The disc is the soft cushioning structure located between the individual bones of the spine, called “vertebra.” It is made of cartilage-like tissue and consists of an outer portion, called the annulus, and an inner portion, called the nucleus. The consistency of the nucleus is very similar to crab meat, and the annulus is similar to several layers of canvas wrapping around the nucleus. In most cases, the disc is flexible enough to allow the spine to bend. An artificial disc is a device that is implanted into the spine to replace the disc and then imitate the functions of a normal disc, therefore preserving motion.
Artificial discs are usually made of metal or plastic-like (biopolymer) materials, or a combination of the two. These materials have been used in the body for many years. Total disc replacements have been used in Europe since the late 1980s. The most commonly used total disc replacement designs have two plates. One attaches to the vertebrae above the disc being replaced and the other to the vertebrae below. Some devices have a soft, compressible plastic-like piece between these plates. The devices allow motion by smooth, usually curved, surfaces sliding across each other.
Cervical Artificial Disc Replacement has been FDA-approved since 2007.
The indications for disc replacement may vary for each patient. Some general indications are pain arising from the disc that has not been adequately reduced with non-operative care such as medication, injections, chiropractic care and/or physical therapy. Each vertebra in the spine is separated by a disc, which is made up largely of water. As discs lose water content because of disease, injury or age, they compress, or lose height, which causes the vertebrae to move closer together. This reduces the disc’s normal functioning, which may lead to pain, bone spurs and narrowing of the nerve openings. If a disc ruptures, it can place pressure on the surrounding nerve roots and the spinal cord, resulting in pain, numbness and/or weakness.
Typically, you will have had an MRI that shows disc degeneration. Often you have a CT scan performed to verify the bony architecture of the joints and vertebrae. Dr. Lanman will correlate the results of these tests with findings from your history and physical examination to help determine the source of your pain.
The PRESTIGE® Cervical Disc is a stainless steel surgical implant indicated to treat patients suffering from degenerative disc disease (DDD) of the cervical (neck) spine. The patented ball-and-trough design allows for a variable center of rotation, meaning the disc is designed to better replicate the motion of a naturally functioning cervical spine.
It is estimated that more than 200,000 patients receive surgical treatment for cervical DDD. Patients suffering from single-level cervical DDD with problematic radiculopathy which is arm pain numbness, tingling, and/or weakness from a pinched nerve in the neck related to a herniated disc. Many patients will also have some element of neck pain going along with it. Patients may also have bone spurs causing irritation of the nerve root, with arm pain and/or neck pain.
Spinal fusion is the current standard of care for patients suffering from DDD. It is a widely used and successful therapy that shows a 95% success rate based on radiographic imaging. However, fusions restrict motion at treated levels and literature suggests that it may cause additional complications at adjacent levels of the spine. The PRESTIGE Cervical Disc design allows for preservation of motion at the treated level and is an effective and safe treatment for many patients. Spinal fusions will still be indicated for certain patients, but there now exists another option for patients suffering from DDD.
The disc was approved by the FDA after reviewing data from the largest completed clinical trial to date involving the cervical spine. Patients in the study showed superior overall success and superior neurological success which incorporated sensory, motor, and reflex functions. The PRESTIGE Disc is the first artificial disc approved by the FDA for use in the U.S.
The Bryan Cervical disc is a composite device with articulating polyurethane ring with a saline-filled chamber. It attaches to the bone via ingrowth of the vertebral bone into the porous-coated end plates for final fixation. The fixation process of healing takes 2 months.
The Prodisc-C is a chrome cobalt metal device, which is secured into the host vertebrae by a keel as well as by bony ingrowth. It features a semi-constrained design with an ultra-high density polyurethane dome articulating in an oval-shaped metal cup.
The Secure-C cervical artificial disc is a cobalt-chrome metal device, which is secured into the host vertebrae by a keel as well as bony ingrowth through a plasma spray coating. It features an unconstrained design with an ultra-high density polyurethane core articulating in an oval-shaped metal cup on the top and a trough on the bottom. This allows for a more natural physiologic motion of the cervical spine.
The PCM cervical artificial disc is composed of two alloy metal endplates, one with a spacer. The endplate surfaces that face the bone have ridges and are coated to enhance post-operative fixation to the bone. The Porous Coated Motion (PCM) cervical artificial disc is designed to preserve flexibility and motion by keeping the normal cervical spacing intact.
The Mobi-C® Cervical Disc Prosthesis consists of two metal (cobalt-chrome alloy) endplates and a plastic (ultra-high molecular weight polyethylene) insert. It has a hydroxyapatite coating over the metal plates to provide fixation to the vertebrae.