"Decision matrix" for choosing ADR / Choices pep-talk

[jburdman7]

I apologize. A decision matrix doesnt exist. And might never exist as new styles are continually introduced.
Lets take a practical look at where we are here.
We are pioneers. But being early has risks.
Have you ever wondered what you would do if you were given the opportunity to participate in something cutting edge? If Ben Franklin was your neighbor and said "Hey check out the foil I have here in the glass jars repel each other."
* You can fear it. Fear should play a role.
* You can savor the opportunity, but please dont go crazy. Did you know that Ben Franklin's odds of being killed fooling around with that kite were fairly high?
* You can let the existence of unknowns incapacitate you, which I can guarantee you is no life at all.
And may I say that we can thank our creator to live in a time when we have options other than fusion!
We can also be thankful for the information age when we can collaborate on sites like this and find out how real world implants are fairing as fast as their manufacturers can, and not be at their mercy to tell us if problems arise.

Originally Posted by laid up doc

I look at pretty much everything as a risk vs benefit analysis...

And that is what they did when the ADR trials were done. The results were, from what I understand, that the downside risks are about equivalent to fusion, but the longevity of the adjacent discs are improved with an ADR, with or without the shock absorbing function.

Someday in the future there may very well be an "ADR decision matrix." If you are young / old / want to swim / run / have adjacent discs that look good / bad; perhaps tests will be developed to test your remaining discs for some marker that will help in the decision as to if its neighbor should have the shock suppression feature or not.

Someday.

Until then everything is a crap shoot. If the M6 discs last forever, shock absorbing ADRs will become the only style available. Or in the future they might only be recommended for those who do not do much land travel because they, and Im just pulling this from thin air, may be found to fail more rapidly if exposed to mild vibration.

I am content to 'hedge my bets' on this. I think I will go with a simple one and figure that I am unlikely to wear it out. But that is just me. There is no right or wrong answer here. I will check back here occasionally to see how the decision matrix forms and what "do's and don'ts" that means for me.

If you dont want to be a pioneer, go get a fusion. If you want to contribute to medical knowledge for the ages, do something cutting edge. Say you get a shock absorbing disc and you are the first to determine that swimming or running or something actually makes it last longer. Now dont laugh. It has been shown that car tires need run / flexed to keep the softening chemicals distributed. They will stiffen quicker from non-use. Might that be the case with ADRs?

So here we are in 2012 with cutting edge options.
You can let fear assist your ADR in lasting another five years-- as you give yourself an even earlier heart attack worrying about it.
Or you can savor the opportunity. Say a prayer. Take your best shot. Time will tell where history places your decision.
Step up to the plate and swing!
Just dont do it in a lightening storm. Really. Ben. That wasnt very smart. But then again there are no pages in the history books, be they the history of the US or what will become the history books for ADRs, for those who do not take risks.

[laid up doc]

it seems to be common sense that one should remain active, but not to extremes... driving on a tire isn't the same as taking it off-road

[Dingie]

I agree there are no certainties with this or any other surgery. However, although fusion has been the Gold Stndard for decades the success rate is slightly better than 60%. that figure is well supported in medical literatire and the reason 3 US MD s advised ADR for me, I have severe DDD in three lumbar discs.

Life is a crapshoot, I agree with LUD I also weigh the risk/benefit of any major decision. i am 50 and an avid athlete, long distance runner, long distance triathlete up to 3 years ago when it became so severe as to put me on the dreaded sidelines.

When I had my consultation my MD Dr. Clavel had corrected my inaccurate belief that my running days were over. He said recent studies are showing a benefit to running for the low back, and he encouraged me to return to myprevious activites after I healed.

As to the longevity of shock absorption discs, I don't know the answer, I know each style has unique potential challenges. facet degradation, device failure, unknown for the newer generations.

A checklist would be nice but I am going to make a leap of faith, I can always return to my nearly crippled state, or simply stay here. for me the benefit outweighs the risk.

I wish you good health and good luck in your surgery and recovery.

Laurie