Retrolisthesis

#1 09-27-2005, 01:02 PM

Is mild Retrolisthesis a contraindication for ADR?

Alastair · #2 09-27-2005, 01:53 PM

No it is not -- - no problems with this at all - - - - - -some Drs use the Maverick ADR specially for this problem in patients where it is a marked problem.

I thought I had all this in FAQ`s but it seems not- - - - -work to do there, and the appropriate pictures will not come easy to hand.

I will get on with this soon
Best
Alastair

mmglobal · #3 09-27-2005, 02:16 PM

Mickey,

About 1.5 years ago, I noticed that out of the failed ADR patients I knew, a substantial percentage of them had some retrolisthesis. I compiled a presentation of films and showed it to many of the top ADR surgeons at the Spine Arthroplasty Society's annual congress (Vienna, May, 2004). My presentation was well received and generated a lot of thought and discussion, but no concrete answers. All the surgeons have experience with successful and failed patients in all types of configurations.

Alastair, what surgeon(s) do you know that would use a Maverick specially for this issue?

Mark

Alastair · #4 09-27-2005, 03:03 PM

Mark, I've actually given you all this information previously, it is one of our UK doctors who is doing a special trial on people with this problem and is specialising in using the Maverick prosthesis. It is proving very successful.

It's a Dr Khan in the UK, and he's been doing it now for almost 2 years. There are references on the Internet about it also. I can't remember his initial off the top of my head. He is in the south of England.

onecrazyhouse · #5 09-27-2005, 03:13 PM

What is considered the max for a retro?
Depuy states 3mm,and I`m at 7mm. I have talked to Dr`s here and overseas and have been told that 7mm is too much(Mark you know my story)I would be very interested in what you have found out

mmglobal · #6 09-27-2005, 03:23 PM

7mm is pretty big. Much would depend on the condition of the facets. If you've been that bad for very long, they might be too far gone.

The most important factor would be the reason for the instability. 7mm is probably too much to be considered degenerative instability that might be corrected by restoring disc height.

I know two people who got ADR in spite of known instability at a level that would now be considered too great for ADR. One (Jacob) was absolutely not successful. The other (Jill) was. She knows that she has some limitations and is at risk in some configurations and was willing to try anyways. I haven't spoken to her in a couple of months, but last I heard she was about a year post-op and had returned to her life.

Alastair, do you know why Dr. Khan uses Maverick in this case? Does he just use Maverick anyways, or does he typically use another device and only uses the Mav in certain cases. I hope to spend the end of the week at the NASS conference (if other demands ease up so I can go). If he's there, perhaps I can talk to him about it. I hope he'll be OK with that. I'd hate to endure his wrath.

Mark

Alastair · #7 09-27-2005, 03:44 PM

Dr Khan uses the Maverick as it does not give any "Slip in any Direction" (pivots around a point)he tells me with mild Retrolisthesis and Listhesis. He seems to be doing well and so do his patients.

He claims "Slippage still happens" with Charitee and prodisc - - -which you seem to confirm in your lecture and findings.

Its a long time since I spoke to him and since the "Lightening Strike " on my PC which ended up a blob of plastic I havent spoken to him. We have a number of Dr Khans and I have run it down to 3 Drs but cannot decide which he was now.

I agree with you 7mm is more than mild Retrolisthesis - - -I really was adressing this to Micky Davies as you probably understand
Best
Alastair

PS Mark please look through stuff I sent you about this, if you have lost it would you like me to "Chase it up"?

onecrazyhouse · #8 09-27-2005, 03:58 PM

Alastair, does it matter who has the retro? or do you chose to only address the people who ask the question?

Alastair · #9 09-28-2005, 04:28 AM

I think it's quite an important factor for everybody that has spine surgery. I think there's a huge number of patients who don't even know that they have this problem.

Remember successful spine surgery should be done by careful selection of the patient by the surgeon. He should know his limitations, and abilities and requirements.
best,
Alastair

Alastair · #10 09-28-2005, 04:33 AM

Mark there is this conversation here we have had this conversation before

http://www.adrsupport.org/private-cgi-bin/ultimatebb.cg...;t=000352;p=2#000034

He is in the UK Dr Directory