Thread: DIAM vs ADR
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Old 04-03-2009, 01:12 PM
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mmglobal mmglobal is offline
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I'm glad I took the time to read the whole thread, because first I was going to respond to this...

Quote:
Originally Posted by Katie View Post
Yes the same doctor that is doing the DIAM wants to put a Medtronic disc in my neck, but refuses to put them in my lumbar. He thinks it will make the pain worse. That I can't imagine!
with... If the disc is causing your pain (and there are no other pain generators), if they put an ADR in properly and don't cause any new problems, your pain goes away. (Obviously, it's not that simple, but that is the situation for many of the people who have the remarkable recoveries.) If you have a lot of pain generators, the situation is very complex and there can be a huge difference from one treatment to the next.

I'm glad I read this:

Quote:
Originally Posted by Katie View Post
Your problem is not the discs but the stenosis of the canal as a result of ligamentum flavum hypertrophy and facet joint osteoarthritis. Such a situation will not only rule out the possibility of disc replacement...
This makes a lot of sense. If the problem is not in the disc, ADR may not be best. Some time, many different treatments may be successful. If the problem is the disc, an interspineous spacer will leave the painful tissues, but offloading the posterior annulus may still resolve the pain. If the problem is hypertrophic ligamentum flavum, ADR may restore the disc space and retension the ligamentum flavum, resolving a buckling or bulging from the collapsed space, resolving the stenosis and pain. That is why there is often a crossover in indications... one doc wants to do a spacer, another wants to do ADR. The key is to do enough homework so that you are comfortable with your decision.

Being evaluated by a surgeon who does a lot of ADRs and no DIAMs will likely yield a different opinion than one from a surgeon who does a lot of DIAMs and no ADRs. They may both have motivations and opinions that are colored by issues not relevant to your case and they both may just be wrong about certain types of cases. But, again... do enought homework so that YOU are comfortable with your decision.

All the best,

Mark
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