Can anyone tell me if one of the endplates move to the point of uninlinement with the others what can happen or what action should be taken.

Interesting question. Wonder if this happens and to what degree w/different ADRs.

Eric, I am unclear about the intent behind your question -- are you talking about subsidence due to improper placement? Or "sinking" because of osteoporosis?

Placement is critical with any device. Have you already read this helpful paper? See:

"Lumbar Total Disc Replacement: Charité Artificial Disc."

http://www.adrsupport.org/articles.html

Harrison
I guess my question was really, once the device is in place , how easy is it for one(endplates)to be shifted out of alinement with the other endplate and what are the consequences. Is there anything that can be done externally with out going back in an realining them.

The answer to this question is very straight forward. After the Charitee ADR has been implanted, good practice expects the medical establishment where they had it implanted to check immediately prior to leaving hospital,that is usually two to three days after surgery. If movement has happened then it is quite easy to rectify this, with revision surgery. There is no easy way to realign the plates other than by surgery.

After six weeks bony growth has established itself round the prosthesis, again, at this time good practice by the medical profession is that x-rays again should be taken to establish that nothing has moved and the positioning is still good.

It is most unusual if the above is done for any problem to be seen with the plates at six weeks, or after six weeks. I have known people be in really bad car crashes at three months after ADR, and I'm sure there are plenty of people here who have had bad falls in skiing accidents, and there has been no movement of the prosthesis.

The pro disc of course is a totally different matter, and if that moves then there are extremely big problems. However, if good practice as above is done, then there should be no problems with that either.
Best,
Alastair http://adrsupport.org/groupee_common...icon_smile.gif

Alastair
Would the patient know if a endplate had moved other then by looking at a Xray? Can it create other pain in other area's.
The reason I am wondering is because of all the emphasise put on not bending or twisting for at least the first 4 to 6 weeks. Is this correct.

It could quite well be, that movement of an endplate might cause pain, but the only guaranteed way is by x-ray.

Yes you're absolutely right, bending and twisting apart from not being helpful and overstretching minor muscles blood vessels and ligaments that are trying to heal, could quite well move a plate if it is not well secured and hammered in (Charitee). Also if you notice in my previous reply to you, at six weeks, there is good substantial bony growth round the prosthesis and from that point on everything should be secure providing the positioning is correct in the first place. The positioning and experience of the surgeon in my humble opinion is 99.9% of a successful surgery.
Best,
Alastair http://adrsupport.org/groupee_common...icon_smile.gif

Sir A,

Nice replies. I usually do not like to play devil's advocate, but I sometimes wonder how many "perfect placements" and "perfect patient selections" take place, but still somehow the outcomes are less than perfect. Overall, I've argued, that your summary is correct. But many people think otherwise.

There's no answer, of course, but some day there will be -- or I should say "some decade(s)."

They do say that "Perfect Placement" has an error factor of 1mm and this preferably should be anterior if any error is noted.

Patient choice well thats the skill and experience of the Dr.

I still cannot give anyone an answer why some ADR`s do fail, and why some seem to make an absolutely amazing recovery in about 4 days and go off hunting etc(Its annoying for the rest of us, but joyeous for them).

Its that "Slow and Steady" recovery which is the best average solution I have found over the many years I have been researching ADR -- -still lots we don`t know
Best
Alastair http://adrsupport.org/groupee_common...icon_smile.gif

Thanks for all your imputs. I am now going on my 5th week Post Op and I am at least in my opinion(not sure what it is worth) I feel great. I still have some numbness in my right uper leg and some pain sometimes in my left heel, which is what drove me to the ADR in the first place.(so bad could not walk for more then 15min).
I was a little concerned with my Doctors experince(12 operations before mine). I was told that a very experinced Surgeon(The investigating Kinflex Study Surgeon here at the Center)would be right there to assist if necessary. I remember what you said about the experince level of the Sugeon and I agree also. I remember when I was a young Pilot the passengers would look at me kinda funny until they saw the Gray haired Co-Pilot sitting next to me. They never ask me how many landings and take-offs I had made. So I kinda use this experince I had in my younger years to understand there is a learning process we all have to go thru. The only thing I do think about is that some professions are more forgiving and have a larger margin for error then others(In Mine there is None as far as I am concerned)
I did find this bit of info quite interesting.
see attachment.