Artificial Disc Replacement

Artificial Disc Replacement: Definition

Artificial Disc Replacement, also known as artificial disk replacement, refers to the artificial disc replacement surgery and to the man-made device, which replaces the entire function of the diseased or damaged intervertebral disc of the spinal column. The Artificial Disc Replacement (ADR) was developed to overcome the shortcomings of older fusion technology, which is associated with reduced flexibility, poor success rates, high re-operation rates and adjacent segment syndrome. See patient stories about Artificial Disc Replacement

Artificial Disc Replacement: Indications

• Degenerative Disc Disease

Artificial Disc Replacement: Contraindications

• Severe Scoliosis (in mild scoliosis ADR actually can better respect the natural balance of an individual spine than fusion can. In degenerative scoliosis ADR can address and correct the cause of this scoliosis)
• Fresh fractures in the proposed surgical area
• Tumors in the proposed surgical area
• Spondylosysis with Spondylolisthesis (degenerative pseudoolisthesis is not a contraindication – ADR will realign this secondary slip if the spondylothisthesis is grade one or below)
• Pregnancy (for the lumbar ADR)

Artificial Disc Replacement: Disc Choice

Although Prof.Dr. Bertagnoli favors the Prodisc-C and Prodisc-L artificial disc, he has done implants of all other type of ADRs, should the patient insist on another type. However, Prof. Dr. Bertagnoli will advise the patient on the pros and cons of these devices, a few of which have had some definite negative outcomes over the years.

Artificial Disc Replacement: Cervical

Current cervical artificial disc replacements available in Europe are the:

• Prodisc-C Click name for large picture
• Spinal Kinetics M6 Click name for large picture
• Bryan Click name for large picture
• Cervicore Click name for large picture
• Kineflex-C Click name for large picture
• Mobi-C Click name for large picture
• PCM (Porous Coated Motion) Click name for large picture
• Prestige Click name for large picture
• Secure-C Click name for large picture

*Prof. Dr. Bertagnoli does not necessarily recommend every device listed here.

Artificial Disc Replacement: Lumbar

• Activ-L Click name for large picture
• Charite Click name for large picture
• Flexicore Click name for large picture
• Maverick Click name for large picture
• Prodisc-L Click name for large picture

*Prof. Dr. Bertagnoli does not necessarily recommend every device listed here.

Artificial Disc Replacement: Surgery

Artificial Disc Replacement surgery techniques are very similar between devices. This is because the steps for implantation and the instrumentation for implantation are quite similar and many of these standards were established by Prof. Dr. Bertagnoli. The greatest difference in surgical steps is the whether or not the device is in one or two or three parts and whether or not the device uses spikes, keels or nodules. There are advantages and disadvantages of these approaches. Both Cervical Artificial Disc Replacement and Lumbar Artificial Disc Replacement require an anterior (front) entry wound, with the exception of the Prodisc-O, the Nuvasive and TSMS discs, which represent special spine cases in the lumbar. The patient should also be aware that not doctors do this surgery in the same manner. It is strongly believed that the safety and likelihood of a good outcome are based in the fundamental steps a surgeon takes.

Artificial Disc Replacement: Surgery Risks

All surgery carries risks from anesthesia, blood clots and infections. If complications from these risks arise, they most often can be successfully treated. The physical condition of the patient (such as obesity and diabetes) can also add risk to surgery.

Artificial Disc Replacement: Surgery Long-Term Outlook

The appropriate surgical procedure properly executed will provide long-term relief for the degenerated disc(s) treated. However, if the condition was allowed to continue too long and the nerves have become damaged, there may be some remaining pain or numbness or no improvement. Also, any degenerative process will likely continue, therefore problems in other areas of the spine may appear at a later time.

Artificial Disc Replacement