[Harrison]

This kind of conversation comes and goes through the years – I’ve been reading these topics carefully while also talking to patients since 2004. Please see this crusty reminder, an inherent risk of looking at this community as a “scientific” resource. This site does attract the largest number of pre and post-op ADR patients, which has always been the focus and goal. But it's a discussion board; nothing more.

Here are the facts as I see them:

1. Most patients who are carefully selected for artificial disc replacement do as good as -- or better -- than fusion patients.

2. Cervical patients generally recover more easily with ADR than lumbar patients and also have less pain; perhaps for obvious reasons.

3. ADRSupport community surveys continue to support these conclusions, but it’s time to re-evaluate the last six months of data.

4. Every practicing ADR surgeon has had patients that have done exceptionally well and others patients who have fared exceptionally poorly. (OK: that's my opinion and I can't prove it).

There are some crucial issues pertinent to patients’ recoveries that continue to be overlooked, even ignored, by both patients and doctors:

1. Patients are not Lego’s that can be disassembled and reassembled so easily. Degenerative disc disease presents a localized disease, a symptom of a compromised immune function – and an indication that the patient’s body is not healing as it should if it were completely healthy. Our specialized medical system only amplifies and exacerbates this “Lego” approach. We need to treat patients holistically to truly heal from a degenerative disease (see Dr. Max Gerson’s concept of totality).

2. Patients who make lifestyle changes (e.g., their diet) and way of life before and after surgery will fare better than others who fall back into an unhealthy routine.

3. Surgeons and patients show nominal interest in using advanced diagnostics to determine the pathology of excised spinal tissue from the ADR procedure. Given the small number of causes of disc disease, it’s amazing more patients do not ask their doctors about pathology testing of their diseased body parts. Undiagnosed problems like arthritis surely play a role in post-op pain.

4. Regarding disc designs, I’ve said this before: keeled designs are more injurious to affected/diseased levels, so that surely is a contributing factor to longer healing times and even complications. As well, keeled designs make revision surgery more complicated, as they weaken the vertebral bodies. That’s why I continue to be a proponent of cleated designs rather than keels. Synthes won the marketing wars, and poor surgical skills by a small number of doctors (particularly Stenum in 2004 and 2005) and law suits helped the “market” steer away from unconstrained (cleated) designs like the Charite'. Sadly, imprecise device positioning continues to occur in some patients. These positioning "errors" may or may not cause pain. Why? Absent of disease and inflammation, the spine and human body give us humans amazing compensatory abilities.

Please consider these points above, as I believe that they account for the wide variance in patient outcomes. I hope this is helpful, albeit "tough love."