ADR concerns as you age?

[PDiddy]

How many people are worried (enough) about the effects of aging on the vertebra (bones becoming more porous, etc) after an ADR versus a fusion? Would a fusion be more durable? If so, then a fusion may be more desirable as long as one can dodge the additional levels becoming diseased requiring further surgery. On that note, can anyone help me understand where this additional risk comes from? I know the lack of movement can contribute to it, but I've not seen anything that indicates this has been proven to be the reason; it's equally possible that a person whose disk degenerated enough to need a fusion in the first place may simply be predisposed to them and thus has a greater likelihood of them. Would that then mean that people like myself, who are looking at a fusion solely due to physical trauma that resulted in a disk herniation, may be better off with a fusion and perhaps avoid this risk?

I'm really torn up about which way to go - fusion or ADR (even if I choose ADR I have a 1/3 chance of getting fusion). Thing is if I decide traditional fusion is the better way to go I'd rather just CHOOSE it since that obviates the need for participating in the study and coming back for more x-rays and such.

[WILLIAM]

Interesting post, I am having the same thoughts. I just wondered why you say you have a one in three chance of getting a fusion if you choose ADR....could you clarify ?

[CindyLou]

PDiddy,

I'm not worried about the effects of aging on the vertebra because Dr. B performed 3 vertebroplasties in between each of mine, for added strength and durability.

[fritz925]

I'm 29 and I have the PCM disc at C5-6. I was told that my bone fused to each end of it. If anything, I'm less worried about the ADR aging than the fusions I have at C6-7 and L5-S1.

I was afraid that the added pressure from the fusion would help deteriorate the levels above. In my neck, that's exactly what happened...hence the ADR.

Wow, I wish I didn't have this much experience with spinal surgery. Boo.

[annapurna]

I am not aware of any risk inherent with ADR leading to bone becoming more porous. There is a theoretical risk associated with plastic wear particles that's been discussed here several times. Other than that, sucessful surgery permitting renewed activity is the best method for preventing bone loss. Inactivity and lack of loading of the skeletal system is the best means to cause bone loss. Lack of movement would generally lead to self-fusion of a level, not necessarily bone loss.

[PDiddy]

Originally posted by WILLIAM:
Interesting post, I am having the same thoughts. I just wondered why you say you have a one in three chance of getting a fusion if you choose ADR....could you clarify ?

Well the only way I know of to get a cervical artificial disk inside the US is by way of clinical trials that are underway as we post. Most of them are 50/50 trials where half the population in the study get the artificial disk and the other half get the standard fusion procedure. The study I'm involved in does 2/3rd to the disk and 1/3 to fusion.

[PDiddy]

Originally posted by CindyLou:
PDiddy,

I'm not worried about the effects of aging on the vertebra because Dr. B performed 3 vertebroplasties in between each of mine, for added strength and durability.

Can you tell us more about this procedure and how it helps?

[PDiddy]

Originally posted by fritz925:
I'm 29 and I have the PCM disc at C5-6. I was told that my bone fused to each end of it. If anything, I'm less worried about the ADR aging than the fusions I have at C6-7 and L5-S1.

I was afraid that the added pressure from the fusion would help deteriorate the levels above. In my neck, that's exactly what happened...hence the ADR.

Wow, I wish I didn't have this much experience with spinal surgery. Boo.

But we're glad to have your experience to help guide us in making a good choice.

So in all you're satisfied with the ADR and think it's a superior treatment to fusion?

[PDiddy]

Originally posted by annapurna:
I am not aware of any risk inherent with ADR leading to bone becoming more porous. There is a theoretical risk associated with plastic wear particles that's been discussed here several times. Other than that, sucessful surgery permitting renewed activity is the best method for preventing bone loss. Inactivity and lack of loading of the skeletal system is the best means to cause bone loss. Lack of movement would generally lead to self-fusion of a level, not necessarily bone loss.

That's an excellent point - I HAVE become less active due to my chronic injury and pain. I fully intend to return to body building activities I had to stop due to this after my surgery.

How long after surgery do you all think it would be before I can do something like that?

Also does anyone think the ADR would be more, less, or equally stable for such activities? My surgeon mentioned he's had people get one-level cervical fusions and go back to playing professional football. But I noticed he said FUSIONS and may have purposely left off the "and ADRs" in that comment...

[annapurna]

Originally posted by PDiddy:
How long after surgery do you all think it would be before I can do something like that?

Also does anyone think the ADR would be more, less, or equally stable for such activities?

First, recovery time can not be predicted. Could be anything from slow careful cardio workouts within a few week to a year or more before everything settles down enough that you'll feel up to it. Stay in as good shape as you can now and you'll skew things to faster recovery.

Stability is a difficult question. I really have no idea of what "Stability" means for a cervical spine ADR. It would seem like a ADR that closely mimics natural movement coupled with a good placement, and good conditioning of the muscles and connective tissue during recovery would provide a lot better "Stability" than a ADR that solves the problem like using duct tape to "fix" a broken hinge on a plastic part.