Shorter ADRs Less Facet Joint Stress????

Michelle Maree · #1 (**permalink**) 07-05-2009, 01:27 PM

Hi,
Just pondering out loud here..........Why arent there ADRs with shorter disc heights?
Why do they have to restore disc height to normal?
I mean if a person has had a reduced disc height for a couple of years and so the facet joints have degenerated accordingly ,it seems to make sense to me that the facet joints would have trouble adjusting to this new height and range of movement. And if they made shorter discs then the range of movement might better match the facet joints and not stress them out as much. Just a thought.
Does anyone know which ADR is the smallest out of all the brands?

treefrog · #2 (**permalink**) 07-05-2009, 08:01 PM

Michelle, I can only tell you what I know about ProDisc-L.

It comes in 2 different foot prints (maybe 3, from what Dr. Bertagnoli was telling me), medium and large (Dr. B. said he could also use size small).

There are 3 different heights, 10, 12 and 14 mm.

There are 2 Lordotic angles, 6 degrees and 11 degrees.

That gives 12 (or 18) anatomical implant combinations, to best match a patients anatomy.

I don't know about other disc brands, but the ProDisc does come in a variety of sizes.

Michelle Maree · #3 (**permalink**) 07-06-2009, 07:10 PM

Hi Cathy,
Yes I have done a bit of research into prodisc and also read they made 3 degrees lordosis as well. I dont know, my disc is bone on bone at the edges and about 4 mm in the middle. I just reckon stretching it to 10 mm would be a bit too risky,and I do have a bit of facet pain, purely from the DDD. Stenum said they would put a Maverick in based on my MRI scans. What was your disc height before surgery? Did you have much distraction pain after? and have you had a lot of movement and adjustment in your spine since the surgery, facet clunking and so on?
Thanks ....Michelle.

treefrog · #4 (**permalink**) 07-06-2009, 08:41 PM

Michelle, my disc height was still pretty good before surgery (but I don't know exactly what it was), so the adjustment after was not bad. I did gain an inch in height, though I had lost a half inch before surgery (so in total I gained a half inch). I do have some distraction pain, but from what I can tell of what others have described, mine is very mild. Now the distraction pain is intermittent, but the first two weeks was constant.

My L4/5 disc: Core - size M, 10mm; Inferior plate - size M, 8 degrees; Superior plate - size M, 3 degrees.

My L5/S1 disc: Core - size M, 10mm; Inferior plate - size M, 3 degrees; Superior plate - size M, 3 degrees.

But I would have to say that I wouldn't worry that much about this issue. I mean of course you should talk to your surgeon about your concerns, but I think part the reason for having the surgery is to restore the height of your spine. Yes it will be painful for a while, while your body adjusts to the new mechanics of your spine, but in the end it is better.

fuzzy · #5 (**permalink**) 07-07-2009, 02:44 AM

I was almost bone to bone before and now at about normal, 10 mm disk height. No facet problems. The degen had gone for years, not overnight.

KenG · #6 (**permalink**) 07-07-2009, 09:29 AM

Hi Michelle,

I feel it makes sense to regain the disc height by surgery rather than leaving the
reduced disc height with DDD as it is. of course if you don't have symptom or pain with it, surgery is not needed, I think. I haven't had ADR yet, but I just got
reply from doctor telling me that by regaining the disc height, it helps realign the spine and get less load to the facets and also good effect to the ligament laxity.
that is what I heard.

the thing is (sorry for my english), the present artificial disc is a little bit higher than the normal human disc, so it gets a little bit more of the height with artificial disc, but I personally feel a little higher is better than shortage of the natural height I guess. I think the minimum height of the discs now are 8.5mm
to something like 10 mm as I read somewhere.

JohnK · #7 (**permalink**) 07-20-2009, 07:16 PM

I am also concerned about putting an ADR into my L5-S1 and straining the facets. Dr. Bertagnoli's site details Zyre for facet problems. It looks like a simple product made of buttons and a string that is easy to install, so I wonder why no one is discussing it as a possibility to work with an existing ADR.

Does Zyre completely stop facet movement or just limit it?

Also, have the makers looked into limiting the motion further on current ADR products?

John

JohnK · #8 (**permalink**) 07-21-2009, 07:28 PM

Tim Vicknair with Dr. Bertagnoli's office sent me the following today:

"The short answer is most definitely yes, the Zyre implant is used when doing ADR surgery or in facet surgery alone or as a follow-up surgery to ADR surgery. As you probably know, loss of disc height telescopes the facets and often causes damage to the facet joint."

Sounds hopeful, but I wouldn't want to influence anyone to get adr, or not to. I personally will do kinesiological testing (muscle testing) or other intuitive testing on therapies from now on to see whether they are safe for me. Such testing has given me great answers, and I've often gotten hurt by procedures which I did not test in that way ahead of time.
John