[WakesurfMike]

I received and Preauthorization for Artificial disk replacement surgery for Active L disc at the end of the month. This would be in Charlotte North Carolina at Carolinas Medical center.

I am seriously considering about getting a next generation disk with cushioning and passive resistance instead of the Active L. I figure I only got one shot at this and will be stuck with the choice for the rest of my life so might as well get the best one I can get even if I have to cash out part of my retirement savings or wait a year until the disk I want gets FDA approved.

When I met with Dr Coric a few weeks ago I asked him if he was in my shoes and had the money to get the best disk available what would he do. He said he would travel to Germany and get a next generation disk with cushioning and probably the M6 since it has been tested the most. He did say the Active L disk is a great disc and he does have patients that have done very well and are able to be very active and run and jog with this disk.

I am still trying to narrow down what would be the best artificial disk for me and where and when I could get it my disk replaced.

1. Cheapest option since insurance will cover in USA. I would only pay 10% since I have met my deductible. The Active L disk is the latest disk that the FDA has approved in 2015. It has an 87% success rate and most patients achieve a reduction of pain to less 2 out of 10 within a few months after surgery. This disk has anatomically designed S1 endplate which is the level I need replaced. I has XL endplates (size 33 mm X 40 mm) It allows for motion but does not have any cushioning or passive resistance to motion.

https://www.soactivesofast.com/low-b...rtificial-disc

Active L disk Study results and success rates.

https://www.dovepress.com/the-activl...t-article-MDER

2. My top choice Axiomed Freedom disk. http://www.axiomed.com/
Made in USA. Not FDA approved yet but should be by end of 2017 , over 800 installed worldwide- Available in Canada, Australia, EU. This disk has cushioning and passive resistive motion. This is has large silicone polymer core the full width of disc. Really strong polymer-metal bond. This disk actually 5 times stronger than human disk. I am really impressed with the 45 degree 15mm sheer test at 2 minutes in the video below. I think this test would probably destroy any other disk I have seen.

https://www.youtube.com/watch?v=2k8WRoBjS6s

I should probably just stick to wakesurfing. But I am thinking the Freedom disk would survive wakeboard wipeouts  https://www.youtube.com/watch?v=XxTgCKwEM8o

Freedom® Lumbar Disc —Clinical Outcomes BenchmarkedAgainst All TDRs in theSWISSspine Registry http://www.axiomed.com/pdf/WPaperSWISSSpineReg.pdf

Half the patients in a 50-patient study of the Freedom Lumbar Disc reported less than 10 percent disability score and less than 1/10 on the pain scale two years after surgery.
http://www.beckersspine.com/orthoped...s-to-know.html

I have not found a document with sizes available yet. If you find one please let me know.

I am also not finding many doctors that use the Freedom disk yet. It seems to be mainly used in Switzerland. I have been in communications with Dr Zeegers and he would consider it. He has met with Axiomed reps since I have started communication with him.

3. ESP Elastic Spine Pad http://www.esp-disc.com/ Made in France- available in EU. Does not seem very common outside of France. I have not done lots of research on this yet. Just learned about it from this forum a few weeks ago.

4. The spinal kinetics M6 disk is probably the most widely used. Made in USA, but not available in USA. . Over 10,000 installed. Have not even started and FDA trial for Lumbar in US. This might be higher on list if I needed a disk at another level or had smaller bones I just don’t think it would be a good choice for me at L5/S1. The bottom of my L5 is 37mm x 50mm. The M6 disk is only about 25mm diameter with an even smaller diameter center core. It does have XL 33mm x 44mm endplates but disk size is only 25mm and covers 50% of width of my spine at the L5/S1 level.

http://www.spinalkinetics.com/m6-l/m6-l-procedure/ (This link shows sizes available, I would need the XL)

I keep thinking of the old Pontiac Grand Prix wider is better commercials https://www.youtube.com/watch?v=RO6U_KawAdg

M6 disk https://www.youtube.com/watch?v=O0pOn09DnB8

As far a Doctors and Hospitals are concerned If I am going try get Bluecross to pay I would probably need to stay in network. I do have emergency coverage worldwide. https://www.bluecardworldwide.com/ RVP is code on my card to search for providers. When I talked to Bluecross in US about possibility of getting surgery in another country since better disc are available I was told I would need a waiver from my employer to allow an elective surgery out of the country. I work for Varian Medical Systems and we even have a factory in Switzerland where we make the robotic arms that holds the X-ray tube that I was changing out when I herniated my disk back in 2007.

My girlfriend would rather go to Canada Vancouver/Victoria island since she has a friend she could visit and we could stay there. It wouldn’t be as long as a flight as Germany. I am dreading a flight and looking for travel options. BMW factory is in SC and ships cars from SC Europe several times a month. Maybe I could travel on a cargo ship and stay in bed for a few week.

I really want an experience surgeon in Blueworld network that would do most of all or what Dr Bertagnoli says on his superior surgery page. http://www.dr-bertagnoli.com/superior-surgery.html

1. Preserve the anterior longitudinal ligament ( I have seen dozens of videos where they make two cuts and remove a 10-15 mm of this anterior longitudinal ligament instead or preserving it. )
2. drill or saw the keyway for the keel and clean out, not just chisel it in.
3. Application of bone wax to ADR preparation sites in the bone or remodeled areas of the bone helps prevent osteophytes from growing.
4. implants a protective membrane to prevent adhesions between the operated area and the veins and arteries in ventral lumbar surgery. This is a look to the possible future for the patient, because it is these adhesions that make future operations in this area so dangerous.
5. packs the surgery site between and around the vertebrae with anti-thrombin agents to efficiently inhibit thrombin-induced fibrin formation and platelet aggregation