Artificial Cervical Disc Replacement

The traditional surgical treatment for a disc herniation in the neck is removal of the disc followed by fusion of the vertebrae at that level.  See the section on anterior cervical spine surgery.  This surgery is used for compression of a nerve that is causing arm pain or weakness, and for spinal cord compression.  This "gold standard" involves removing the affected disc material then fusing, or creating a bond between, the vertebrae on either side of the disc space.  The procedure has been successful in many patients; however, a disadvantage associated with spinal fusion is the loss of motion and flexibility in the treated vertebral segment.  A fusion creates a permanent and inflexible bond between the vertebrae involved.  This increases "wear and tear" at the surrounding disc space levels and has been termed "adjacent segment disease".  We now know that if 10 people undergo single-level fusion, at 10 years three patients have had to undergo another operation to treat narrowing at the next level either above or below the original fusion.  This is not all caused by the fact that fusion has taken place, some being a result of the progression of the process that lead to the original problem.

Several clinical trials are underway to develop an artificial disc that would simulate the function of the original disc.  The PRESTIGE® Cervical Disc is the first artificial disc to be approved by the U.S.  Food and Drug Administration for use in the cervical spine.  Constructed of two pieces of stainless steel in a ball-and-trough configuration, the device is inserted into the remaining intervertebral disc space after a diseased or damaged disc has been removed.  The new artificial disc, called the PRESTIGE® Cervical Disc, is inserted into the neck using a similar procedure to the technique surgeons use when performing a cervical disc operation and fusion. 

In the U.S. clinical trial of the PRESTIGE cervical disc, patients who received the disc showed improved neurological success at 24 months and improved overall success.  The clinical trial is the largest, completed, prospective randomized controlled study of its kind in the cervical spine enrolling a total of 541 patients.  The PRESTIGE cervical disc showed superior neurological and overall success outcomes in a recently concluded clinical trial that compared the clinical outcomes of cervical artificial disc replacement (PRESTIGE Cervical Disc) to anterior cervical discectomy and fusion (spinal fusion) procedures. 

The artificial disc is not appropriate for all patients.  Some patients would benefit more from a fusion procedure than a disc replacement, and some do not meet the criteria for arthroplasty.  Most people will improve without surgery, given sufficient time and non-operative treatment.  If this fails and you have been diagnosed with cervical degenerative disc disease causing a pinched nerve in the neck, spinal cord compression or both with the presence of disc herniation and/or bone spurs, you may be a candidate for disc replacement.

For further information go to PrestigeDisc.com.