Cervical Total Disc Replacement
For patients whose pain does not improve with non-surgical treatments, surgery may be necessary. Disc replacement may be performed to treat damaged cervical discs or to alleviate nerve pinching. Its goal is to relieve pressure on the nerve roots or on the spinal cord by removing the ruptured disc (disc herniation).
What is the ProDisc-C Total Disc Replacement?
The Cervical Total Disc Replacement implant is composed of top and bottom metal (cobalt chromium molybdenum) endplates and plastic inlay that form a ball and socket joint.
The Cervical Total Disc Replacement implant allows motion by allowing the top endplate to move over the plastic ball attached to the bottom endplate. The materials used in the ProDisc-C Total Disc Replacement implant have been used in spinal disc replacement for over 20 years in Europe and are the most commonly used materials in knee and hip replacements worldwide.
©2009 Synthes, Inc. or its affiliates. All rights reserved.
How is surgery with the ProDisc-C Total Disc Replacement different from other surgical choices?
ProDisc-C Total Disc Replacement surgery is an alternative to anterior cervical discectomy and fusion (ACDF), which is the surgery that is most commonly done for your condition. In both the ACDF and the ProDisc-C Total Disc Replacement procedures, the unhealthy disc is removed and the height at the level of your spine is restored to relief pressure on the nerves and/ or spinal cord. In an ACDF procedure, the bones are fixed in position with plates and screws and bone graft.
In some ACDF procedures, the bone graft may come from your hip in a separate incision. After surgery, the two bones are supposed to grow together, creating one solid piece of bone and eliminating motion at the level of your spine, this is called a fusion.
In a Total Disc Replacement procedure, the artificial disc is inserted to restore the height at the level of your spine. A Total Disc Replacement procedure does not require a bone graft and the spine is not fused.
Who should receive the ProDisc-C Total Disc Replacement, and what is it designed to do?
The ProDisc-C Total Disc Replacement is used to replace unhealthy (diseased and/or degenerated) disc of the cervical spine after the unhealthy disc is removed. The typical patient wil have neck pain together with nerve pain going down the arms.
The ProDisc-C Total Disc Replacement is designed to reduce pain by removing the unhealthy disc while potentially allowing your neck to move after surgery. (Synthes Fact Sheet)
What are the possible risks and complications?
The risks of this procedure are the same as with anterior cervical discectomy. The difference is that this device is not a fusion. With motion, the device can migrate or wear down. These possibilities are being studied. This device is not released for general use, only as an investigational FDA device.
In skilled hands, this is a very safe procedure. Possible reported risks and complications may include:
- Damage to the spinal cord (about 1 in 10,000)
- Implant extrusion
- Continued pain
- Adjacent disc disease
- Injury to the trachea or esophagus
- Difficulty swallowing- usually temporary
- Hoarseness of the voice- usually temporary
- Injury to the vertebral artery or carotid
The general procedure :
a. The Cervical Total Disc Replacement is implanted in the cervical spine through a small incision in the patient’s neck.
b. During the Cervical Total Disc Replacement procedure, the surgeon removes the diseased intervertebral disc, decompresses the neurological elements and inserts the Cervical Total Disc Replacement implant into the disc space.
What can I expect before the surgery?
Your doctor will review your condition with you and explain what all your possible choices are, including medications, physical therapy, and other surgeries such as removal of the diseased disc, fusion, etc.
What can I expect during the surgery?
During the total disc replacement surgery, you will be under general anesthesia. The surgeon will make a small incision in the front of your neck to get to your unhealthy disc. Then the surgeon will remove the unhealthy disc. The surgeon will insert the ProDisc-C Total Disc Replacement implant into the disc space. Finally, the surgeon will close the incision.
What can I expect after the surgery?
Surgery with the ProDisc-C Total Disc Replacement is considered major surgery, you should expect discomfort, as well as a period of rehabilitation. Your doctor may prescribe medicines to help you manage any pain or nausea you may experience. On average, you should expect to stay in the hospital for a day or two.
After you go home
You and your doctor should talk about a plan to steadily bring you back to normal activity while the healing process occurs. It is very important to follow your doctor’s instructions. You can begin moving soon after surgery, but try not to do too much too soon.
After surgery, your doctor may refer you to a physical therapist who will teach you exercises to improve your strength and mobility while protecting your spine.
Contact your doctor immediately if you:
- Have a fever
- Notice fluid draining from your wound
- Have trouble swallowing or breathing
- Have trouble urinating
- Have new or increased neck pain, arm pain, numbness, or weakness
What are the expected outcomes of the surgery?
The U.S. clinical study of the ProDisc-C Total Disc Replacement showed that ProDisc-C Total Disc Replacement was just as good as fusion surgery in helping to relieve pain and restore normal function. The rates of complications were about the same between the two groups in the first two years following the surgery. The clinical benefit beyond two years has not been measured. Ask your surgeon more details about the clinical study and its results.
Making the choice for surgery
You should discuss both surgical and nonsurgical treatment options with your doctor. If surgery is selected, your occupation, activity level, weight and the condition of the spine will be considered when determining if you are an appropriate candidate. Only your doctor can decide if you are an appropriate candidate.
©2009 Synthes, Inc. or its affiliates. All rights reserved.