Activ-L vs M6-L ----- for L4/L5
 

Hello,
I am doing research to better select a artificial disc for my injured and severely degenerated L4/L5 that already has two microdisectomies in 1997 & 2014

On the safety perspective, is it true that the Activ-L has a much safer lateral anterior retroperitoneal approach option for both initial first time surgery as well as revision surgery? (Safer distance from the Veins and Artery?)

Is it true that the Activ-L is safer and easier to remove or re-position if a revision is necessary?

Is M6-L more difficult to revise?

I am no expert but I am thinking the M6 will seat better with the keel but more difficult to revise if problems occur, on the other hand the Activ-L won't fit as secure but safer to remove?

There are many good doctors using either the Activ-L and/or M6-L, but my main concern is which technique and disc is safer if I ever need a revision.

I have not come across anyone that had a problem nor revision @ L4/L5 using the Activ-L...... M6 however I did hear a few people needed revisions.

Any comments or advice is appreciated... PM me also great... Thanks!

existing threads
 

there are a couple of existing threads that compare the m6 and activL

http://www.adrsupport.org/forums/f51/next-great-super-disc-12767/
and
http://www.adrsupport.org/forums/f51/m-6-successful-lumbar-surgery-not-12752/

While I certainly hope I never need revision, I did have my L3-4 installed, removed and re-implanted during my surgery in April.

They're both good ADR. Dr Clavel had both on deck but wanted to reaffirm my bone density. Said bones, once inside, were good, but confirmed also with another DEXA. I could have gone with either ADR, but ranked M6 higher last minute in my case due to blood metal allergy test which may not have been an issue at all but why risk? Nickel was reactive as well as chromium coming up close to reactive. And no articulation thus wear debris. That said Activ L is fantastic with excellent results.

As far as revision for M6, Clavel said they were easy for him. Bierstedt said same thing. Clavel told me revision tools for M6 make it pretty straight forward.

M6-L opinion
 

Andy,

I would be a fine example of an M6-L not working out.
There is no "golden" disc.
We don't know why some work on some people and not other's.
I do know that the lumbar is harder to predict than the cervical's.
Every doctor has told me that the lumbar area is harder to do and the
success rate isn't as good as the cervical's are.

One thing I would point out....
I was told that my revision is a bit easier to do being at the L5-S1.
If it were the L4-L5, I was told that would be a whole different ball game.

The forum is helpful and has many great tips but in the end, a DOCTOR
is the one who has the experience and education.
You have to find one you trust as to why he's using the disc he's picking, or procedure
he's doing. Make them explain why so there is no question unanswered.
That's all you can do. The outcome is unpredictable and there are no guarantee's.

There is a trend that everyone think's their doctor and their disc is the best and wants to defend their belief but you have to live with your decision.

I pray for you to have a great outcome with whatever YOU decide on.

Activ-L
 

Thanks everyone for the input...
Both the M6 and Activ-L are very popular but both discs have less than 10 years of data. M6 only about 5 years.
Since my problem is at L4/L5, I am leaning more towards the Activ-L at this point because of the Oblique Lateral pararectus approach option in case reposition or revision is needed. If Zeegers says this is a little safer and easier to revise, then I must believe him because he has over 20 years of experience with very minimal problems with ADR, especially with Activ-L.
Although he does use the M6L if he thinks it will be more superior in special circumstances.
I do agree selecting the surgeon is the most important, someone who I feel comfortable and trustworthy.

For those of you with either M6 or ActivL, I hope you are doing great and recovering awesome! I'll keep posting and asking questions until my surgery date comes. Not sure when... we will see. I hope Zeegers don't retire anytime soon :)

Thanks!

Andy, it sounds like Dr Zeegers will be your surgeon? When is your surgery? Good luck!

just to clarify
 

Just to clarify:

Zeeger's said that the L5-S1 is easier to revise than the L4-L5 because that L4 level is closer to the arteries than L5-S1.

Andy,
you can pm me.
I live in Sarasota.
If you're planning a trip over to Germany, let me know when you are going.
Maybe we can visit each other.

Excellent choice Andy. He's not a young guy anymore and I believe only does 1 surgery per week at the Beta Klinik (Wednesdays), but he is extremely thorough. He is passionate about restoring suffering people's spines. His surgical skills are still top shelf and he is brilliant at diagnosing.
When you get closer, my wife can give you plenty of help finding places to eat or shop for food.

dr z
 

I agree with everything henry said above. I am 16 days post surgery and doing great. Dr zeegers drove two hours to the air port just to have coffee and see me off to Canada. That says something about a Dr if they do that out of the kindness of their heart!

Yes, I think Zeegers did say that L5/S1 is easier than L4/L5.

But for L4/L5 alone, the Pararectus Lateral Retro approach is a little safer than the mid line approach because the veins need less manipulation towards your right side to clear the disc path. (For both initial surgery or Revision)

Again this is what I have read on the Activ-L Procedure manual as well as words from Dr. Zeegers. (Activ-L "Spike" Version)

This factor may or may not be crucial to other surgeons but at least I get a little comfort from knowing this.... at least I researched and tried to understand as best I can about the different approaches :)

Several people here with M6 done by Bierstadt and Clavel said these two doctors claim they can remove the M6 from mid-line approach (both L4/L5 & L5/S1) with the same risks as the Activ-L's pararectus lateral removal. "Makes no difference"

For me I think I'd rather have revision from the lateral instead of Mid-line.
Just my gut feeling :)