I have a choice: Pro-Disc or Charite? (L4/L5 and L5/S1) Your thoughts?

[Trish]

Hello,

Most of my history will post in my signature so I won't repeat here. I'm glad to see the exponential growth of this discussion board since the last time I checked in out in Summer 05.)

After waiting in severe pain for 16-months it seems that I have a choice of Charite or ProDisc. It's a long and boring beaureaucratic story explaining how the Norwegian medical system works, so I won't bother you with that.

I would be very grateful for any insight or references anyone can give me to help make my decision.

I have been leaning towards ProDisc since it is the only one that I have found which has performed a study including 2-level patients. Also, the surgeon using Pro-Disc has the most experience.

I have had a skin patch test reveal that I am allergic to Cobalt and Nickel. However, whenever I mention this, every doctor so far has pooh-poohed this as needless worry. I don't know what the materials are in these two brands. Anyone? I think Pro-Disc has cobalt.

In favor of the Charite, is the fact that it is the new and improved version. It doesn't have the large keel like Pro-Disc which could be an issue if I get osteoperosis later on (that's just my guess that something drilled into the bone would be worse.) Also, I think the new Charite is titanium...no allergies there, I think. I know the old Charite had some "problems" with migration and such, but hasn't that been compensated for in the new version?

Does anyone know which one has the best record when it comes to wear particles or the little bits that fall off (or grind off through the years.

That's about all I can think of. Please help. My surgery can be in as little as 2-weeks. They can't give long notice, also due to set-up of Norwegian medical system.

Thanks in advance for your help,
Trish (American married to a Norwegian)


Both my mother and grandmother have/had osteoperisis, onset in their 60s. I am 38.

[chasswen]

trish
i went to germany for a single level prodisc with dr b and was told the implant dr. b uses is titanium end plates. and that mat'l differs here in the usa.
so it seems where you get your surgery will matter when it comes to what the plates are made of.
food for thought while in germany i had a room mate that was from finland and paid out of pocket for his 2 level with dr b and last i spoke to him the gov of finland was to reinbrust the money for his surgery. in full prehaps more for you to look into possibly having dr. b doing your surgery and getting it paid for.
chuck

[Trish]

I wish. I've checked that out already. The government denied reimbursing a claim for the exact same thing...except I think she went to Dr. Bertangoli. Judgement: ADR is still experimental?!!

[chasswen]

well that suxs.
well i'm pro prodisc as now that im feeling better all though i was a extreme case due to all the distraction and beginning to fuse at the op level.
zero disc space to 1 inch taller ouch its been rough on the legs but with PT they are coming around.
chuck

[annapurna]

I've heard secondhand that Zeegers is the only one who did 2 level Charite and that even Bertagnoli felt that the placement of the Charite was too picky for him to use it for two levels.

[Alastair]

Hi Trish,
As you know I went to the AlphaKlinik and had the Charitee ADR. There were other reasons than the actual implant that I went to the AlphaKlinik.

Firstly, Dr Zeegers is the world's most experienced ADR surgeon, and experience in this technique is very important. Also they have never had a case of infection since they opened the AlphaKlinik in 1984, and we have some dreadful infections in the UK in our hospitals. Again the good care and familiarity of the procedure at the AlphaKlinik was another reason that I went there.

Personally I don't think there's a huge difference between the Charitee and the pro-disk. Dr Zeegers does up to three level Charitee, and Dr Bertanogli has done three levels (and some five level) pro-disk.

There have been occasions when whilst inserting the pro-disk, this has caused vertebrae to split and crack, also once inserted the pro-disk cannot easily be removed or adjusted in the early days as the Charitee can.

The decisions are, as always, yours, I think the biggest question is, the name of the surgeon that is going to do the procedure.
Best,
Alastair

PS Waving to you from the UK

[Mariaa]

Trish,
It would appear if WC would authorize a surgery here for me I would have the option of Charite or Prodisc at one level and fusion (at L5S1).

While L3 is not concordant for pain at this time, it is disrupted with an annular tear and for myself I have to wonder about getting another Charite put in possibly in the future if L3 would go later on (all this is hypothetical since surgery isn't even authorized yet) and I've pretty much come to the conclusion that I would prefer Prodisc if I needed to have multi levels done or something more in the future.

This is just my thinking now~ as I said, even tho the hybrid surgery has been suggested by spine surgeons here the last year or so (vs. 2 level ADR) WC has yet to authorize, and in fact they have denied it several times to date.

Good luck w/your decision, it's great that you have the choice and can get something done!!

[Trish]

Alistair - Thank you for responding. I was also leaning to the most experienced doctor (ProDisc) no matter what they use (short of popsicle sticks) because I think that the skill during the procedure itself appears to be major unpredictable element.
Mariaa - It seems so unfair that some Worker's Comp. Ins. give approval (ADR member in NJ...Eddie G??) and some do not. I'm an attorney now in a different field, but I used to work for a Workers' Comp. atty. I seem to recall that you could bring them in front of an Independant Physician who will force their hand so to speak. Do you have a good worker's comp. attorney? I don't know how it would work out since they usually work on a percentage fee based on the amount you recover, but I don't know how that works for the choice of treatment aspect.
Annapurna - Thanks for that info. I thought the 2-level Charite was rare.

Trish

[Trish]

zero disc space to 1 inch taller

Chuck,

Ouch indeed! I didn't think that drastic increases were considered a good outcome? Too bad technology hasn't come up with one that gradually increases in height via remote control...[dream sequence]....Oh, well. I admire your attitude.

[Alastair]

Trish,
if you have a choice, then you have the best surgeons near you. Dr Z or Dr B. Can you choose or do you have to have a surgeon in Norway.?

I`m leaning out as far as I can out of my window waving - -
Best
Alastair