Welcome, I am sorry for your years of suffering. You’ve asked some questions that really need to be posed to a highly experienced spinal arthroplasty surgeon – a doc that knows fusion
and motion preservation. Also, if you could find a doc that has experience with multiple artificial disc designs, that knowledge may be helpful. Dr. Blumenthal at TBI comes to mind, as does Dr. Bertagnoli, who favors the ProDisc.
If I am not mistaken, Dr. Blumenthal has the most US experience implanting the widest variety of artificial disc design types; so his grasp of spine kinematics is a shade better than mine.
Actually, I have no knowledge of spine mechanics – just an incredible appreciation for the complexity and miracle of motion! The more I read on kinematics, the less I know. Seriously.
Without a doubt, the most “normal” positioning of artificial discs translates to minimal loading and stresses of the device; thereby minimizing wear. So if the spine is unstable, mal-positioned or deformed, you increase your odds of complications post-operatively. So your question(s) are wise to consider.
Jeff offers a good point (thx Jeff!). If you have some time, you may be able to track these patients down and find out for yourself. In the meantime, these past discussion topics may help you:
Letter to the Editor: Regarding Bryan disc related cervical kyphosis
http://www.adrsupport.org/forums/f51...kyphosis-8134/
Effect of Modified Techniques in Bryan Cervical Disc Arthroplasty
http://www.adrsupport.org/forums/f50...2009-may-9977/
Sagittal Alignment as a Risk Factor for Adjacent Level Degeneration: A Case-Control Study
http://www.adrsupport.org/forums/f50...neration-5981/
And from the Internet:
Multilevel cervical arthroplasty with artificial disc replacement
http://thejns.org/doi/pdf/10.3171/2010.1.FOCUS1031
and:
Cervical spinal disc replacement.
J Bone Joint Surg Br. 2009 Jun;91(6):713-9.
Denaro V, Papalia R, Denaro L, Di Martino A, Maffulli N.
Department of Orthopaedic and Trauma Surgery, Campus Biomedico, University of Rome, Rome, Italy.
Cervical spinal disc replacement is used in the management of degenerative cervical disc disease in an attempt to preserve cervical spinal movement and to prevent adjacent disc overload and subsequent degeneration. A large number of patients have undergone cervical spinal disc replacement, but the effectiveness of these implants is still uncertain. In most instances, degenerative change at adjacent levels represents the physiological progression of the natural history of the arthritic disc, and is unrelated to the surgeon.
Complications of cervical disc replacement include loss of movement from periprosthetic ankylosis and ossification, neurological deficit, loosening and failure of the device, and worsening of any cervical kyphosis. Strict selection criteria and adherence to scientific evidence are necessary. Only prospective, randomised clinical trials with long-term follow-up will establish any real advantage of cervical spinal disc replacement over fusion.
Alas, if you are not exhausted with neuron and eye fatigue, see this important topic:
http://www.adrsupport.org/forums/f51...ications-9620/
Please, please remember to share your experiences with us during your journey, as
we are all in this together. BTW, what the hell is your screen name all about?!