[LauraB]

I've been in contact with Dr. Bertognoli and Dr. Bierstedt in regard to my upcoming multi level ADR. Now keep in mind I have a fusion sandwiched inbetween the two cervical levels in need of ADR. I have already decided to go with Dr. Bertognoli and the ProDisc C

Per Dr. Bertognoli (copied from a recent email describing his ADR choice)
Prof. Dr. Bertagnoli would use a pro disc c nova model. It`s esp. suitable for cases like yours – multilevel, and it can slip next to a plate without compromising on primary stability.
Dr. Bertagnoli does not favor unconstrained disc replacements, esp not for multilevel: Having a “free core” means no guidance of movement by the ADR, which is intended. And which is close to a physiological discs, which does not have a fixed centre of rotation either. But: degenerated discs are not virgin discs. They as a rule lack the necessary external guiding structures. A natural disc IS guided in it`s movement by ligaments, annulus and facets. It`s not “wobbling freely”. Exactly those structures are involved in the degeneration process, and either are slack, or calcified and tense. In ADR implantation with a good mobilization and regain of disc height e.g. the dorsal and lateral annulus has frequently to be resected. One should not compromise on nerve liberation to keep them unresected. And hence the additional guidance of a semiconstrained disc (like Pro Disc or PCM etc.), are highly appreciated. These factors are the more relevant in multi-level, where positioning can positively influence spinal alignement in semi-constrained ADRs. And these factors in Dr. Bertagnoli`s judgment far outweigh the lack of a “cushioning function" in ball-and-socket concepts. Cushioning in the spine is predominantly provided by the global s-shape.
MRI-options postop are similar in any models made from the same materials – incl. M6. And we routinely do MRI after ADR, with relevant blurring by artefacts only in the immediate surrounding of the implant. Adjacent levels or soft tissue structurs behind the spine at the implanted level are usually well visible. And they are why an MRI is made.


Dr. Bierstedt had actually ''CALLED" me. As mentioned before in another thread, I was very impressed with his personal attention. He explained that the M6 (preference unless size became an issue) because it is the "state of the art" device. I've read its reference in design to be most like the natural disc, that it is called the true, "artificial Disc." Dr. Bierstedt feels the Prodisc needs a more aggressive approach for placement.

BUT, Harrison you've talked about keel design, and being that I'm not an engineer, what are the pros and cons of either device? I really only have the choice between the two????? I've read about both and easily swayed by each doctor's argument. Sorry guys.....I'm not trying to have someone make the decision for me, but just when I feel i'm on the home stretch, something else stirs me in another direction. PLEASE PLEASE PLEASE help me out here. This is the LAST time I'm having surgery on my neck - I know it, therefore I want to make the best informed decision.