Disc design question : keel or spikes ?

[KenG]

Is there keel's advantage like easier to place the disc at center(right and left) position with keel ? I may be completely wrong but i just felt so...

[KBear]

Is there keel's advantage like easier to place the disc at center(right and left) position with keel ? I may be completely wrong but i just felt so...

This is a guess; but I don't think so. I think that has more to do with the surgeons skill than the design of the disc. From what I have heard and read, the surgeon is the single most important factor in a successful surgery. For instance, a good surgeon, with lots of experience can do a good job with an inferior device. Whereas, a surgeon with little experience coud have the best device in the world, on a perfect patient and still not get a good outcome. I had a 50/50 shot at getting the Charite or Active L. I wasn't crazy about possibly getting the Charite; but I trusted my surgeons skill and felt I would get a good outcome regardless.

[Justin]

Is there keel's advantage like easier to place the disc at center(right and left) position with keel ? I may be completely wrong but i just felt so...

Hi Ken,

This is a great question. I know Dr. Bertagnoli prefers the ProDisc because the keel greatly helps with centering of the device. The slots that are created in the cranial and caudal vertebral bodies helps to ensure correct placement (centering) of the device. (Of course, fluoroscopy is also used to help establish the midline before any chiseling is done.)

Here's a link to the Surgical Technique brochure on the Synthes ProDisc website --> ProDisc-L Total Disc Replacement Technique Guide

I hope this helps.

[Justin]

But Justin, they have been using the equivalent to these materials in hip and knee replacements, have they not? I thought they had proven through those that the wear was neither significant nor dangerous, as per uptake of the metal ions, etc.

Am I all wrong on that?

Hey Katie,

I just posted a new thread about UHMWPE and Wear Debris. The book has sections on hip/knee joint replacement and includes discussion on wear particles causing osteolysis, or active resorption of bone, as well as production of free radicals.

There is a new section for this edition that talks about UHMWPE wear and the spine.

The book is a limited preview through Google Books, but almost the entire book is still viewable -->

UHMWPE Biomaterials Handbook, Second Edition: Ultra High Molecular Weight Polyethylene in Total Joint Replacement and Medical Devices by Steven M Kurtz --> Chapter 12: The Clinical Performance of UHMWPE in the Spine

I hope this helps.

[Katie]

I just checked with my surgeon regarding the lawsuit about the Medtronic/Maverick disc that we were considering for my lumbar. He briefly replied that he could also use the Active L and Synthes discs, so I am going through old posts trying to find out more about them.

Thanks for all the information already posted. If you have more to add, I'd appreciate it

[KBear]

I have the Activ L, feel free to call me with any questions. I'm better at explaining talking than typing.

[Katie]

Hey Kathy,

I'll try to call tomorrow. Thanks for the offer.

[Justin]

I just checked with my surgeon regarding the lawsuit about the Medtronic/Maverick disc that we were considering for my lumbar. He briefly replied that he could also use the Active L and Synthes discs, so I am going through old posts trying to find out more about them.

Thanks for all the information already posted. If you have more to add, I'd appreciate it

Hey Katie,

I'm not sure if you noticed above, but this link has detailed information about almost every artificial disc replacement device that is on the market:

UHMWPE Biomaterials Handbook, Second Edition: Ultra High Molecular Weight Polyethylene in Total Joint Replacement and Medical Devices by Steven M Kurtz --> Chapter 12: The Clinical Performance of UHMWPE in the Spine

[Katie]

Sorry Justin, that crawled right past me. Sometimes I need a good smack to see what is right in front of my face. I feel like crawling under a rock right now. I'm way too much and very embarrassed with you having to post that twice....even coffee isn't working anymore

My studio tour is on this coming weekend and next and I'm trying to pull something together for it. I've done so little the past two years, it's almost embarrassing to have people come through to see the same old stuff mostly. Hundreds of people every day

That and being on pins and needles, waiting for the blood test to come back...lots of good excuses, no?

[Justin]

No worries, Katie. I just wanted to make sure you saw that resource, as it is quite good. (BTW: I think the link was redirecting to a blank page, so I updated it a few days ago).

Let me know if you need anything else. :thumpup: