Surgeons need more experience in choosing the correct disk size and placing it properly. “There's an art to placing these things,” Dr. Graziano said, adding that “the reproducibility between surgeons is not there yet.”
DePuy has trained about 2,200 surgeons at its Center for Spine Arthroplasty at the Endo-Surgery Institute in Cincinnati. Surgeons can also train with or observe colleagues who have Charité experience at 50 regional sites.
Dr. Gokaslan and Dr. Graziano agree that artificial disks are at the stage interbody fusion cages were 10 years ago. An initial burst of enthusiasm was followed by the recognition that cages were not a panacea.
“It took 5 years to figure out who should get cages and who shouldn't,” Dr. Graziano said.
Although patients are asking for the Charité disks, surgeons will likely resist the pressure, Dr. Gokaslan said. “It's hard to change the habits of surgeons when there is no serious evidence showing this is better than what they've done in the past,” he said.