DDD questions

[TheFerrell]

I am not sure if this is the correct place to post this but i am hoping for some help.

First off, i want to say that my doctor/surgeon is not the best. However, his staff is the BEST I have personally ever dealt with. The doc spent a little time with me as a patient as possible.

What is DDD? in stupid trems please lol.

Will this effect other discs in the back?

How will ADR effect the other discs and how long is this thing supposed to last? Will i have to have another replacement in years down the road?

With the ADR damage the other discs?

Sorry for the stupid questions...
any and all help is and will be appreciated. I want to thank you all in advance.

[Slackwater]

Originally Posted by TheFerrell

What is DDD? in stupid trems please lol.

Will this effect other discs in the back?

How will ADR effect the other discs and how long is this thing supposed to last? Will i have to have another replacement in years down the road?

With the ADR damage the other discs?

Sorry for the stupid questions...
any and all help is and will be appreciated. I want to thank you all in advance.

These are responses from a patient & surgical-candidate. Please consult your medical professional(s) for real advice.


What is DDD?
DDD is a widely used term, but possibly mis-nomer per one surgical consult. Everybody ages. The age of a person & one's intervertebral disc are related, complicated by trauma, nutrition, genetics, ...

May I please ask, do you drive a car? The car's engine sits on bushings to isolate vibration, shocks, ...; they're probably made of rubber or polycarbonate, flexible, ~elastic. 250,000 miles of driving may indicate the bushings need to be replaced.

Will i have to have another replacement in years down the road?
Good question. The results for multiple human life-cycle ADR/TDR testing are not completed. Assume the probability is OK+ there will be no replacement of an ADR/TDR based on reported data & trends to date.

It's the same answer for TKA (total knee arthroplasty) and THA (total hip arthroplasty). TKA and THA have more patients (surgical data) and decades of wider usage. Some % of people do get replacements. People get successful joint replacements and there are no issues.

Flip.Side:
A family relation by marriage is diabetic, overweight, with other issues and that person had three (3) TKA's. The knee is now fused.


Individual results vary; normative trends are developing. Please assume you will not get one (1) ADR/TDR replacement at the same L4/5 in your spine based on current surgical practices.

[annapurna]

A few additions to Slackwater's answer:

DDD is degenerative disk disease characterized by loss of water then loss of disk height. Why is happens is the subject of many, many opinions but practically the disk turns dark on MRIs (if you use water, not fat, contrast modes) then the disk starts losing height. It could take more years than you'd be alive or it could go pretty quick, often it depends on why your disk went bad and how you're treating it after it's diagnosed.

Slackwater drew the analogy to total knee replacements. The total hip replacement is a better analogy in that there are THAs designed to last the lifetime of the patient. Some get that time, some don't. All currently available total knees have limited lifetime expectancy. ADRs were designed to last a full lifetime. Whether or not they achieved it and how realistic the testing to show that achievement was is also the subject of many, many opinions but, if it helps, ADRs have been in use for over 20 years in Europe and there's not been a whole lot of posts or comments to the effect that the old ones are running out of life or failing due to age.

Hypothetically, a degenerated disk in your back will alter the loading on all adjacent disks and their facets (the spiny things behind the spinal cord) and lead to adjacent level and facet damage. That's the theory behind the creation of ADR; if the disks continue to move more or less correctly the loading differences will be minimized. Some ADRs tout that they do this better and some tend to be silent in their advertising. Research is just coming out that particular disks are actually doing better in clinical trials. Previously, there had been finite element studies that suggested one disk or another was better but I personally have little trust because the input parameters for FEA work heavily affect the results. A reality of the studies, though, is that the ADRs don't mimic the real life disk perfectly so there are some that say that the ADRs can also lead to adjacent level or facet damage.

[Harrison]

These are most definitely not stupid questions -- they are really smart questions to ask -- and the right ones too I'll chime back in soon; glad you were able to post OK!

Steve, Laura, Jim: Thanks for helping so many people with your posts for so many years. I hope some day to buy you winning lottery tickets -- at least that's my goal!

[TheFerrell]

Still a little confused, however, you've cleared up a lot for me. I'm very hopeful that my ADR does not cause damage to surrounding discs. I am 27 and to young for all of this. Still in the recovery process and that's not going well. Thank you all for your informative input. This is very helpful.

[Slackwater]

Originally Posted by TheFerrell

Still a little confused, however, you've cleared up a lot for me. I'm very hopeful that my ADR does not cause damage to surrounding discs. I am 27 and to young for all of this. Still in the recovery process and that's not going well. Thank you all for your informative input. This is very helpful.

Keep asking questions. Some items get generalized answers, some with more detail ( dehydrating discs is absolutely correct, add extracellular matrix, blah blah blah, ... ).

Your signature line is surgery September 2010.

Please be ~patient, focus on small steps to recovery, put the operation in a longer term perspective. The FDA looks at the two (2) year results as normative for ADR/TDR and Fusion. Your recovery period will vary as do all people that get ADR.TDR or Fusion.

There are some 5 and 8 year ADR/TDR v. Fusion results. Something may show up in the Articles section in a few hours.

[JKDE302]

what is the FLD clinical trial?