Monday, 4 February 2008

I've received a response from Germany:-
Meanwhile I have now received (and attached as a jpg image) the consultant radiologist's report on my recent scan (you have the MRI images on CDROM) and would like to ask you to comment on his findings particularly regarding items
1. Are the presence of chronic and acute reactive endplate changes a contra-indicator for successful ADR?
Not at all – as long as they are not fully destructive. End plate changes are on the contrary a sign of clear discogenic degeneration – and thus confirm the expectation of ADR addressing your predominant pain generation.

2 & 3 The report mentions twice "facet joint hypertrophy". I believe that pre-operation condition of facets are critical for ADR success and have heard that the thickness of the discs of less than 5mm are a contra-indicator for ADR success. What is your own view of the indications in my case?
Facet joint degenration is one item, that we closely evaluate when deciding on ADR. Facet joints physiologically only take over a minor share of axial spinal load. Disc height collaps brought about by disc degeneration will massively overload them. And foster degeneration.
ADR implantation is capable to restore disc height and renormalize the segmental movement pattern from what it has become by disc degeneration. So in our experience your degree of facet degeneration will be positively addressed by ADR. This biomechanical consideration is confirmed by Dr. Bertagnolis long-standing experience in his case series. Of course high-grade facet destruction would speak against ADR. Which is not at stake in you acc. to Dr. Bertagnoli`s judgment. I hope I could help you on.

I find this response curiously unhelpful. Maybe it's due to the problems of interpretation from German to English but I end up with the impression that whatever I raise as a possible problem the answer is "Don't worry!" Makes me question still further the quality of the answers and advice from the clinic.

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