any thoughts??

[john walls]

i was rear-ended by a truck, causing me to hit the car in front of me. i have had L4-L5, L5-S1 and C5-C6 replaced with the charite. my primary physician is located in the u.s. i traveled to germany in 12/05 for these surgeries. based on my latest MRIs, i was told i would need another surgery at C4-C5. does anyone know if a different type of disc can be used? do all replacements need to be the same? what type of complications result from multiple adr's? thanks!

[annapurna]

Your lumbar ADR could be Charite, but I wasn't aware of a cervical Charite (this is the less informed Jim, not the super informed spine paitent Laura). Is it possible you have some other disk in your C-spine?

[john walls]

thx anna. no, its all charite. will there be a conflict if another type is used in the upcoming surgery?

[tmont]

Hi John,

I'm a cervical case as well. I think your question is a tough one because to me it's unusual to think about using different kinds of discs in one person; I don't recall seeing that come up here before but I could be wrong.

I googled until my eyes started to water but didn't come up with anything concrete on combining 2 different discs; maybe someone else can?

Just my thoughts tho: some people feel that most of the discs out there are pretty much the same performance-wise (where are you, Sir A?) and that it's the surgeon who makes all the difference in the world at this early stage in the game--by that I mean no real long-term data on any disc out there--and on that I tend to mostly agree.

But as far as combining two different kinds of discs goes: not sure that would fly. Pure speculation here, but if I were to have a Prodisc at C6-C7 (instead of my fusion) and then implanted a Mobi-C in C5-C6, I would worry about the difference in core mobility between the two, and how this would affect the overall result. The Mobi-C's core is more mobile than the ProDisc's, so how would that affect spine biomechanics is completely beyond me, but I personally wouldn't take the chance and would use 2 of the same unless someone explained to me it was better not to. Also, as Brad has been so kind to explain to me--the shape of the endplates is different, so that could also affect the result.

My two levels are adjacent-- but could one theoretically use different discs if they were more widely spaced, or 1 cervical and 1 lumbar? guess that's what you're asking, innit?

What does/do your doc(s) say? I'd be really interested in the response at any rate.

Could you also give a little more data on your Charité cervical disc? I can't find anything on that type of prosthesis either

Trace

[Fortitudine]

I'm wondering why you need another ADR at c4/5. Was the problem missed on the earlier films? Or is it new? Is it a herniated disc, osteoophytes, or ???
I'm asking because ADR has been sold partly on the fact that it should prevent adjacent segment degeneration...

[john walls]

thanks trace! "googled until your eyes watered". ha! geez...youre french, your english is better than mine, and i majored in english. anyways, my doc, is doc.....Z! i used him for my previous 3 adrs. i trust him. i have yet to ask him about any conflicts, thought before i head back to munich i would put this adr site to the test. find out from a real time test. guess there arent any. i like what you have to say. seems reasonable, and you are obviously well informed. again, thank you. john

[john walls]

Originally posted by Fortitudine:
I'm wondering why you need another ADR at c4/5. Was the problem missed on the earlier films? Or is it new? Is it a herniated disc, osteoophytes, or ???
I'm asking because ADR has been sold partly on the fact that it should prevent adjacent segment degeneration...

... hi fortitudine, huh, neat name! thanks for your response. its osteoophytes. pinching down on c6. enough is enough! wow, avoiding 3 level fusion? why are fusing? what made you ask about osteoophytes???? is this normal for this to develope? if so, what do other people do when this condition results? again, thank you. john

[john walls]

Originally posted by tmont:
Hi John,

I'm a cervical case as well. I think your question is a tough one because to me it's unusual to think about using different kinds of discs in one person; I don't recall seeing that come up here before but I could be wrong.

I googled until my eyes started to water but didn't come up with anything concrete on combining 2 different discs; maybe someone else can?

Just my thoughts tho: some people feel that most of the discs out there are pretty much the same performance-wise (where are you, Sir A?) and that it's the surgeon who makes all the difference in the world at this early stage in the game--by that I mean no real long-term data on any disc out there--and on that I tend to mostly agree.

But as far as combining two different kinds of discs goes: not sure that would fly. Pure speculation here, but if I were to have a Prodisc at C6-C7 (instead of my fusion) and then implanted a Mobi-C in C5-C6, I would worry about the difference in core mobility between the two, and how this would affect the overall result. The Mobi-C's core is more mobile than the ProDisc's, so how would that affect spine biomechanics is completely beyond me, but I personally wouldn't take the chance and would use 2 of the same unless someone explained to me it was better not to. Also, as Brad has been so kind to explain to me--the shape of the endplates is different, so that could also affect the result.

My two levels are adjacent-- but could one theoretically use different discs if they were more widely spaced, or 1 cervical and 1 lumbar? guess that's what you're asking, innit?

What does/do your doc(s) say? I'd be really interested in the response at any rate.

Could you also give a little more data on your Charité cervical disc? I can't find anything on that type of prosthesis either

Trace

opps. guess i need to figure out this site and how to respond! my reply is located below. sorry. i know you spent considerable time helping me and i didnt want you to think i dont appreciate it. all i know about the cervical is that its charite. hmmm, i dont need to be concerned about this do i? why, cant lumbar charite be used in the cervical?

[annapurna]

The lumbar ADR is a huge device and, to the best of several people's memories, has never been offered in a small enough version to fit in the C-spine. There are C-spine ADRs that look like the Charite but aren't exactly the same. We're pressing you on this both because news of a brand new C-spine device would catch a lot of attention among all the c-spine sufferers here and because you may not be mixing devices as much as you think you are. I suspect your C-spine ADR is something more middle of the road like a Pro-disk C, which many use and has already been used in multiple levels. I believe it even has been used in combination with fusion and when implanted at one level then a subsequent surgery implanting a second ADR at an adjacent level. You might wish to contact Dr. Zeegers and ask what you have and whether or not he thinks there would be a problem with a second ADR.

Then, when he turns out to be too busy fixing spines to answer your email, I'd go ahead and contact the Alpha Klinik, assuming that's where you had your surgery, and ask if they could tell you what kind of disc he put in your C-spine. The AK has been very good about getting back with easy questions like this and understanding about Dr. Zeegers' difficulty in replying.

[john walls]

Originally posted by annapurna:
The lumbar ADR is a huge device and, to the best of several people's memories, has never been offered in a small enough version to fit in the C-spine. There are C-spine ADRs that look like the Charite but aren't exactly the same. We're pressing you on this both because news of a brand new C-spine device would catch a lot of attention among all the c-spine sufferers here and because you may not be mixing devices as much as you think you are. I suspect your C-spine ADR is something more middle of the road like a Pro-disk C, which many use and has already been used in multiple levels. I believe it even has been used in combination with fusion and when implanted at one level then a subsequent surgery implanting a second ADR at an adjacent level. You might wish to contact Dr. Zeegers and ask what you have and whether or not he thinks there would be a problem with a second ADR.

Then, when he turns out to be too busy fixing spines to answer your email, I'd go ahead and contact the Alpha Klinik, assuming that's where you had your surgery, and ask if they could tell you what kind of disc he put in your C-spine. The AK has been very good about getting back with easy questions like this and understanding about Dr. Zeegers' difficulty in replying.

thanks againn anna. i agree. i will contact dr z. he has always replied the same day. would it be your thought that i am wrong about the charite in the cervical? does he implant the pro-disk?