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  • masterquin
    Participant
    Post count: 1

    Hello! I’ve been dealing with a herniated/bulging l5/s1 since 2009 when my only option was a fusion, which I’m glad I didn’t (as my mother from the same surgeon has now had 10 surgeries, 9 fusions plus rods installed broken and partly removed) so I’ve waited, now the pain is horrible and I fear I’m loosing muscle and nerve due to the disc issue. The new MRI shows degeneration of L2/L3, L3/L4, and the worst that has needed surgery L5/S1. I haven’t been able to speak with the surgeon and his PA that did the interview I dislike and refuse to accept her surgical options. The spacing between the disc’s measures appx. 11mm if I recall correctly, she tossed a couple numbers. However the disc she spoke of the prodisc-l probably wouldn’t fit and I’d end up with a fusion anyway. I never got any information about the second disc the Avtiv-L they offer, which apparently comes in different size options. I’m not feeling comfortable having all these questionable outcomes, as told to me, everything ends in a fusion…..if the disc don’t fit, if it’s installed incorrectly, if it malfunctions or needs repaired, who does the surgery, as I can barley pin down the surgeon whom I recently find is retiring this year! I’m scared, need a little reassurance please. I was not pleased with the meeting and am having another on 1/2/19. I suppose my question is……..Is this the option, a fusion if the one disc doesn’t fit?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8460

    Don’t look at your mother’s outcome and discount your chances of a good surgical repair but maybe you don’t need a fusion. If your disc space at L5-S1 is really 11mm thick, this should be a reasonably good disc (normal disc height is 10-12mm). I personally do not implant lumbar artificial disc replacements (ADR) as these devices fail at a higher rate and cannot be revised if they fail. Mechanically, the ADR also does not absorb shock, a significant problem allowing too much pressure on the mechanical disc/vertebral endplate with impact, leading to endplate subsidence and fracture.

    As you note, if the anterior procedure to implant the ADR does not work, this disc level will be fused.

    I can tell you that my happiest patents are ones that undergo a one level fusion for disc degeneration.

    Dr. Corenman

    Donald Corenman, MD, DC
    Moderator
    Post count: 8460

    Don’t look at your mother’s outcome and discount your chances of a good surgical repair but maybe you don’t need a fusion. If your disc space at L5-S1 is really 11mm thick, this should be a reasonably good disc (normal disc height is 10-12mm). I personally do not implant lumbar artificial disc replacements (ADR) as these devices fail at a higher rate and cannot be revised if they fail. Mechanically, the ADR also does not absorb shock, a significant problem allowing too much pressure on the mechanical disc/vertebral endplate with impact, leading to endplate subsidence and fracture.

    As you note, if the anterior procedure to implant the ADR does not work, this disc level will be fused.

    I can tell you that my happiest patents are ones that undergo a one level fusion for disc degeneration.

    Dr. Corenman

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