What is a Balanced Back?
Disc replacement allows the patients spine to find its own balance.
Re-mobilization is the key.
Symmetrical Failure to Re-mobilize; Failure of a segment to re-mobilize is not Implant failure.
Re-mobilization is accomplished when both sides of the posterior longitudinal ligament are released.
If the segment fails to remobilize, and unload the facet joints, the implant may never move as intended.
This is not implant failure but a case where full re-mobilization never occurred.
A-symmetrical Failure to Re-mobilize; If the segment re-mobilizes more on one side than the other then instability and segment shift can occur.
This is not implant failure or surgeon error but an unfortunate yet and likely is not a critical event.
Different treatments are appropriate for different stages of the degenerative disc disease.
The Unstable Spine; There are patients who have considerable instability and need more stability.
Extreme instability is an indication for Fusion. We are not always going to get this right.