Cervical Artificial Disc Preserves Neck Mobility: Part 2

An Interview with Richard Guyer, MD

SpineUniverse: Did the technology behind the development of the PRODISC-C® technology evolve from the lumbar artificial disc? Are there differences between the two?
Dr. Guyer: The PRODISC-C technology evolved directly from the lumbar PRODISC disc replacement device. The design, materials and fixation philosophies of the PRODISC-C are the same and are based on the favorable clinical results observed with the PRODISC lumbar device. Some of the design elements of both artificial discs include:

1. A ball and socket design enables normal range of spinal motion and protects the diseased segment against shear forces, which can cause vertebrae to slide.

2. The device is made of proven joint replacement materials: cobalt-chrome alloy and ultra high molecular weight polyethylene (a plastic).

3. The artificial disc device is fixed in place by means of the built-in central keel (for stability) and titanium plasma spray. Titanium plasma spray is a bonding product that allows for bony in-growth and long-term cement-less fixation. It is considered to be the industry 'gold standard' and has been used in hip replacement procedures.

4. This disc replacement technology allows for 20-degrees of flexion/extension and 20-degrees of lateral bending.

loss of disc height

Figure 1. Pre-operative lateral (side) view of the cervical spine.
Loss of disc height can be seen in the space between the two 'marked' vertebrae.

loss of disc height

Figure 2. Post-operative lateral (side) view of the cervical spine
indicating the location of the implanted PRODISC-C.

loss of disc height

Figure 3. Post-operative anterior (front) view of the cervical spine
indicating the location of the implanted PRODISC-C.

SpineUniverse: Are all patients who undergo anterior cervical discectomy and fusion candidates for a PRODISC-C artificial disc?
Dr. Guyer: No. Right now artificial discs are under clinical investigation through regulations established by the Food and Drug Administration (FDA). Patients must meet specific criteria for inclusion into an artificial disc study. Likewise, there is a separate set of criteria that excludes patients from study participation. For example, if a patient has more than one diseased disc that requires surgical treatment, that patient would be excluded.

SpineUniverse: What are the other types of cervical artificial discs and where are these available?
Dr. Guyer: Currently, there is a variety of cervical artificial disc designs such as semi-constrained, one-piece, two-piece with an anterior plate construct, metal with polyethylene, metal with metal, and polyurethane.

The Bryan® and Prestige artificial discs are available in Europe and since December 2002, the PRODISC-C has been available in Europe on a limited release basis. In the United States, these artificial discs are undergoing Investigational Device Exemption (IDE) trials. The Bryan cervical artificial disc was first implanted in the United States in May 2002 and since then 4,000 have been implanted worldwide. The PRODISC-C was first implanted in the United States in August 2003 and more than 150 have been implanted worldwide (at this time). Further, there are other cervical artificial discs that will begin to be studied in a similar investigational manner in the near future.

SpineUniverse: Can you comment on the patient outcomes where the PRODISC-C has been used?
Dr. Guyer: The early results for the PRODISC-C echo our findings with the lumbar artificial disc, PRODISC. Patients return to activities sooner with similar pain relief and the advantage of restored cervical motion maintained versus the limitations of a traditional fusion. The outcomes are promising.

Updated on: 07/07/17
Continue Reading
Cervical Artificial Disc Preserves Neck Mobility
Continue Reading:

Cervical Artificial Disc Preserves Neck Mobility

A cervical artificial disc may be implanted to relieve pressure on spinal nerves. Spine specialists refer to this condition as nerve root compression.
Read More