Charite Survivor

[Rocky D]

Wow! I don't know what to say...
Dale , Maria , Katie , Crystal , Jim , Nomorepain , I really appreciate getting back online and reading all of your replies.
I felt good just writing about this thing, now I feel even better after reading all your kind and thought provoking replies.
Online therapy! Who would've guessed?
Thanks for the smile.

[mmglobal]

Rocky, I'm so sorry that you had a poor outcome. I have 2 Charite's that have worked well for more than 7 years now. If you look on the GPN website (linked in my sig file below), you'll see a vide of me playing tennis with the very first Charite' patient... done in east Berlin, 1984. There are some design issues with the Charite that have been improved upon over the years. However, I believe that the disc works well (when properly installed in a properly selected patient.)

The problem with the old Charite' is that with the highly mobile core, lack of a locking mechanism and the thin rim; in the presence of a significant structural issue, the failure mode can be catastrophic. Many of the other designs will have a less frightening failure mode when things like subsidence or migration of the plates occurs.

Most of the problems I see with the Charite' are related to poor implant sizing, improper location and other surgical mistakes. Sadly, with spine surgery, even when everything is done perfectly, significant failures still occur. Even though the catastropic expulsion of the core, breaking of the rim and wire and other Charite' specific problems are not likely or not possible with other prosthesis, horrible outcomes with other devices (and fusions) occur at rates similar to the Charite'. Sadly, many of the problems might have been avoided with more experienced or careful surgeons.

I know that none of this helps you at all. For you the failure rate is 100%. My heart goes out to you. I hope you can find some relief.

Mark

[Crystal33]

Regarding playing tennis, of interest I recently read there are four top professionals playing who have suffered herniated spinal discs, but chose no surgery whatsoever. Tsonga is the most high profiled of them. I never would have thought it possible to return to such high level of intensity. Are there any pro tennis players with lumbar ADR's?

[Crystal33]

I'm wondering if this report on Charité III disc replacements is bad as it sounds, or am i misinterpreting something?

Survival and clinical outcome of SB Charite III disc replacement for back pain -- Ross et al. 89-B (6): 785 -- Journal of Bone and Joint Surgery - British Volume

Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 6, 785-789.

Copyright © 2007 by British Editorial Society of Bone and Joint Surgery

Survival and clinical outcome of SB Charité III disc replacement for back pain

R. Ross, MBChB, FRCS(Ed), FRACS, Spinal Surgeon1; A. H. Mirza, MBChB, MRCS(Ed), Spinal Fellow1; H. E. Norris, BA(Hons), RGN, Research Nurse1; and M. Khatri, MS(Orth), FRCS(Tr & Orth), Consultant Spinal & Orthopaedic Surgeon1

1 Salford Royal NHS Foundation Trust, Eccles Old Road, Salford, Manchester M6 8HD, UK.

Correspondence should be sent to Mr R. Ross; e-mail: ersross@hotmail.co.uk

Between January 1990 and December 2000 we carried out 226 SB Charité III disc replacements for lumbar disc degeneration in 160 patients. They were reviewed at a mean follow-up of 79 months (31 to 161) to determine the clinical and radiological outcome. The clinical results were collected by an independent observer, who was not involved in patient selection, treatment or follow-up, using a combination of outcome measures, including the Oswestry Disability Index. Pain was recorded using a visual analogue score, and the most recent radiographs were reviewed.

Survival of the device was analysed by the Kaplan-Meier method and showed a cumulative survival of 35% at 156 months when radiological failure was taken as the endpoint. The mean improvement in the Oswestry disability index scores after disc replacement was 14% (6% to 21%) and the mean improvement in the pain score was 1.6 (0.46 to 2.73), both falling below the clinically significant threshold. Removal of the implant was required in 12 patients, four because of implant failure.

These poor results indicate that further use of this implant is not justified.