Three Level Lumbar Hybrid Fusion-Total Disc Replacement: B.H.
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B.H. is a 40 year old male with over 20 years of low back pain after an injury while weight-lifting in college. The pain has been getting worse with more frequent bouts of debilitating pain, now to the point that it is greatly interfering with his life.
After failing extensive non-operative treatment including physical therapy, chiropractic, and acupuncture, aqua therapy, we decided to proceed with the hybrid artificial disc replacement/fusion surgery.
Pre-surgical MRI and CT scan of the lumbar spine show disc degeneration and collapse at L3-4, L4-5 and L5-S1 with nearly bone-on-bone collapse at the L3-4 level:
![](https://cuellarspine.com/wp-content/uploads/2023/04/custom_images_case_BH1-1024x768.webp)
Pre-surgical standing lumbar spine XR show disc height collapse at L3-4, L4-5 and L5-S1 levels. The L3-4 level is collapsing asymmetrically, giving him an early “degenerative scoliosis.”
Post-op XRAYs after two-level artificial disc replacement with ProDiscL above a one-level anterior lumbar interbody fusion using a cage and plate at the L5-S1 level*:
(*Note: 3-level lumbar disc replacement or hybrid is not yet approved by the FDA so it’s use is physician-directed)
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