Dr Del opinion on the differance between Pro and Charite, comments appreciated.

[Steve Kegel]

Dr Delamarter explained during a presentation at Harbor View General the big difference in his opinion between Pro Disc and Charite. That being the Pro Disc is semi constrained and the Charite is unconstrained. This difference according to Dr. Del. Is the problem. The Charite being unconstrained allows flexion and extension translating to the facets, causing them to bang and wear, this eventually causing pain leading to a higher rate of fusion. The Pro Disc because it is semi constrained spares the facets keeping them from banging and wearing. Any comments would be appreciated. The Web address for the Harbor View presentation is: www.uwtv.org/programs/displayevent.asp?rid=1975

[Dano]

Different Doc's have different opinions on the two main disks. Bottom line is they are both good in the application that they are designed for. I�m sorry; I see this all the time, You get a couple of cardiologists and they will disagree like cats and dogs over what cardiac rhythm they see. (that�s no joke) Both of these disks have their place, and have good track records. Rick is very out-spoken and there are just as many doc�s on both sides of this issue. Take care Dano.

[Steve Kegel]

Thanks Dano,
I appreciate the feedback, my concern is that because I am L5S1 which doesn't move much anyway, therefore thinking it is best for L5 to be semi constrained. Also I noticed that all the newer Disc Maverick, Flecicore are all adopting the keel design, giving them the semi constrained feature. Wondering if all that indicates that the Pro Dics is more cutting edge, (new evolution Etc.)

[Dano]

You know this has been discussed to death on others forums. There are those who feel that if you are not near anatomical in movement that you place more strain on the disk above. My original problems started at L/5-S/1 and eventually tore L4-L5 due to no disk at the lower level. I'm in a very hard occupation so I�m not a good example. Like I said, there are 100's of opinions on this subject. You have two of the best in Europe who like the Chartie for one-two levels depending on patient presentation. For big multi-levels it's defiantly pro-disk. I would not go with keel no keel, some is marketing some is patents. Some is a bunch of stuff no one knows. What I would recommend is find a Doc at a major comprehensive spine center, not necessarily a surgeon but a pm guy. (and yes this depends on how much testing you have already had) Once your comfortable with the doc's you have, then let them first decide what's wrong, second what can be done that is conservative in nature first. Then if all the other stuff failed then decide with your team of doctors and decide on your plan. Shop doctors, not disks. If you must get all info then poss. mmgobal (mark m) can help. But really get some great doc's educate yourself and ask questions. I hope this helps, Dano

[Alastair]

Hi Steve,
at the moment, because ADR is new to the USA, doctors are recommending what is their particular opinion of the protheses. Doctors are not angels, and remember most of them are usually on a franchise for certain types of ADR. It's the same in the UK and they only recommend one particular type because of the financial implications.

I would look to the European doctors for the facts about this.

Both the Charitee and the Pro Disc are equally good as Dano says this discussion has been around various boards for a few years.

The acid test is what is being used out in Europe at the moment, and when people like Zeegers has been using the Charitee since 1989, and done well over 1200 surgeries with 90% plus success, I think you should know the answer. Dr B. uses the Pro Disc, all this information is on this board. Please see my other posting about the Maverick
Best wishes,
Alastair

[andromeda1111]

Actually when you do not have flexion or extension... which is the natural physiological movement of the spine to begin with, you would have more of an overload of the facets not less. Under an unconstrained environment the facets are allowed to move as they should and were designed to do, not be restrictively contained. Lack of movement of a joint makes it stiff, joints are designed to move. I don't buy that statement at all.

Andro1111

[Harrison]

I have too much to say on this (and have said it before any way) and just leave y'all with this question: which design offers a more "life-like" movement?

[JeffreyD]

Steve,
Thanks for sharing the information regarding Dr. Delemarter's discussion. It is always good to hear different opinions from ADR surgeons; especially if it causes us to dig a little deeper in our research. I am looking forward to seeing the final FDA study paper on the ProDisc. As far as I know, there have been few studies of the ProDisc as compared to the Charite.

Jeff

[Sabrine]

Hi Steve!

Guess you and I are in the same boat- I am also trying to find out which protheses I should go for.
Thought maybe you wanted to see what Dr. Fenk-Mayer/Bertagnoli answered me when I asked:

1. As I understand you favour and use the Prodisc. Can you please tell me exactly why you prefer using the Pro-disc and not the Chartie?

"Dr. Bertagnoli has used all 3 available evaluated types in selected cases (Charite, Pro-Disc, Maverick). He does though prefer and generally implant Pro-Disc. Due to compact insertion, without the need of overdistraction during implantation. Due to optimized tooling, developed by himself. Due to the semiconstrained core biomechanics, which appear superior esp. in need of relevant decompression, disctraction or in mulit-level use."

2. Does the Pro-disc place more pressure on the facet-joints due to its reduced range of motion (a mono-convex design as an opposed to the bi-convex design of the chartie and b.anterior-posterior motion vs. the lateral direction of the Pro-disc-keel?)
"The range of movement of Pro-Disc is higher than the natural ROM of a natural healthy disc � this is intended, exactly to prevent the mechanism you have described. And to prevent leavering of the metal-plates in end-grade movement.

So in this respect no biomechanic difference to the Charite"


Good luck!
Sabrine

[Steve Kegel]

Alastair,
Can you please direct me to your post on the Maverick disc.
Thanks!