The MAVERICK™ is a two piece metal-on-metal design that incorporates a more posterior center of rotation.
In most cases the MAVERICK™ implant is the best option available today.
It's design allows for less distraction of the vertebrae, which is critical in cases where severe disc space collapse is present.
The MAVERICK™ also provides a more stable joint, where indications like retrolisthesis exist, and would be contraindications for implants like the Charite.
With MAVERICK™ metal fixation into bone is excellent and there is no polyethylene wear issue.
The unique insertion method used in the MAVERICK™ implantation process allows for a larger plate size to be used. This limits the risk of plate subsidence leading to revision surgery(required in as much as 4% of Charite, and 8.7% of ProDisc patients).
Metal-on-metal wear for the MAVERICK™ ball and socket implant, that is semi constrained, has been tested extensively and there is essentially no metal wear at 31.5 years of simulated loading. (Unlike the constrained ball and socket design which is similar to a constrained ball and socket total knee replacement design that predictably failed at the ball and socket junction. These implants, like the Flexicore will most likely break at the ball-and-socket joint or will pull off the bone prior to bone in-growth fixation.)
The European experience with the MAVERICK™ implant is very good. Presented studies report greater than 82% good/excellent results at two-year follow-up.
Our experience is that the MAVERICK™ disc results are extremely good, much better than spinal fusion surgery or other disc replacement implants.. The MAVERICK™ implant has the best design and material to last the patient's lifetime. It also best replicates the normal biomechanical forces at the implant and adjacent spinal levels. Of all the disc replacements at this time, we feel the MAVERICK™ will likely have the best results and longevity.
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Disc replacement verses other surgical options
Currently several options exist for treatment of disc related problems. Often early disc disease is treated with removal of all or part of the disc or adjacent bone structures. These treatments discectomy (removal of disc material) and laminectomy (removal of the bone) primarily are intended to relieve the symptoms but do not treat the underlying cause , the bad disc. In addition, discectomy and laminectomy can destabilize the level and lead to future complications and likely future surgeries. Another more invasive procedure, spinal fusion, welds the vertebra together preventing motion at that level. This creates stress on adjacent levels and almost always leads to additional surgeries.
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Disc Replacement Superior to Fusion!
A new, prospective, randomized, multi-center clinical trial, which looked at nearly 600 patients who received either Medtronic’s Maverick total disc replacement or an anterior lumbar interbody fusion (ALIF) using bone graft, has concluded that the artificial disc replacement (ADR) approach is superior to an ALIF.
The investigators found that patients with an ADR showed statistically better improvements than patients with fusions, as measured by the Oswestry Disability Index (ODI), SF-36 PCS, back pain and patient satisfaction scores at all postoperative follow-up points.
Matthew F. Gornet, M.D., was the principal investigator and he said of the study: "If we look at ODI success as a 15-point improvement, this is the first study to ever have any group of patients to have greater than 80% success. The Maverick [group] was able to do so at six months on. More importantly, statistically, superiority was concluded for the Maverick for 15-point improvement at 24 months compared to our fusion control [group]".
The ADR group also returned to work 21 days earlier, and 86% of the patients reported that they would undergo the procedure again vs. 73% for the fusion group.
Ref; Maverick™ Total Disc Replacement versus Anterior Lumbar Interbody Fusion with the INFUSE® Bone Graft /LT-CAGE® Device: A Prospective, Randomized, Controlled, Multicenter IDE Trial
The Spine Journal, Volume 7, Issue 5, Supplement 1, September-October 2007, Page 1S
Matthew F. Gornet, J. Kenneth Burkus, Hallett H. Mathews, Randall F. Dryer and John Peloza
Total lumbar disc replacement in athletes: clinical results, return to sport and athletic performance!
Thirty-nine athletic patients fulfilled the inclusion criteria for this study. These patients participated in a large variety of different types of sport. Significant and lasting pain-relief was attained following TDR with a mean follow-up of 26.3 months (range 9–50.7 months; FU rate 97.4%). Sporting activity was resumed within the first 3 months (38.5%) to 6 months (30.7%) with peak performance being reached after 5.2 months. Thirty-seven patients (94.9%) achieved resumption of sporting activity. Athletic performance improved significantly in 33 patients (84.6%). Minor subsidence was observed in 13 patients (30%) within the first 3 months with no further implant migration thereafter in 12 patients. Participation in all types of sport recorded in this study was accessible for a high rate of patients up to the level of professional athletes as well as those participating in extreme sports. Preoperative participation in sport proved to be a strong positive predictor for highly satisfactory postoperative outcome following TDR. In a selected group of patients, however, preoperative inability to participate in sporting activities did not impair postoperative physical activity.
Abstract of; European Spine Journal, Springer Berlin / Heidelberg, Volume 16, Number 7 / July, 2007, Friday, January 05, 2007
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