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Old 01-03-2008, 12:52 AM
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mmglobal mmglobal is offline
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Fortitudine,

This is a great question. It's a concept that is grossly misunderstood by the patient community (and by a large part of the doctor community too.) I often hear doctors and patients say, "Oh that disc (ADR) is too tall." Yes, there is much discussion in the surgical community about it.

The patient community has embraced the term "distraction pain". You don't hear me reference it unless I'm talking about what someone else is saying. I don't call it distraction pain, I call it "surgery induced leg pain" (or any other radicular symptom.) Some doctors call it "stretch neuropraxia"... I think that is a misnomer as well because often times the surgery induced leg pain has NOTHING to do with distraction, over distraction, restoring disc height, etc. It's just surgery induced leg pain and may be caused by many things. Even without restoration of anywhere close to normal disc height, fusion patients may experience this. (Although I do believe that it is more common in ADR patients, but there are many other factors besides distraction... like continued motion.)

You will see discs that may appear to be too tall in patients who have cores implanted that are larger than the smallest available. That is not necessarily because the surgeon didn't know his own strength and overdistracted the system when he squeezed on the distraction tool. Remember that tension on the system is required for it to have structural integrity. If they disctract the disc space and put in the shortest prosthesis available, the system may be too loose... possibly resulting in instability or greater chance of migration. The height of the disc should be determined by the surgeon distracting the disc space to the appropriate tension and seeing what size trial implant best fits the space. She will not necessarily choose the shortest one... it's best fit... not smallest possible.

Marty, I don't think that you need to be active to have your discs continue to break down. It's a degenerative process that afflicts inactive people the same way it does active people. The active people may even have an advantage because they maintain core fitness and strength.

Mark

PS. I have retreads on my 740... they seem to work fine unless I go over 140 mph. Then they require replacement.
__________________
1997 MVA
2000 L4-5 Microdiscectomy/laminotomy
2001 L5-S1 Micro-d/lami
2002 L4-S1 Charite' ADR - SUCCESS!
2009 C3-C4, C5-C6-C7, T1-T2 ProDisc-C Nova
Summer 2009, more bad thoracic discs!
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