Quote:
Originally Posted by RedLava
Should I need surgery I really can't decide which would be the safer choice between ACDF and ADR. All roads seem to lead to a fair number of horror stories.
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Truism: There are horror stories for any procedure you look up.
Addendum: The horror stories spread faster and further than the tales of success, which leaves one to feel amazed that there are any good results out there at all.
This is a pet peeve of mine so please forgive my rant. I'll try to keep it short. Anecdotal information, like what you get from reading stories here, is horrible for forming a real picture of your chances for a good or bad result. Bad results are discussed and occasionally distorted and re-reported as if they were a new, different, bad result. Good results are often not reported at all because the patient is out living their life and not commenting on this board. Yes, there are a few of us that continue to post years later. I feel like Laura and I were led to answers beyond what we could have found on our own and we're simply paying back the good that was done on our behalf. That's why we're still here.
I can't tell you how to perceive risk. The statistical evidence I've heard suggests that the likelihood of a complete recovery to full functionality for a ACDF patient is lower than for ADR. I don't know this but I suspect that the likelihood of a well-emplaced ADR is lower than a well-fused ACDF but the functionality of a patient with a well-done ADR is much higher.
Functionality after a decade is still debated. At first, ADRs were touted as having much high patient functionality after many years. The evidence seems to still support that but emplacement mistakes and poor designs have clouded the data enough so it's a murky mess. If you chop out all of the "bad" data, ADRs seem to come out ahead. It's just arguing over what gets included and what doesn't, e.g. do you include Rich and Laura as "good" patients who have an obsolete lumbar ADR design but reject those patients who had it and did poorly because the design did have some flaws? That's commonly referred to as cherry picking data; statistical shorthand for lying.
Basically, do you roll the dice hoping for a really good outcome with an ADR or accept a less good outcome with a potentially lower chance for a really bad outcome? Remember also, you can affect your odds by surgeon selection and very careful discussion of your condition. Many of the not-so-good ADR outcomes were with patients who were borderline for getting an ADR at all. If they knew then what we know now, they would have at least understood the risks, if not have made different decisions.