Treatment Decision Guides
Evidence-based tools to help you understand treatment options, compare approaches, and make informed decisions about your spine care.
ADR vs Fusion: Key Differences
Motion Preservation
Artificial Disc Replacement (ADR)
Maintains natural movement while addressing disc problems
Benefits
- • Preserves natural movement patterns
- • May reduce adjacent level stress
- • Faster recovery to activities
- • No bone graft needed
- • Maintains disc height and alignment
Requirements
- • Healthy facet joints
- • Good bone quality
- • Appropriate alignment
- • Adequate disc height
- • No significant instability
Stabilization
Spinal Fusion
Eliminates movement to address instability and pain
Benefits
- • Addresses instability effectively
- • Corrects alignment problems
- • Works with damaged facet joints
- • Long track record of success
- • Eliminates painful movement
Considerations
- • Eliminates movement at fused level
- • May stress adjacent levels
- • Longer recovery period
- • Bone graft healing required
- • Activity restrictions
ADR Candidacy Assessment
Are You a Candidate for ADR?
Key factors that influence motion preservation candidacy
Ideal Candidates
- • Single or two-level disc disease
- • Healthy facet joints
- • Good bone density
- • Normal or correctable alignment
- • Age 18-65 (flexible)
- • Adequate disc height
- • No significant instability
- • Realistic expectations
Relative Contraindications
- • Mild facet arthritis
- • Osteopenia (mild bone loss)
- • Previous spine surgery
- • Smoking (can quit)
- • Mild alignment issues
- • Metabolic bone disease
- • Psychological factors
- • Litigation pending
Absolute Contraindications
- • Severe facet arthritis
- • Significant instability
- • Severe osteoporosis
- • Active infection
- • Tumor or malignancy
- • Severe kyphosis
- • Allergy to implant materials
- • Pregnancy
Special Considerations
Athletes
High-demand patients and sports considerations
ADR Advantages
- • Preserves athletic movement
- • Faster return to sport
- • Maintains performance potential
- • Reduces adjacent level risk
Special Considerations
- • Sport-specific demands
- • Contact sport restrictions
- • Staged return protocols
- • Long-term durability
Older Adults
Age-related factors and considerations
Key Factors
- • Bone density assessment
- • Facet joint condition
- • Overall health status
- • Activity expectations
Optimization Strategies
- • Bone health improvement
- • Medical condition management
- • Realistic goal setting
- • Careful device selection
Revision Cases
Previous surgery considerations
Challenges
- • Scar tissue formation
- • Altered anatomy
- • Bone quality changes
- • Increased complexity
Success Factors
- • Careful patient selection
- • Advanced imaging
- • Experienced surgeon
- • Realistic expectations
Treatment Readiness Self-Assessment
Evaluate Your Readiness for Surgery
Consider these factors to help guide your treatment discussions
Symptom Assessment
Readiness Factors
This self-assessment is for educational purposes only and does not replace professional medical evaluation. Discuss your results with Prof. Dr. Bertagnoli during your consultation.
Decision-Making Framework
1
Understand Your Problem
- • Type of pain
- • Imaging findings
- • Functional limitations
- • Conservative care response
2
Know Your Options
- • Conservative care
- • ADR candidacy
- • Fusion indications
- • Hybrid approaches
3
Consider Your Goals
- • Activity level desired
- • Work requirements
- • Sport participation
- • Long-term function
4
Make Informed Choice
- • Risk-benefit analysis
- • Timeline considerations
- • Support system
- • Expert consultation
Ready to Explore Your Options?
Use these decision guides as a starting point for discussions with Prof. Dr. Bertagnoli. Every patient is unique, and personalized evaluation is essential for optimal treatment planning.