Hi Harrison, in the states, like TBI, they implant ActivL ($35,000 total package).
I prefer the LP-ESP disc (Dr. Biren Desai $15,800 total package). Its not just pricing, but the technology of the implant and skill of surgeon. I've researched the different discs and its led me to LP-ESP. If its not a fit for my X-Large vertebrae, he'll do an M6.
https://www.youtube.com/watch?v=r7T74bRip2g
Here is response from Desai about my X-large vertebrae:
As you mentioned, the sizes of the TDR´s on the market are different and there could be a mismatch between the patient vertebra and the implant.
In more than 90 % of all patients the diameter and size of the LP-ESP fits well, because the Disc is placed on the cortical ring of the vertebra. It has not to cover all of the surface of the vertebra. In my opinion only very big /tall patients may have a problem with a TDR which ends in the center of the endplate. In these cases we might see a subsidence of the TDR into the endplate of the vertebra.
I saw this phenomena only twice. In both cases the patient was male and over 198 cm tall.
We can also Implant the M6 but in my history and opinion the LP-ESP is the experienced and better implant.
In doubt we prepare both of the implants and decide during the procedure. If the M6 trial fits better, we choose M6.
Please send me the CD with MRI to the address:
Dr. Biren Desai
Head of Department Spine Surgery
Dreifaltigkeits-Krankenhaus Köln-Braunsfeld
Aachener Straße 445 - 449
D-50933 Köln
Germany