Michelle,
I considered ADR and consulted an Ortho who is very much in favor of ADR and does not like to fuse but I was precluded due to low disc height. I was on the fence with ADR anyway but this sealed the deal. After reading countless threads on those who had ADR at L5/S1 the trends did not seem positive. Overall I did not get the sense that manufacturers have come up with a device that is a long term homerun and I did not like reading the numerous accounts of facet joint problems from those who had radiographically "perfect" facet joints prior to ADR but then developed problems down the road. It is a very tough thing to decide what kind of treatment to undergo but after researching and consulting highly skilled Orthos or NSs you will land on a solution that will feel right for you. The only piece of advice that I can offer is to find a top notch surgeon who is highly skilled in whatever procedure you go with. Surgeons will perfect the procedures that they are best performing. Good luck
One size does not fit all when deciding ADR vs Fusion there are just too many factors weighing these or any other major procedure. Here are some things to consider while researching your options and talking to your doctor:
Your age and general health - Is bone density an issue? Do you have any other health issues? Arthritis?
Your surgeon - what does he/she specialize in, are they known for being a top doc in this specialty? Do you know someone who has had the procedure from this doc that can give a good reference or at least share their experience?
How active are you? - What are your expectations for recovery?
Risk tolerance - Know the risks for any procedure and determine what you can live with.
Hardware/Procedure - With ADR there are more and more devices coming out. Learn what you can about them and understand the pros and cons of each. Which one will you have and why does your surgeon choose the device? With fusion, there are different methods and hardware devices as well. If you went this route would your surgeon perform an ALIF, TLIF, PLIF or XLIF? Would you use donor bone or BMP or your own?
This is just off the top of my head, I am sure there are many more factors to consider. I'm sure others will chime in.