In a prospective, randomized, controlled and double-blinded study, Sekhon and colleagues compared post-operative imaging characteristics of the four currently available cervical arthroplasty devices Bryan, Prodisc-CPrestige LP, and PCM at the level of implantation and at adjacent levels.
Albert, MD Peer Reviewed The intervertebral disc is the cornerstone of the joint complex that comprises the spinal motion segment. The authors concluded that the findings of this study is promising, but that longer follow-up is needed to determine the durability of the Charite artificial disc and its long-term safety and effectiveness.
The median age of all patients was 47 years range of 36 to 60 years. Studies with conflicts of interest reported lower rates of HO.
In contrast, the average range of motion in the fusion group was 0. Statistical analysis was performed comparing quality before surgery and after disc implantation at the operated and adjacent levels and between implant types.
A systematic review and a meta-analysis were performed for articles published up to March The authors stated that further investigation in the form of large, randomized, prospective studies is needed to ascertain the long-term effectiveness of this procedure as well as to determine the patient populations that may benefit most from cervical disc arthroplasty.
The authors concluded that the Nubac prosthesis improved lumbar discogenic pain in a short time, however, a minimum follow-up of 4 years is needed to make a definite conclusion. However, presence of HO did not alter the clinical outcomes.
At 24 months follow-up, subjects receiving the Charite Artificial Disc had 7. Radiographically, none of the TDRs developed spontaneous fusion. Secondary outcome measures included neurological status, secondary surgery, ODI, SF, VAS assessing pain and satisfaction, radiographic data, narcotic use, activity, and recreation status.
Davis et al evaluated the safety and effectiveness of 2-level total disc replacement TDR using a Mobi-C cervical artificial disc at 48 months' follow-up.
In the paper reporting on year results, Lemaire, et al. The authors concluded that single-level ProDisc lumbar total disc arthroplasty is a safe and effective treatment for debilitating lumbar discogenic LBP.
The Active-L seems to be currently the preferred implanted disc by many doctors throughout the United States in terms of diminished complications post surgery. Pre-operative characteristics were statistically similar for the 1- and 2-level patient groups.
Gender and multi-level surgery did not affect the outcomes, whereas prior lumbar surgery or an age of less than 45 years was associated with slightly worse outcomes. A temporary benefit was experienced by 12 patients, while 14 patients reported no benefit at all.
Available published peer reviewed evidence of the Nubac disc prosthesis is of a preliminary nature.It replaces the previous guidance on Prosthetic intervertebral disc replacement in the cervical spine (NICE interventional procedures guidanceNovember ).
Description. A number of devices have been developed for the cervical spine. Under general anaesthetic the patient is. The major potential advantage of a prosthetic intervertebral disc over current therapies for degenerated disks (suc as spinal fusion or diskectomy) is that the prosthetic intervertebral disk is intended to restore or preserve the natura biomechanics of the intervertebral segment and to reduce further degeneration of adjacent levels.
Aetna considers lumbar prosthetic intervertebral discs (e.g., the activL Artificial Disc, the Charite Artificial Disc, and the ProDisc-L Total Disc Replacement) experimental and investigational for lumbosacral degenerative disc disease and for all other indications. an artificial prosthetic intervertebral disc (IVD) that can be used to replace degenerated intervertebral discs (Diwan et al, ).
Most of the published clinical evidence for artificial prosthetic intervertebral discs has been of those that replace the entire disc. Artificial disc replacement (ADR), or total disc replacement (TDR), is a type of arthroplasty.
It is a surgical procedure in which degenerated intervertebral discs in the spinal column are replaced with artificial devices in the lumbar (lower) or cervical (upper) spine.
Examples of other prosthetic intervertebral discs are the Maverick artificial disc prosthesis, the BRYAN® disc, Mobi-C®, SECURE®-C, and Prestige®-LP. See chart below for FDA approval status of specific device.
Criteria: CWQI HCSA A. Intervertebral disc prosthesis is medically necessary for 1 or more of the following indications: a.Download