Didn't care for one thing the doc had to say..

[Jason B]

So I figure it's been 2 years since I went to see the Orthopaedic about my back. I figured he's had time to do some ADR's since then etc.

Well he mentioned he would probably choose fusion for me over ADR because likely my facet joints are shot in the L4-L5 region where my disk height is so low.

This isn't what I wanted to hear. I'm all about some of the newer motion sparing procedures out and coming out.

He did say they would peform some kind of test on the facet joints to verify whether or not they were ok.

He also mentioned that since I am a big guy he dosn't know how well ADR's will last for someone like me. I'm also very active. Work-out jog etc. (just in a lot of pain doing it!)

So what is the procedure for checking the facet joints and what is the likelihood that an ADR style procedure wouldn't help me....

[annapurna]

If your facets show advanced arthritic changes on an MRI or CT, you're probably questionable. On the other hand, those changes take some time after you begin to lose disk height. If you move quickly towards ADR, you may be able to get to it before your facets show damage.

There are a number of injection techniques to determine if your facets are pain generators but, as you presumably have a painful disk at L4-5, you'd have a hard time separating the pain generators and understanding what's going on. MRIs or CT may be a faster and easier approach.

There are facet replacements being worked. If your facets are marginal but probably okay, you might try ADR and bet that a facet replacement would be available if your facets do turn out to be unacceptable. Otherwise, fusion would be the preferred approach.

[Alastair]

A good link to facet joint problems is here
best,
Alastair

http://www.spine-health.com/topics/c...etjoint01.html

[Jason B]

Thanks for the info. I surely hope that my facet joints arent the pain source. I have ZERO desire to have fusion. I want to keep my back as close to how nature designed it as possible while fixing the part that fell out of spec.

[Harrison]

Jason, your question is very specific and smart to ask at this stage -- good for you. It's good to get an understanding of the specifics of your facets now, as there are many questions about how certain artificial disc designs "load" the facets. The more you learn now, the better off you will be with your next decisions, whatever they will be.

For what it's worth, AnnaPurna knows a great deal about the complex world of facets. Also, fusion is not a "bad" option for many people. Having fewer options -- after a research process -- can make that decision more "comfortable."

I can put you in touch with some company execs in the field of facets; but we should chat at your convenience (# below) so I can learn more about your condition and questions.

Take it slow.