[annapurna]

1) Projected life has been called out to be 25 + years, 50 + in some models and for some test/analysis efforts. The first Charite used in Europe has been in for over 20 years. I do not believe that there are any reports yet of a well-installed, well-placed ADR failing simply due to wear yet. That said, simple physics says it going to happen. The problem is wear prediction models are poor for making that kind of exact prediction, and I'm saying this a a professional who both used and created similar predictions. Basically, if you have a successful ADR, you should expect that the whole spine surgery market will be different by the time you need a new ADR. That might be working to your advantage but it might not, depending on which way the market goes.

2) We've already seen some people having poorly placed ADRs fused around or removed and replaced with a fusion. Not a fun surgery but possible.

3) I do agree that you're asking the right question, "who's the best surgeon I can get to and afford" but there's a ton of opinion and emotion tied up with that answer. Every successful surgery patient will swear that their surgeon received divine inspiration and is a gift to the world as a whole. Every failed surgery patient will simply swear in a much more straightforward fashion.

Some thoughts: how bad is your back? How likely is it you will need constant ongoing care while you recover from surgery? How likely is it that your recovery will be swift and complete? Do you need the skills and experience of true cutting-edge people? Would you do better if the surgeon could call upon some techniques or devices approved outside of the US but not in it? Think through those and guide yourself to a top few candidates. Then correspond or meet them in person and make sure you're comfortable with the surgeon and the office he/she works out of. Remember a lousy office that blocks access can trump a wonderful surgeon and make your post-op life hell.