Quote:
Originally Posted by robertodnr
There is a lot of information on this forum but I will give some quick points:
- Cervical spine doesn't need to support lots of weights and also weight changes in the future will affect it marginally. On the other hand, lumbar spine will have to carry with lots of weights for all your life
- Cervical surgery is easier (less dangerous) than lumbar. The lumbar area has major blodd vessels that can be damaged and men can have ejaculation problems later.
- Revision surgery can be very dangerous after an ADR surgery (barriers does not always work)
- Some spine surgeon will do cervical ADR but not lumbar ADR because they know the results are not the same
- Surgical outcomes fron lumbar ADR on this forum are VERY variable.. I think cervical ADR has shown better results
- I would need to have surgery abroad so local doctors will not see me after a surgery they don't perform here
- I can see that it is very difficult to get a response from.doctors after surgery abroad
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I can more or less agree with all your points. But we have to consider the actual options at hand. Yes, cervical ADR is on average more successful than lumbar, but if you have problems in the lumbar spine, then the cervical ADR being better or worse does not really matter. In essence, if you have lumbar problems, the main choices are:
- Do nothing, suffer, maybe it gets better (or then it does not!)
- Lumbar Fusion
- Lumbar ADR
For most people reading this forum, the first option has probably been exhausted or is about to be.
Then, we are left with the two options Lumbar Fusion vs. Lumbar ADR. Let us not focus on the potential negatives of ADR and ignore the negatives of Lumbar Fusion... Lumbar Fusion is not a "safe and trusted" procedure. You have to read on about all the complications in fusion, too. Read the stories of fusion failing, pain remaining, re-surgery taking hardware out, pain remaining, re-fusion again, and most importantly --- Adjacent Disc Syndrome ---. Adjacent Disc Syndrome, the eternal curse that spreads through your spine, emptying both your wallet and will to live as you keep having to go to new surgeries. They call fusion the "gold standard", but these words are an insult to the lives ruined by this procedure. My father has a good friend who went the fusion route. From what I have been told, his life is miserable and he is now going in for surgery again. I think this is his third or fourth surgery.
So in the end, we have to do a well-informed decision based on knowledge. I prefer looking at the research and published outcome in journals. They all show that ADR has been same or better than Fusion from the very beginning. Not to mention that ADR technology, surgical techniques, and surgeon experience keeps improving. Therefore, the advantage of ADR over fusion will keep growing. Clearly, many of the early failures in ADR are also due to poor patient selection. For some patients ADR is simply not an option (low bone density or metal allergy). However, if you are a good candidate for ADR, you will be damned to go for fusion just because the local doctor does not know how to do ADR and is too old and cynical to learn new surgical skills. But in the end, just as you say, we have to make our own best informed decision and live with it. With these words, I merely want to emphasize looking at the choice objectively and weighing the options on equal grounds.
