Expanding Indications for Cervical Artificial Disc Replacement

Cervical Disc Replacement, Herniated Disc, News, Uncategorized

The indications for cervical artificial disc replacement are expanding.  Based on a number of recent clinical research trials, the benefits of cervical disc replacement are becoming more apparent, not only for treating patients with single level disc herniation, but also for patients suffering pinched nerves from herniated discs at two levels, and patients with spinal cord dysfunction due to herniated discs. Until recently, patients with these conditions were managed with spinal fusion which may have detrimental effects on the remaining discs over time.

Jeff McConnell, MD, was honored by the invitation to present information on cervical artificial disc replacement at the November, 2017 Cervical Spine Research Society meeting in Hollywood, Florida.  During this prestigious scientific forum, Dr. McConnell presented 2 studies based on the results of the landmark two-level Prestige-LP cervical artificial disc IDE clinical trial:

  1. “Long-term Outcomes of Arthroplasty for Cervical Myelopathy versus Radiculopathy, And Arthroplasty versus Arthrodesis for Cervical Myelopathy”
    • The results of this study challenge the traditional recommendation of spinal fusion to treat patients with cervical myelopathy (spinal cord dysfunction) due to herniated discs.
    • Patients with myelopathy treated with disc replacement at two levels did just as well as those treated with fusion.
    • Patients with myelopathy demonstrated similar rates of clinical success as patients with radiculopathy when treated with two-level disc replacement.
  2. “Comparison of the Long Term Results of One-Level vs Two-level Cervical Total Disc Replacement and Anterior Cervical Discectomy and Fusion”
    • Although patients with herniated discs at two-levels in the cervical spine have twice the problem, and require more surgery to correct, they do equally as well as patients treated with artificial disc replacement at one level.
    • Patients who received cervical fusion had higher reoperation rates at the operated levels and adjacent disc levels.

The information presented by Dr McConnell and his coauthors adds to the growing body of clinical evidence that cervical artificial disc replacement, at one and two levels, is safe and effective for treating a number of conditions due to cervical disc disease.

Learn more about cervical artificial disc replacement.

Two Level Artificial Disc Replacement Effective in Treating Cervical Myelopathy

, , , Cervical Disc Replacement, Herniated Disc, News

congress of neurological surgeons

At the October, 2017 Congress of Neurological Surgeons meeting in Boston, Jeff McConnell, MD, gave a presentation entitled:  “Long-term Outcomes of Arthroplasty for Cervical Myelopathy versus Radiculopathy, And Arthroplasty versus Arthrodesis for Cervical Myelopathy”

The study results were significant because the conclusion challenges the traditional treatment of patients with cervical myelopathy (spinal cord dysfunction) due to herniated discs in the neck.  The standard recommended treatment for this condition has been decompression and fusion. However, fusion has been shown to have detrimental effects on the function of the cervical spine leading to adjacent segment problems. Cervical artificial disc replacement has been shown to be superior to fusion in treating patients with one or two level herniated discs and radiculopathy (nerve root pain). Additionally, the role of decompression and cervical disc replacement in treating patients with myelopathy has been controversial.

The information presented in the study was based upon the FDA IDE clinical trial data for the two-level Prestige LP artificial cervical disc, in which 2 comparisons were made:

  • The first found that clinical outcomes between artificial disc replacement in patients with myelopathy versus patients with radiculopathy (nerve root pain) alone were equally safe and effective.
  • The second comparison examined the difference between patients with myelopathy treated with artificial disc replacement and those treated with fusion. Compared to fusion, patients treated with disc replacement demonstrated similar levels of clinical improvement and had less implant related complications.

The results of this study challenge the traditional thinking that fusion is the only option for treating patients with two-level cervical disc herniation and myelopathy – it demonstrated that artificial disc replacement is a safe and effective alternative for managing this condition. Learn more about cervical artificial disc replacement.

X-ray showing two level artificial disc replacement using the Prestige-LP performed by Dr. McConnell