Cervical Artificial Disc Replacement?

I have a choice between a multilevel fusion or a multilevel ADR. To make things easy, I have 2 well respected surgeons recommend a fusion and another 2 respected surgeons recommend ADR  . Thoughts?

NateB wrote:

Real question is - are you really sure you need this?  Every neck over 40 looks bad in an mri and these surgeons make a lot of money selling the procedure.

Yeah, I'm real sure. I've been managing my symptoms conservatively for 10 years and it's time to get it done. I know or have talked to plenty of people who've had ACDF but have not ADR. I guess I'd like to hear from any climbers who have had ADR and what their experience has been like.

That sounds like a tough decision. Have you looked into what the recovery timeline differences are between the two? From what I've read, ADR is supposed to preserve more range of motion, but fusion might have a more predictable recovery path. 

Might be worth asking those surgeons what they're seeing in terms of return-to-climbing timelines for each option. A climbing partner dealt with neck issues (fusion route) and the PT process was intense but having clear benchmarks helped

Hope you find some folks with ADR experience to weigh in!

Having symptoms myself that make climbing less enjoyable and would welcome inputs here.  Fusion was recommended for me as a future consideration.  

I've had multiple family members and close friends undergo multilevel fusions, including one who had it in her early 30s due to a freak climbing accident. The biggest issue with fusions is that adjacent disc degeneration is virtually guaranteed. It's why so many fusion patients go back 10-20 years later to fuse the next disc up. The field seems to be moving towards ADR to preserve mobility for younger active patients. My friend who had the neck fusion due to the climbing accident is already being recommended by her ortho to come back in and get an ADR before her arthritis in the other discs gets worse.

I don't think it's surprising you received different recommendations from different doctors. All spine surgeons are taught fusions, but not all are taught disc replacement. I think for those that learn ACDR, many then focus on that as the primary option when the patient is able to get that type of surgery. My surgeon said fusion is still the gold standard even though he does ADR as well.

You can always go down the fusion route if ACDR fails, but not vice versa. Of those two recommending ADR, what disc are they saying they use and what are they saying is the realistic lifespan of the disc? You should look at the disc options and make sure understand the pros and cons. 

I'm too early into my post-recovery from ACDR to give you much useful info about recovery and proper expectations. I would say that unless you have muscle loss, gait/balance issues, or something more severe than pain going on, I wouldn't put all my faith in surgery being the right answer. 

I'm four years post adr at c4/5. Shoot me a message if you are still wanting info