With ADR, it's easier to consider leaving a suspect level next to a still moving segment; than it is to consider leaving it next to a fusion. Fusion next to an already damaged disc will speed the degeration. ADR next to the already damaged disc may actually slow it down if it restores more natural kinematics, thus reducing the 'overload' of the adjacent segment that is increased by the poor motion.
We all know that fusion does not guarantee adjacent level disease.
We also know that ADR does not guarantee against adjacent segment disease.
Nobody knows what the timeline is. It's hard to imaging taking a healthy segment prophylactically... just because it may go at some time in the future.
This is especially true in the cervical spine where repeat surgeries are not nearly as difficult to consider as they are in the lumbar spine.
Mark
|