that too. Will continue the research and post outcomes so that I may help others too!

Thanks all!