[Maria]

Hi and welcome,
I think that it really depends on what is going on with each individual's clinical picture as to what would be best for that person. If there is something that is truly contraindicative to the ADR implant at L5S1 yet fusion is still possible and recommended perhaps that would be the best option.

I'd want clarification of that like to have the films and to be able to get a 2nd/3rd surgical opinion from equally as reputable spine surgeons as the one you've consulted that work with both ADR and fusion.

At one time I was a candidate for 2 level ADR then several years later I wasn't (because of facet changes at L5S1) and was a candidate for ADR at L4 and fusion at L5S1. I didn't want the fusion period but probably would have gone ahead w/the surgery if I felt worse or no better than I had been feeling for quite a number of years. Now I've been told I'm not a candidate for ADR period however am not seeking surgery at this point.

Has your insurance already approved the hybrid surgery in the states?

Seems from what I've read and what I was told on my last surgical opinion which has been 5 or 6 years since that there's not that much mobility at L5S1 anyway so fusing that level shouldn't disturb the ability for movement there. Having the ADR at L4 might help to prevent adjacent level problems altho there seem to be a number of newer multi level fusion patients that are doing relatively well.

I think it's again what would work best for you esp.if there are any contraindications for ADR period. Hopefully you'll continue to find that out and make your surgical decision from that point. Good luck and keep us posted if you're so inclined.