Artificial Disc Replacement: Contraindications

[Justin]

Contraindications for Artificial Disc Replacement

Individuals who may not be qualified to have artificial disc replacement surgery include those with the following conditions or factors:

• Multi-level disc degeneration
• Instability in the spine (such as spondylolysis, spondylolisthesis, spinal instability secondary to altered posterior elements [e.g. following laminectomy], or fracture)
• Anyone with poor bone quality (such as osteoporosis [defined as DEXA bone density measured T-score ≤ -2.5] or osteopenia)
• Severe central or lateral spinal stenosis
• Severe facet joint arthrosis / symptomatic facet joint problems
• Some patients who have had prior spine surgery (Some patients who have had minor back surgery may still be candidates to have the artificial disc.)
• Patients who are pregnant
• Anyone with a widespread infection or a spinal infection (previous / latent infection)
• Severe Scoliosis
• Tumors in the proposed surgical area
• Compromised vertebral body (irregular endplate shape)
• Severe myelopathy
• Metal allergy (allergy or sensitivity to implant materials: cobalt, chromium, molybdenum, polyethylene, titanium, stainless steel, etc.)
• Psycho-social issues[/U][/B]

(Note: the list above is not exhaustive. However, it is based on FDA guidelines as well peer-reviewed publications.)

[Gilbert P]

Hi Dr J

Well this puts me out of any surgery in the U.S. bur if I go out of country they will do it all??????

All for money

Gil

[claudia]

I was crushed when I learned that scoliosis is a counter-indication for ADR, and therefore out of the question for me. I hope that some day an artificial disc is developed that can work in people with scoliosis, especially since scoliosis itself can lead to DDD.

[Cindylou]

Claudia, on the scoliosis, it does depend on how severe it is. My scoliosis was workable for Dr. B, and he was able to improve it even, somewhat.

[Katie]

Well, thankfully we CAN go out of country for some of this. I have more than one level that several surgeons questioned in my cervical area, and both Stenum and Dr. Bitan were going to do ADRs there, albeit a hybrid with Dr. Bitan in NYC because he isn't allowed to do multilevel in the US.

Dr. Pimenta decided that one level of ADR was sufficient, that doing that will help the adjacent level, and so far it seems to have worked. There are no guarantees that it won't bother me in ten years as my whole body continues to deteriorate, but so far all my pain and neurological problems have disappeared.

[Carson]

Exactly. It's worth noting these are FDA guidelines, not global law. If multilevel disc degeneration was a contraindication to ADR surgery almost no one would be receiving ADR. Including the numerous members here and other boards with two and three levels. If you read across the forums you'll find more members with multiple level ADR than single.

The first contraindication topping the list could use some clearer context as to what constitutes contraindicative multi-level disc degeneration according to the FDA as well as why it's a contraindication. That said, the list reads very sound and critical to grasp; in particular facet arthrosis, bone density, sever scoliosis, etc.