[ian]

I've only heard of three level ADR from L3/L4 to L5/S1, but I'm unfamiliar with complications concerning vessels at L2/L3. I've read that Dr. B is one of the few doctors who performs ADR higher up, especially in thoracic vertebrae.

Ask to speak with Dr. B over the phone. I was able to clear up all my questions in one conversation that would have taken countless back and forth emails.

While he primarily uses the M6, he also uses the disc that he feels works best on a particular patient, or in a particular area of the spine. With that said, I've never heard of the Triumph disc.

Originally Posted by drewrad

Waiting for Zeegers 'perfect diagnosis'. In the meantime, he gave me a little taste of it which shows multi-segmental lower lumbar DDD, the bottom two showing the most damage.

Malte got back to me yesterday. He is recommending a two level M6 at the L4/L5 which is basically gone as well as the L5/S1 ditto.

Here's his own words:

Dr. Bierstedt reviewed and commented your medical data.

Findings/diagnosis
Severe Degenerative disc disease L4/5, L5/S1
Moderate DDD at L2/3 and L3/4

Here's their recommendation.

Surgical decompression of the spinal canal by total discectomy, removal of osteophytes and artificial disc replacement L4/5 and L5/S1

Pre-operative discussion on disc replacement L2/3 and L3/4.
Assumption: these levels are clinically irrelevant. If symptoms develop in the future, additional disc replacements can be offered by lateral or posterior surgical approach.
For now these findings could be ignored.

I responded back to Malte and asked this.

I was curious about this....

" If symptoms develop in the future, additional disc replacements can be offered by lateral or posterior surgical approach.For now these findings could be ignored."

If I needed these two levels later on, do you mean you couldn't approach from the anterior like you would be this time? And if so, why? I never knew you could do an ADR from the posterior.

He responded back thusly.

The surgery will be performed by Dr. Bierstedt.
Ref disc replacement in high lumbar levels:
The anterior access to L2/3 is complicated due to the vessels. or higher leels Dr. Bierstedt uses a posterior approach

referencing this, the Triumph. Was wondering if anyone heard of it?

TRIUMPH® Lumbar Disc, posterolateral approach - Spine

However, what I want input on is that some here have received a 3 level ADR and vessels weren't an issue with you I assume so it is possible. Did Biersdadt or any other doctor mention higher lumber levels being a contraindication from an anterior approach?