Pro disc in 2001 success but now a new level issue and bone marrow edema
 

Background: had lami lots of disc loss, thus I had a pro disc l4/l5 in 2001....what I would call a true success...

Now jump 12 years later, pro disc is fine...but I also know though it gives me more flex than had I got a fusion some of that movement is more than natural...I say this without a question just as background...I also note fixing a pro disc failure surgery is a dangerous plight but again I have been a pro disc success

Now my issue arthritis has spread to my lower disc s1/l5 and bone marrow edema detected in MRI in s1 area...pro disc area still clean though a hint of arthritis nothing of concern...

So here's a question with all my research I can't seem to get a concrete answer...if I were to need surgery in S1/l5 I would choose a fusion solely from the back. Would one add the prod disc level to the surgery with instrumentation leaving pro disc in, and used thus as a cage/spacer??

You see my lower disc area is far worse than my pro disc now and to ward off one day that I could have a failed pro disc for whatever circumstance is it better to literally use instrumentation and combine the two levels ....

So if anyone has any experience or read about this would greatly be interested...and this bone marrow edema is of course a concern as it is part of my new sciatica issue emanating from l5/s1..I don't know much about the bone marrow edema so any info or treatment or experiences welcome..in other words the pro disc is the only part of me that hasn't failed to date...thanks

Ash, the bone marrow edema may not be related to you pain syndrome in the way you think. It's just one of the degenerative changes that occurs as our discs break down. I'm sorry that you are suffering with adjacent segment disease... we have ADR in the hope of avoiding it. If you do have some intervention at L5-S1, you may or may not include L4-5. If the segment is functioning well and there is no reason to suspect it's involvement in your pain... why even think about it?

Mark