Choosing an artificial disc is a very daunting task and I did a great deal of research before I took the plunge! Some of the devices that impressed me, other than the Spinal Kinetics M6-L, were the LP ESP disc, the Axiomed Freedom Disc and the NuVasive XL-TDR. The LP and Freedom discs are simpler designs that seem to be stronger and more durable than the M6, though they also seem to be bonded to the endplates(I could be wrong), which has caused issues with earlier elastomer devices. The XL TDR uses a minimally invasive lateral approach that preserves the anterior and posterior longitudinal ligaments, but offers no shock absorption or 6 degree constrained movement. Ultimately, it came down to my choice in surgeon, though it helped that he uses the most widely-used and available of the so-called “2nd” generation implants.
In Canada, the few surgeons that practice ADR appear to use the A-Mav from Medtronic.(I can only find a description page in Swedish from medtronic!) While I admire the simplicity and robustness of this design, I don’t think my facets would enjoy the ride, given their hypertrophy. I ruled out the Prodisc for the same reason.
It is important to note that any prosthetic device will have both strengths and weaknesses. It’s entirely up to us as patients to pick our surgeons wisely and educate ourselves as much as possible. Ultimately, the choice for surgery comes down to a hunch… a hunch that brings with it significant risk! It’s really too bad we’re still a few years away from more effective biological treatments for our degenerative discs.
This is an excellent discussion on SPS with a Medical Device Engineer. A great read!
Below are the studies and technical documents that helped me the most in my decision making process: