[Brad]

I love these detailed posts.

Mark,
If everything is prefaced with the fact that it depends on the surgeon then your item 1. is not a factor just as non-keel pop outs of the charite are not a factor when the placement is correct.

I would think that the revision of a charite, after the bone has grown around the prosthesis, would also preclude another ADR in most cases. They will most definately have to carve out the plate and do a number on the bone (although for sure much less than a Pro-disc but both will probably result in a fusion).

I believe that even if the disc is taken out from the side the doctor will still have to take the vessels and separate them from the vertebrae and the outer fibers of the remaining disc structure. If the vessels have scarred to both the upper and lower vertebrae, above and below the ADR, then the doctor will have to separate them otherwise he will not be able to distract the vertebrae enough to get the Charite out without tearing and pulling on the vessels (again, though it is still less than the pro-disc or the Activ-L).

Since none of us are doctors I would love to find this out from Dr. B or Reegan who have done a number of revisions. But we can imagine that any revision is bad, very bad.

I think the best argument for the Charite is that the core is easier to replace, than the Pro-disc. To me, this is what may wear and may need to be replaced long term. With the Charite, and the Activ-L, I can see that this can be done completely from the side without much problem or disruption. For the Pro-disc I think it must be taken out from the front and will need the vessels to be moved aside just as much as the original surgery.

I dont know about the Charite but the Activ-l even has a special tool for revising the core. It grabs the inlay (core) from any direction so you can take it out and put a new one in. This is one of the improvements they have made in this design.


Mark, maybe sometime when you are with Dr. B you can ask him his opinion about the ease of replacing just the core of each type of disc and let us all know. I really do think that this should be more of a discussion than the ease of which the plates are revised.

Hopefully we will get 50 years out of the core of each type and not have to worry about it!

Brad