I found the above to be a very interesting discussion...I mean about disc heights left and ADRs and I see that people are not aware of device labeling...
(Btw, I have never heard of such a tall natural disc height-21 mm!?!!!...It must be a mistake here or Michelle is a super human!
11 maybe... (I read that a human's disc is 10-12mm in average...))
I couldnt walk away from that topic after I briefly glanced at it as I see that many people dont know what is right, what is wrong, what are just opinions or rumors and because of that, there are dangerous misleading presentations given that can lead to a situation like mine.
It IS being specified that ADR is contraindicated if your disc has collapsed to less than 5 mm, so
Rule is a Rule and one must not neglect it at the expense of a patient, just on an assumption and hope that it might work anyways because it worked for several people ...
I disagree about "comfort level of the surgeon" comment.
If a specification for a particular device application is given-one must follow it even if your "comfort level" tells you that you can do much more. We are talking about humans here and not just animal specimens...
I assume that everyone knows that as a disc collapses, the load is transferred to the facets and this is why it is being said that the disc height must be at least 5 mm. (along with a concept of over distracting the spine during implantation of course). Below is a simplified page how by collapsing,the disc is "taking" facets with it down too:
http://www.backrack.co.uk/compression.shtml
I suppose in rare cases, it is possible that people have bone on bone situation and still good facets but that doesnt justify ignoring the rule. It is so easy to tell to poor naive desperate people that whatever concern they have is ok and that the doc knows better
but if they had those confidential specs from the manufacturers, they would be able to read the rules for a specific device implantation and make at least an informed decision for themselves...like if they want to take the risk of doing something that considers to be a contraindication but a doctor feels comfortable ignoring it.
Unfortunately, such rules are not open for a general public and one needs to have connections (or however one calls it) to get those...
