facets are the $500,000 question. If the facets are the main problem, ADR may not be indicated. Some doctors will consider grade II facets a contra-indication, while others will usually do grade II, and sometimes do grade III facets.
I reality, some with minimal facet degeneration will have their facets go south with ADR. It's not magic and if there is some other reason for your facets to go, they may still go bad. Some doctors will do grade III facets and I've seen many films of facets that have actually recovered after ADR. Not that ADR is designed to halt facet degeneration, but in some configurations, restoring the disc height, more normal facet loading and kinematics; may actually allow the facets to recover. I wish there was some way to tell who is who in advance. If we could do that, spine surgery wouldn't be so exciting.
|