What would you do? Thoughts?

[Justin]

Steve,

Personally--I would do whatever is the least invasive option now, or if you are confident on surgery (deciding between ADR / fusion), pursue that route.

I would not base your decision based on cost alone. I know cost is a real issue (I had to sell my brand new truck at the time, etc.), but it should not overshadow your surgical decisions. Surgery is a significant life event and the decision making process can be overwhelming... I wish you the best in this process Steve. Don't hesitate to contact me by PM.

Just some general statements:

1) Many on this forum and other forums say "I could get the ADR and just fuse if it doesn't work out." This is a very dangerous thought process and was popular when ADR was "new" in America.

There is no way around it: spine surgery is MAJOR surgery.

2) You only want to be operated on once, if at all possible. Anesthesia has inherent risks, and, remember, surgery is not a guarantee of a reduction of pain. Multiple surgeries in the same part of the body present subsequent challenges (the normal process of scaring post surgery and the alteration of anatomy, access, etc.)

In regard to surgery: it should be only pursued after all conservative treatment has failed. Surgery is forever... there are no "do-overs."

3) You only get 1 spine in life....... and that's it. Only cross bridges when you feel absolutely comfortable, have done your research, can no longer live life with your quality of life, etc.

This decision ultimately rests on the patient.

4) Don't schedule surgeries based on meeting deductibles or deadlines before switching insurance companies, etc. IMHO, this should be irrelevant to the surgical decision process.

5) Don't base what surgical options you should pursue based on the outcomes of other patients. I can't stress this enough. People will have surgery and say "why am I not healing as well as so-and-so?"

Remember: we all have subtle differences in anatomy, and we must remember to take into account the duration of injury (1yr, 10 yrs, etc.). Our genetics are also very unique and our lifestyles (how we eat, what we do for a living [stressors], our activity levels [exercise]) also factor in to the equation. Co-morbidities can play a significant role.

We are not carbon copies of each other and surgery won't address everything you have going on in your life. At best, it's a band-aid.