Pre-Dr. Bertagnoli, any other considerations?

[beaverc]

funcrew;

You forgot one FBSS / Failed Back Surgery Syndrome. Apparently if your surgery goes south , you might have contracted the dreaded FBSS. If this wasn't so pathetic it would be comical. The fact that this term even exists is reason enough to go to Europe.

SAD UH?

[funcrew]

Jack,

[EDIT: Upon reading the 2012 follow up study on the ESP that you linked, it looks like they flexed the device 40 million times per direction under 30 to 300 pounds of force, with little to no performance degradation on the elastic core and no failures. That works out to about 3,000 flex cycles per day for my foreseeable remaining lifetime. It still makes me nervous, but I'm going to stick with the ESP.]

What about the non-replaceable cores on the ESP device? You're betting that the flexible core can withstand (in my case) 40 years of flex cycles without failing. If it does fail, then I would need someone to drill out the plates and start over with new ADR or fusion. That seems like a very long service life for a flexible part. Surgery is in 2 days. I meet with Dr. Desai today, will ask whether he would consider a pro disc. Dr. Bertagnoli's salesman Tim Vicknair does not like the ESP for this reason, but he's not an unbiased source.

Originally Posted by JackBauer

So many reasons.


6 degrees of movement vs 3 degrees of freedom.
Endplate material
Keel type design (on the Prodisc)



https://www.youtube.com/watch?v=zj-j2YjFjqI
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3567327/


This is just my personal opinion. The Prodisc has been on the market longer than the LP-ESP but the LP-ESP was first implanted (first gen device) in 2004, so there is a decent amount of history with the device.


There are a lot of people very happy with their Prodisc. Just who knows what their adjacent vertebrae is going to look like 15-20 years after implantation. It is a gamble either way, I'm just more willing personally to gamble with the LP-ESP. And I've researched this quite a bit.

[JackBauer]

Compare the "Literature summary of biomechanical simulations for wear" table at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4705139/

I'm concerned about the PCU aging and plastic deterioration. But when you compare the (apparent) debris generated alone from the ProDisc vs the ESP... And all that metal and plastic that would be thrown out from the ProDisc comparatively...

To be fair there are pros and cons to all of the discs out there. I think the risk vs reward of the ESP is the best. How many completely independent super-respected doctors still use the ProDisc...

Desai, Clavel, Berg, others in Germany, Switzerland... Using the ESP.

And unless we're running, few of us are putting 300lb of pressure on the disc. I know some people go back to weight lifting, etc... I'm going hopefully enjoy my discomfort-free life, improved ROM, etc... And not press my luck.

Good luck - please post an update when you feel up to it in the coming days...

[annapurna]

Originally Posted by JackBauer

And unless we're running, few of us are putting 300lb of pressure on the disc.

While I agree with the basic premise: every ADR has its pros and cons, I do need to comment on your statement about forces on the ADR. If you're living a normal life, you're putting 300 lbs of pressure on your ADR. The biomechanics of lifting ordinary loads, hopping up on a step, etc. generate a lot more force on your spine than you'd think. You may not hit 300 lbs every hour of every day but you'll hit it a lot more than you think you will. The person/being/committee/(whatever your belief system is) who did the original design of your spinal column was pretty smart in how it withstands loads without letting you realize how high those forces are.

[JackBauer]

Let's say the average mass about L5-S1 is about 120 lbs.


I absolutely do agree that walking will put more than 120 lbs of force on your spine. Just not that every step generates a force of 300 lbs.

It's got me wondering now actually what those forces would be though...

Regardless I don't plan on testing it. Live my life, do some light resistance training... brisk walking... But that's about it.

[annapurna]

Activities of Everyday Life with High Spinal Loads

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4035320/

[JackBauer]

Wow there's papers on just about everything.


I guess I'm going to need to be extra careful when lifting anything of any real weight going forward.

[funcrew]

My view is that if you receive fusion surgery (standard in the USA) then Failed Back Surgery Syndrome is very likely to occur in adjacent levels within 5 years. My father-in-law, a gentleman I no longer contact for any reason, is the poster child for FBSS. He does whatever his insurance-paid Texas back surgeons tell him to do. Dude has very little remaining mobility in his entire spine, and constant severe pain.

Originally Posted by beaverc

funcrew;

You forgot one FBSS / Failed Back Surgery Syndrome. Apparently if your surgery goes south , you might have contracted the dreaded FBSS. If this wasn't so pathetic it would be comical. The fact that this term even exists is reason enough to go to Europe.

SAD UH?

[Farmgirl]

Funcrew,
Did you have your surgery in March as planned. If so, how is your recovery going.