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Old 10-11-2006, 08:43 PM
annapurna annapurna is offline
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Join Date: Dec 2004
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Responding to your questions. Sorry about the brief comments.

If the motion from the ADR is not the same as physiological motion, you are putting your posterior motion segments(ie facet joints) at risk for premature degeneration.

Reply: True, and this is an ongoing question but current computer modeling is much better at mimicing real life and has shown that the ADRs tend to perform only somewhat worse than a natural disk and much beter than a fusion for adjacent level forces.

With an ALIF fusion you can minimize adjacent level degeneration because the surgeon can set the lumbar spine in a proper lordotic curve. Also, at the L5-S1 level there is very little motion to begin with, so are you really affecting the spine biomechanics considerably by laying the motion segment to rest?

Reply: I've heard this several times and I've heard surgeons and orthopedic doctors committed to motion preservation say that L5-S1 has a great deal of motion. Whichever is true, you've got to figure that you'd eventually sacrifice your SI joints by fusing L5-S1.

I've heard about problems with discs fitting the vertebral body end plates properly.

Reply: Go to the best surgeon you can find. This is a problem with ADR as well as improper placement of the ADR. Either are pretty much a promise of failed ADR.

Also, problems with pitting and wear in the polyurethane core.

Reply: So far, the only studies that I know of are published by Maverick's (a metal on metal ADR) manufacturer and are fille with bad science or worse statistical analysis. Wear particulate can be a problem in theory but no one's reported firm data of it happening.

It seems all the studies on these discs are done in comparison to a 360 degree, highly invasive fusion. Not a modern, minnimally invasive anterior lumbar interbody fusion with r-bmp gel. I know the recovery and rehab is shorter with ADR.

Reply: You did point out one problem with the comparison study. Right now, anecdotal comparisons are the best you'll get.
__________________
Laura - L5S1 Charitee
C5/6 and 6/7 Prodisc C
Facet problems L4-S1
General joint hypermobility

Jim - C4/5, C5/6, L4/5 disk bulges and facet damage, L4/5 disk tears, currently using regenerative medicine to address

"There are many Annapurnas in the lives of men" Maurice Herzog
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