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Decisions Decisions, ADVICE NEEDED

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:28 AM in Back Surgery and Neck Surgery
My name is Josh, I am 28 years old and in need of 2 level surgery at L4-S1. My orthopedist who will also be my surgeon has recomended a hybrid set up with fusion at L5-S1 and a Pro-Disc at L4-L5. But after waiting 3 months to get an answer from BlueSheildCA they denied the claim. I know that they will cover fusion of both levels. My doctor had made it seem that the fusion surgery would not give me as good a chance as the hybrid of having a normal life and that the next level would be affected, essentially relegating me to a life time of surgery. But on a recent visit to my pain doctor told me the he thought the fusion was a good option and that with some of the failures of the ADR is was a better option. I realize there are risks in both surgerys and nothing is for sure, I just want to make an informed decision. I see that I am not even close to alone in this situation as I have seen that many of you have had either of the proposed surgery's for me. I would appreciate any advice you have especially from anyone around my age.


  • Josh, I recently had surgery to fuse the exact same areas. L4 through S1. I haven't decided if I am better off or not. My surgery was 6 months ago. I used to have extreme pain in my hip and leg. Enough that I could never get more than a few hours sleep a night. Before surgery I could do pretty much whatever I wanted, as long as I didn't mind being completely out of commission for the next week or so. :< I lifted things, gardened (that was the worst surprisingly) did house work etc. I worked when I could. I was let go while I was out recuperating from surgery.
    Now I don't have the hip and leg pain or the stabbing back pain so I do get much more sleep which is quite a releif. However I can not lift anything and I have constant mid-back pain. I am afraid that this is from additional pressure on the L-3. Before surgery this was showing signs of DDD. Yes, I was told that I will probably have to have surgery on this disc within 10 years. I was told that it would depend on how good of condition I could get back in and if I could build my core strength back up. Well before the back problems I use to work out almost two hours a day. I recently tried to get on my elliptical. I did ten minutes two days in a row and was out of commission for two.
    Bottom line I do feel better in a lot of ways, worse in some. I wish that I could offer you better advice. I wish that I would have had this surgery when I was still in good physical condition instead of waiting until I gained almost 50 pounds and haven't been able to excercise in two years. I think that if I had done it earlier it would have been easier to get back into shape. That is really the only advice I could give. If you are still able to get some excercise and are in fairly good physical shape I would do it sooner rather than later.
  • I am in the exact same situation as you I have BCBS of OR and my surgeon said ADR at L4-5 and a fusion at L/5 S1 for the exact same reason.. They just found out after I borrow my surgeon fee's that the hospital wants a $18000.00 deposit and I could make payments on the remainding $60000.00 are they crazy why not pay for us to have the ADR instead of us having to go back year after year for another and another disc to be fused!!! this is what is wrong with our health care in the USA, I dont know what to do either my surgery is scheduled for March 17, 2009 and I am 100% sure I can't pay the $18000.00 they want for a deposit and it is not fair at all.. It didn't take my insurance 3 months only about 1 week to deny.

    I had a Laminectomy/disecotomy on these dates 2/08 4/08 7/08 10/08 in this area L/5 S1 I found a new doctor when my pain was worse than before any surgery and can't feel my leg to my toes have fallen already from the loss of feeling live on pain meds just to do simple things.

    We all need a break all we are asking for is pain to go away not like a vacation although that would be nice :) Hang in there and please keep me posted as I will you
  • To be honest, I have seen just a few people on this particular board with ADR's.
    There is another board that has nothing but people with ADR's.

    Is your surgeon in SoCal?
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • Sorry to hear about what you're going through. You are soooo young.

    what kind of problems are ya having? Any other surgeries or treatments?

    Have you had a second or even a third opinion? I think that it is imperative to have a second opinion. The ortho should also have a fellowship in spine surgery as well.

    I think most people would tell you that having this surgery should be the only option if you're quality of life is seriously compromised. It's a huge decision to make and a very long recovery. Recovery should also be helped by a physical therapist because there will be things we can't do & can increase pain doing it also there will be other exercises we just have to do differently.

    Let us know a little more if you're comfortable if not that's cool too.

    Good luck :)

  • Yes I have had a second opinion and my surgeon is in So Cal. I have been going to the same practice for 3 years now. After a car accident I had 4 1/2 years ago I had a lot of pain in my right hip and back. After much physical therapy an MRI with contrast showed a tear in my labrum in my right hip. Just to make sure my hip surgeon ordered an mri on my back revealing the two damaged discs. That was Dec. 07, I had an epidural in Jan. 08 then the doc decided to fix my hip in Feb. I had arthroscopy and all went great except while rehabing my back just went completely to shit. My quality of life is completely compromised, the way I have to live now is a shadow of what it was. As time goes along the pain only gets worse and the time just drags. I need something to happen soon and I just don't know if its worth to fight for the ADR which could take forever or go for the fusion to get my life back somewhere close. I know all the risks of both but I gotta do something.
  • like you're on the ball.
    Take Care :)
  • My situation is a lot like Maywin26's - except I think I am doing really well post op.

    I too will have my L3 fused eventually. Had S1-L4 fused in July 08. And L3 was close to needing the fusion even then.

    I was advised that even at age 42, I was too young to consider an ADR and that a fusion was the best option. I know that they push fusion the younger you are - at least in my part of the country. I was not convinced and needed a discogram and worsening problems to finally go through with the surgery at all.

    Lately I've seen lots of people with ADR problems and so I really am glad I went with the fusion - even if I have to have L3 fused soon. Just my humble opinion.

    Oh, and accidents just SUCK - your life gets taken away from you after a debilitating accident. The only thing I've found that helps is a determined positive attitude (and you have to be dang determined to get through all the pain and junk!) Best of luck.

    p.s. Have you had a discogram yet?
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