QUESTION:L5/S1 ADR or FUSION?

[Michelle Maree]

Yeah, thanks. I am sorry..... I guess my anxiety is showing.
I am a Gemini and the twins are constantly fighting with opposite opinions neither one gaining the upper hand. I will try and relax untill all the data is available.
It has been an extremely stressful time for me. My partner of 18 years left me late last year. I had to sell our house which I just moved out from and now im at my parents place with my 17 year old. I have other health issues also ....so the list goes.
I am sick of the pain and want to be able to move on with my life but as we all know this surgery thing is no sure garantee of that. I think if I was older than 34 and had lived a bit more I would find it easier and not resent having to take it so slow as much. I will just have to be patient and positive a little while longer.

Thanks for your support,
Runner,cls,Dale,Kathy and Maria.

[guymontag]

I can't really say what would be best for you MM, but since I have a dodgy L5/S1 and if I had a choice of Fusion or ADR. I'd go fusion. I am way too scared of an improper placement or device failure or facet stress. Just reading about Phylly and Mark from Perth and quite a few others, I realise its complicated to get the ADR out.

I've also spoken to a few people who have had fusion at l5/s1 and they have not had much movement limitations. I emailed one lady who works on her farm all day, lifting bales of hay etc, horseriding and she's feeling great. I think the kicker is that any fusion these days must consist or removing the entire disc inserting a interbody and then using bone, preferably donor. Not excising the disc and just fusing with rods and screws will lead to a lot more pain as they disc is still leaking chemical irritant. see MartyUSA blog

Fusion surgery over.....

I'm also now a little wary of BMP from what Mark Mintzer wrote Mimally invasive TLIF w/Hydrocision (interesting BMP data too) I honestly don't know if BMP is the problem or not. But I'd prefer if my doc didn't use it.

I'm not too concerned of adjacent disc degeneration. I wouldn't be planning to do any heavly lifting, I just want to be pain free. So if L4/L5 did degenerate, I'll deall with it then. Perhaps after another 10 years they would have improved on the ADR and you would then assess the options.

probably the hardest part of fusion is to constantly remind yourself that you are still fusing and musn't stuff up that fusion process. Its easy to forget if you are 4 months in and semi fusing and you start bending.

But as you rightly said. There is definitely no guarantees and sometimes just dumb luck can play a part.

hope you can navigate to a pain free existence Michelle.

[Michelle Maree]

Hi Guy,

Yeah, I agree with you and i have decided to have a fusion. I am too far gone for ADR. I have facet problems and Im not going to take the risk of them getting worse.
I am just waiting on an appointment with a spine ortho in Melbourne and will go ahead with it ASAP.

wish me luck,
Michelle.

[dshobbies]

Once you reach a decision you are ready and anxious to move forward. I hope you can get scheduled quickly since your relief is now just around the corner.

I wish you every luck and hope your dreams of a pain free life are realized.

Dale

[runner]

Ditto.

Runner

[Cindylou]

Michelle, you've received alot of helpful insight from all these folks. Bottom line, wait for the Germany results so you have more "muscle" for your decision making. It sounds like you have had major life stressors on top of the pain issues, and that is not an easy path to navigate. I personally have had a fusion at L6-S1 (I have an extra vertebra) last July. I also have 3 lumbar discs above the fusion. My decision was mostly a no brainer due to my pars defect and facet issues at that level. I have to say I do not notice much restriction physically with it. About the only thing that comes to mind is when I am standing and lifting a leg to put on my panties, sometimes I have trouble on one side, lifting my leg high enough to step through the hole. That's about it. Good luck Michelle. You'll come to the right decision.

[Michelle Maree]

I just heard word back from stenum after sending them my information and they are recommending the Maverick ADR. This is probably because on MRI my facet joints dont show anything wrong except mild hypertrophy.
I have decide to make sure first before going ahead with the fusion and will get a facet block booked for 12th June. I think id best make sure.

Michelle.

[Michelle Maree]

Hi,
I just wanted to update and also VENT!.
I went to have a facet medial branch block on Friday. I didnt go off my oxycontin untill the morning (I probably shouldnt have had any the night before but decide to so I could sleep). So consequently i wasnt at the 5/10 pain or over (I was about a 3)which I needed to be for the block.
So at the last minute the doctor decided to give me a facet injection instead. And apart for the first few hours while the anaesthetic was still working it has been far more painfull than before and I am now having pain radiating into my hips that I never had before!
I am so angry for allowing him to change the procedure at the last minute. I would much rather have paid for the medial branch block that wouldnt have shown anything than something that has caused more pain.
I have had this procedure once before and they were in and out really quick, very professional, but this guy was digging around with the needle for ages and his bedside manner sucked. I have a good pain threshhold but I was screaming out and now feel worse and am on more pain medication than before. I hope this isnt permanent damage.

Thanks, I needed to get that off my chest.

Michelle.

Oh, and I definately know where my face joints are now!

[dshobbies]

With any medical treatment, your choice of doctors is a primary concern. Sometimes I'm actually shocked at the treatment I receive for something considered relatively simple. Multiply that by the complicated nervous system and you have room life altering medical errors. Choose carefully.

[Gil Denis]

Hi Michelle

Fusion is forever ADR is unknown.

I think You have a tough choice

Motion preservation is the best to do but will it last?

All the Best
Gil