cervical replacement surgery

Two Level Cervical Artificial Disc Replacement Superior To Fusion

, Cervical Disc Replacement, Degenerative Discs, Herniated Disc, News

 

eurospine conference

During the recent Eurospine meeting in Berlin, Germany,  a paper co-authored by Dr Jeffrey McConnell was presented, which explored the results of one of the longest follow-up studies on cervical total disc replacement to date.

“Long Term Clinical and Radiographic Results of Two-level Cervical Total Disc Replacement from a Level 1 Prospective, Randomized, Clinical Trial”, compared patients who received fusion surgery vs patients who received artificial disc replacement surgery. The highlights:

  • After 7 years, patients who received the Prestige-LP two level artificial disc replacement had superior overall clinical results when compared to the fusion patients.
  • Subsequent surgeries were required 3 times less often in patients who received the two-level artificial disc replacement.
  • Patients who had cervical fusion required surgery at adjacent disc levels twice as often as the patients who had disc replacement.

These long term clinical results demonstrate the effectiveness of total disc replacement at 2 contiguous levels in the cervical spine and the importance of maintaining motion in the cervical spine.

 

The Prestige-LP two level artificial disc replacement.

Cervical artificial disc replacement is a type of joint replacement procedure. An artificial disc, such as the Prestige LPTM cervical disc made by Medtronic, is placed between two adjacent cervical vertebrae to replace a diseased cervical disc. It is designed to maintain the distance between two adjacent cervical vertebrae.

Cervical total disc replacement has been demonstrated to be a very effective alternative to the traditional surgery of fusion for painful herniated discs in the neck.  Total disc replacement in the neck is more successful because it maintains normal motion in the neck while fusion eliminates motion.  This preservation of motion is key to minimizing the degeneration of adjacent cervical discs.

Learn more about cervical disc replacement.

Laser Spine Surgery: Trick or Treat?

, , Back pain, Herniated Disc, News, Spine & Back Health

laser-back-medical1Contrary to popular belief, laser spine surgery is not better than currently accepted surgical techniques when it comes to treating common conditions affecting your spine.

Lasers have been used in medicine since the 1960’s and have proven to be very effective in treating many conditions – for example, LASIK surgery to correct common vision problems or treating certain skin conditions. But due to insufficient evidence,  lasers in spine surgery are not endorsed by most large health authorities like the Mayo Clinic and the National Institutes of Health (NIH). Lasers are more often used as a marketing tool by some clinics that promote “laser spine surgery” as being minimally invasive or noninvasive and risk-free.

There are no well-controlled clinical studies documenting the benefits of laser spine surgery. In fact, in one study comparing percutaneous lumbar laser discectomy (PLLD) with more traditional forms of discectomy (surgical removal of the whole or a part of an intervertebral disc), the results of PLLD were inferior.

The most accepted method to remove a herniated disc in the lumbar spine is to make a small incision, open the spinal canal (a laminotomy), visualize and protect the compressed nerve root and remove the herniated disc material with small mechanical instruments.  Lasers are also ineffective in treating spinal stenosis because lasers cannot cut bone to open the spinal canal or remove bone spurs compressing the nerves.

The key to success in any spinal surgical procedure is an accurate diagnosis and the application of clinically proven procedures performed by qualified, experienced, board certified surgeons.

Learn more about lumbar discectomy surgery.

cervical total disc replacement

Can Artificial Total Disc Replacement in the Neck Prevent Problems at Adjacent Discs?

, Cervical Disc Replacement, Degenerative Discs, Herniated Disc, News, Spine & Back Health

Thursday, October 27, 2016 | Boston, MA, USA

Artificial total disc replacement surgery for painful herniated discs in the neck is an alternative to the traditional treatment of discectomy and fusion.  img_6372

While fusion surgery is generally successful for treating herniated discs in the neck it comes at the expense of lost motion between two vertebra.  Lack of movement  at one disc will increase stress and strain at the adjacent discs.  The disc adjacent to a fusion can degenerate faster and may become painful and require additional surgical intervention.

Dr McConnell recently reported the long term beneficial effects of total disc replacement in the neck at the North American Spine Society Meeting in Boston.  The presentation was entitled:  Motion Preservation at the Operative Level and the Incidence of Symptomatic Adjacent Segment Disease after Treatment with Secure-C or ACDF.  This study followed 380 patients with herniated discs treated with either total disc replacement (Secure-C artificial disc) or fusion to see what happened to the adjacent discs after 7-years.  Of the patients  who had fusion in their neck 17.4% had additional surgery at an adjacent disc while only 4.2% of the patients treated with Secure-C had adjacent disc surgery.  After 7 years, patients treated with fusion surgery in the neck for a herniated disc were 4 times more likely to require surgery at any adjacent disc level then patients treated with an artificial disc.   These results were significant and highlight the benefits of total disc replacement in helping to prevent accelerated degeneration of adjacent discs and the importance of maintaining normal motion in the neck.

 

Read more about cervical total disc replacement.

 

The Scoliosis Research Society 23rd International Meeting on Advanced Spine Techniques

Cervical Disc Replacement, Degenerative Discs, News

Friday, July 15, 2016 | Washington, DC, USA

At this leading and prestigious scientific meeting on spinal surgery, Dr. McConnell presented the 7-year results of the clinical study involving the Prestige-LP cervical disc arthroplasty device. The FDA investigational device exemption (IDE) clinical trial compared the Prestige-LP total disc device to replace two consecutive discs in the neck versus the traditional surgery of two level disc fusion. At 84 months follow-up, patients who received the Prestige-LP two level artificial disc replacement achieved superior overall clinical results when compared to the fusion patients. At 7-years patients who received the two-level artificial disc replacement required 3-times fewer subsequent surgeries at the treated disc levels.  Patients who had cervical fusion were twice as likely to require additional surgeries at adjacent disc levels.  These longer term clinical results continue to demonstrate the efficacy of total disc replacement at 2 contiguous levels in the cervical spine.

Learn more about cervical disc replacement.

 

 

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Case Study: Congenital Spinal Deformity

, , , News, Scoliosis

During Dr. McConnell’s  yearly mission trip to Kolkata, India to support Operation Straight Spine he will often see cases of congenital spinal deformities.  This past year was no exception.  Congenital spinal deformity is caused by an abnormality in the growth of one or more spinal vertebra and occurs before birth.  After the child is born and during their most rapid periods of growth the spinal deformity can become quite severe and produce significant disability if not corrected early.

This is a case of a 22-year old man with severe congenital kyphoscoliosis who came to us complaining of back pain and progressive weakness in his legs.  The 3D CT scan of the spine pictured here shows just how severe his congenital deformity had become over the years.  The deformity was causing pressure on his spinal cord resulting in the weakness of his legs.

Lateral 3D CT image

Lateral 3D CT image

AP 3D CT image

AP 3D CT image

AP Post-op X-ray

AP Post-op X-ray

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Surgery was performed to straighten his spine and relieve pressure on the spinal cord.  The procedure involved removing two of the deformed vertebrae and inserting a cage to replace them. Spinal rods and screws were inserted to stabilize and keep the spine straight while the area fused together with bone graft.
Lateral Post-op X-ray

Lateral Post-op X-ray

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The patient had complete recovery of his leg weakness and was very pleased with his post-operative condition.

To learn more about Operation Straight Spine please visit our website at www.healingspines.org

Spinal News International Interviews Dr. McConnell

, News

Dr. Jeffrey McConnell was recently asked his thoughts on intraoperative fluoroscopic navigation during an opinion interview with Spinal News International. Read his opinion on why this relatively new technology has not been as popular as expected for spinal surgeons from around the world.

2016-sn-logo

Whilst intraoperative fluoroscopic navigation may offer a number of benefits to spinal surgery, uptake in the field is still relatively low. Jeff McConnell talks to Spinal News International about the limits of this technology.

 

What can intraoperative fluoroscopic navigation enable physicians to achieve?

There is an important difference, here, between fluoroscopic imaging and fluoroscopic navigation. I use fluoroscopic imaging frequently to localise bony anatomy to assist in placing pedicle screws percutaneously in the spine. It is truly “real-time” imaging. A disadvantage is that the images obtained are two-dimensional. Capturing these images also leads to radiation exposure. Fluoroscopic navigation can be done in different ways, all based on obtaining anteroposterior and lateral fluoroscopic images using an aftermarket reference frame attached to the C-arm. The images are then correlated using computer software with a pre-operative computed tomography (CT) scan. The simplest software system that I have seen simply requires the surgeon to plot screw direction with triangulation, and then line up the starting point on the skin with fluoroscopy. As long as you maintain the proper angle of trajectory, then placement should be successful. This can be fiddly, and it takes time to plot each screw. This seems less accurate to me.

Read more

Congress of Neurological Surgeons Annual Meeting

, News, Spine & Back Health

Tuesday, September 29, 2015 | New Orleans, Louisiana

At this leading scientific meeting on spinal surgery, Dr. McConnell presented the results of a clinical study involving the Prestige-LP cervical disc arthroplasty device. The FDA investigational device exemption (IDE) clinical trial compared the Prestige-LP total disc device to replace two consecutive discs in the neck versus the traditional surgery of two level disc fusion. At 5-year follow-up, patients who received the Prestige-LP two level artificial disc replacement achieved superior overall clinical results when compared to the fusion patients.

 

Click here to learn more about cervical disc replacement >>

Dr McConnell presented the study results during the Disorders of the Spine and Peripheral Nerves Neurosurgical Forum section of the meeting and the presentation was selected as Top Poster of the session.

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The Scoliosis Research Society 22nd International Meeting on Advanced Spine Techniques

Cervical Disc Replacement, News, Scoliosis

Friday, July 10, 2015 | Kuala Lumpur, Malaysia

At this leading and prestigious scientific meeting on spinal surgery, Dr. McConnell presented the results of a clinical study involving the Prestige-LP cervical disc arthroplasty device. The FDA investigational device exemption (IDE) clinical trial compared the Prestige-LP total disc device to replace two consecutive discs in the neck versus the traditional surgery of two level disc fusion. At 24 months follow-up, patients who received the Prestige-LP two level artificial disc replacement achieved superior overall clinical results when compared to the fusion patients.

 

Click here to learn more about cervical disc replacement >>

IMG_3445Two-level Total Disc Replacement with PRESTIGE LP Cervical Disc vs Anterior Discectomy and Fusion: A Prospective, Randomized, Controlled Multicenter Clinical Trial with 24 Month Results

 

Jeffrey McConnell, Randall Dryer, Todd Lanman, Matthew Gornet, Scott D. Hodges

OAA Orthopaedic Specialists, Central Texas Spine Institute, Cedars-Sinal Medical Center, The Orthopedic Center of St. Louis, Center for Sports Medicine & Orthopaedics


Summary

Cervical anthroplasty at two contiguous levels using the PRESTIGE LP disc showed superior results to 2-level ACDF based on overall success criteria and NDI success.

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