[Artificial Disc Replacement / Lumbar] Lumbar L4/L5 ADR, Lumbar L5/S1 ADR/ALIF

[runagain]

Hello everyone,

I guess I can start my spine surgery thread, since I have already had surgery at one level and my surgery at another level is in a few days.
I would have to say that this back problem has probably been the most frustrating, exciting and unspeakable thing that has ever happened to me.

Today, my surgeon told me to chose between fusion and ADR. I am leaning towards ADR because of what I know about the two surgeries.
I know I will get unbiased opinions on this site.
So I have back pain mixed up with worries about the surgery and the upcoming approach and what I should do.
I am not in the best frame of mind because I am having severe back pain, which seems to be all over and I am stressed. Plus I think the pain medication I am on is causing me to nod off during the day. I have too much to do to get ready for the surgery and too much to do with paperwork, which is now voluminous and threatening to take me over. Help.

[ajj1001]

Hello everyone,

Today, my surgeon told me to chose between fusion and ADR. I am leaning towards ADR because of what I know about the two surgeries..

Which does he advise (not that you should definitely go with that but his reasons could highlight the pertinent issues.

I always make lists of pros and cons when pain and meds cloud my thought processes. Having someone else look at these to check I have made sense is a good as well.

[KBear]

That's a hard one. If L3/4 looks great and shows no signs of ever needing anything, then I would consider the ADR. However, since you already have ADR above that level, a fusion wouldn't cause the above disc to degenerate and there is no below disc. I would also lean torward the fusion, so if down the road 3/4 needed something you could do ADR and not have 3 levels, which I have read can cause too much movement and I would personally be afraid to do.
As of the time of my ADR, I had small herniations above and below 4/5. I think if down the road I needed more surgery, I would probably fuse L5/S1 and go ADR on 3/4. Unless, the technology changes enough where too much movement is no longer an issue.

You have a tough decision and I would definitely write the pros and cons list. Maybe even give them a 'point value' from 1-3, depending how much weight they carry. I'll be praying for wisdom and guidance for you.
Kathy

[Justin]

I just spoke to runagain on the phone. Please keep her in prayer. Her insurance is ultimately cornering her into a very hard decision that comes down to what they will cover.

[KBear]

That sucks. She still hasn't finished fighting the first battle, has she?

[runagain]

No,

KBear, I have just begun to fight.
And I am a fighter, if nothing else.
Leaning very heavily towards ADR.

[Fuzzy]

If ADR is appropriate and you can get it I would try to get it. I don't remember your details but there are times when a fusion is a good thing or no worse then ADR. Sometimes stoppin things form moving is what stops the pain.

I wish you the best

[runagain]

My surgeon called me today and he will not do surgery because of my insurance company refusing to cover the surgery and so I am done with doctors and surgeries.
I cannot do fusion unless it was absolutely necessary and it is not. I have decided to just stop going to the doctors and just accept a life of disability.
I am not going to get my hopes up again because the fact of the matter is until people kick the insurance companies out of health care we are not getting the optimal health care unless we are millionaires or congressmen.

[Justin]

My surgeon called me today and he will not do surgery because of my insurance company refusing to cover the surgery and so I am done with doctors and surgeries.
I cannot do fusion unless it was absolutely necessary and it is not. I have decided to just stop going to the doctors and just accept a life of disability.
I am not going to get my hopes up again because the fact of the matter is until people kick the insurance companies out of health care we are not getting the optimal health care unless we are millionaires or congressmen.

runagain,

I am so sorry that this is happening. I wish I could do something to help--please know that I am here to support you in any way possible. I know you want to give up after everything you've been through. Just remember these words:

No,

KBear, I have just begun to fight.
And I am a fighter, if nothing else.
Leaning very heavily towards ADR.

We're here for you.

[Phylly]

Runagain,

Am I understanding that your Dr. does not think the surgery is necessary and that is why your insurance is not covering it, or your insurance just decided that you don't need it after pre-approving it?

When it was scheduled didn't your Dr. feel that it is was absolutely necessary? I guess I am blown away for you. If your Dr. recommended the fusion would BC have been more receptive of the surgery or did they need to see another discogram or some other diagnostic test?

Sorry, so many questions. You must be so disappointed. I am getting so tired of Drs. leaving it up to patients to decide whether they need surgery when it is obvious that something needs to be done but they don't want to look bad recommending it. We go to Drs. because we need help figuring out what to do, we did not go to med school (except Justin). I don't think that you should be the one deciding on ADR or fusion I think he should recommend what he feels will be right for you. I cannot remember if you saw anyone else when your pain was increasing and what they recommended?

I would also think about what Fuzzy said. A fusion might not be bad if it stops the movement that causes the pain. If your insurance covers it then it will be a win win.

I really wish the best for you and hope this situation can resolve very soon.
Phylly