In the U.S., the fusion simply was not possible
We also consulted with two American doctors, both of whom recommended a spinal fusion at L4–L5. My MRI clearly showed that the L5–S1 disc was beginning to herniate as well, but doctors in the U.S. said they could not address it at that time. Their plan was to fuse L4–L5 now, and then likely perform another fusion at L5–S1 about three years later, once it inevitably worsened due to the fusion above it.
This was a major red flag for us. The long recovery time and risks associated with a two-level fusion—especially for a 31-year-old woman—were deeply concerning. We explored disc replacement options in the United States, but found it extremely difficult to qualify, as their criteria were very strict. What we really wanted was a fusion at L4–L5 and an artificial disc replacement at L5–S1 in the same procedure. In the U.S., that simply was not possible.
Although we initially hoped to avoid traveling to Germany due to the extra cost—and because insurance would have fully covered the fusion in Montana—the long-term benefits of disc replacement far outweighed the short-term convenience. Choosing a solution that preserved mobility and avoided multiple future surgeries made the decision clear. Germany could provide exactly what I needed in one operation.