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  • Artificial Cervical Disc Replacement

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    Old 12-26-2011, 10:28 AM   #1
    kabatron
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    Artificial Cervical Disc Replacement

    This board has been so helpful. I'm wondering if anyone has advice or information on artificial cervical disc replacement in lieu of an ACDF surgery. I have been doing research and the only studies I could find on post-op success rates only go out 9 years from the surgery date. I see that the U.S. has only recently been using ADR and there are few studies that show success rates of multi-level cervical disc replacement. It seems to me this option would be a bit risky considering there is no information for the success rates 20+ years out. Is it ridiculous that I am looking for success rates that are that far out from the surgery?

     
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    Old 12-26-2011, 04:38 PM   #2
    jennybyc
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    Re: Artificial Cervical Disc Replacement

    The reason you only see studies going 9 years out is that they were only approved for use here in necks about 9 years ago. And I'm not sure if the FDA has approved using more than 1 in a neck. They do them in Europe but the last I heard was that using 2 was not yet approved.

    We've had a couple of people get them here and the feedback I got was that it wasn't what they thought it would be like. When you get hip and knee implants they feel so wonderful and I think that is what everyone thinks will happen and it doesn't. In fact, I suspect that unless you absolutely have to have a very mobile neck, you're better off with the ACDF.

    Insurance companies are reluctant to pay for them too.

    I asked my knee replacement doc what he thought about the artificial disks and he said no way. I asked why and he told me the number one problem with all artificial implants was the slow but sure disintegration of the metal and plastic surfaces. When those particles are trapped inside a knee or hip joint that is one thing but when it's in the spinal canal and could possibly migrate to the brain, he was totally opposed to them. Something to think about....and maybe why you don't hear much about them 9 years out. If they were really good we'd be hearing how great they are but we aren't hearing that, are we?

    Just my opinion but you won't catch me getting one in my neck.....maybe lumbar but I doubt it. Just way too risky.

    Jenny

     
    Old 12-26-2011, 05:32 PM   #3
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    Re: Artificial Cervical Disc Replacement

    Quote:
    Originally Posted by jennybyc View Post
    The reason you only see studies going 9 years out is that they were only approved for use here in necks about 9 years ago. And I'm not sure if the FDA has approved using more than 1 in a neck. They do them in Europe but the last I heard was that using 2 was not yet approved.

    We've had a couple of people get them here and the feedback I got was that it wasn't what they thought it would be like. When you get hip and knee implants they feel so wonderful and I think that is what everyone thinks will happen and it doesn't. In fact, I suspect that unless you absolutely have to have a very mobile neck, you're better off with the ACDF.

    Insurance companies are reluctant to pay for them too.

    I asked my knee replacement doc what he thought about the artificial disks and he said no way. I asked why and he told me the number one problem with all artificial implants was the slow but sure disintegration of the metal and plastic surfaces. When those particles are trapped inside a knee or hip joint that is one thing but when it's in the spinal canal and could possibly migrate to the brain, he was totally opposed to them. Something to think about....and maybe why you don't hear much about them 9 years out. If they were really good we'd be hearing how great they are but we aren't hearing that, are we?

    Just my opinion but you won't catch me getting one in my neck.....maybe lumbar but I doubt it. Just way too risky.

    Jenny

     
    Old 12-27-2011, 03:42 PM   #4
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    Re: Artificial Cervical Disc Replacement

    I have had an ACDF and actually need to add a level (HOWEVER, I'm an orthopedic nightmare with very lax ligaments and tendons so don't take my experience as typical.)

    Artificial discs have not been the miracle many thought they would. This is why insurance companies are hesitant to cover them. My prior spine surgeon said the only time he would do them is when there was no other evidence in the whole spine of any possible disc problems, so it was rare.

    If they don't work you can't just "pop" them out, they end up fusing the level to adjacent levels.

    As Jenny said, artificial hips and knees are wonderful and very successful. They haven't been able to translate that into the Artificial Discs. In animations they look easy and simple, but the anatomy of the spine if far more complicated. My spine doctor is known for fixing failed ADRs by other surgeons. So he and his two spine surgeon associates will not do artificial discs.
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    Old 12-29-2011, 05:23 AM   #5
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    Re: Artificial Cervical Disc Replacement

    Thanks that is good to know. My surgeon said if my insurance would cover the artificial discs that he would use them. I'm glad that isn't an option. I am having the ACDF surgery next wednesday, the 4th. He plans to fuse C-5-C7 and not use a bone graft for the disc. He is going to a disc nucleus replacement using an artificial disc made of polyethylene. Is this something I should worry about?

     
    Old 12-29-2011, 06:50 AM   #6
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    Re: Artificial Cervical Disc Replacement

    Why not use a bone graft? It is a proven technique...

     
    Old 12-29-2011, 02:56 PM   #7
    kabatron
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    Re: Artificial Cervical Disc Replacement

    The neurosurgeon said that they don't do bone grafts anymore. He's a neurosurgeon from Mayo Clinic and all he does is spine surgery. I'm kind of worried about the plastic discs.

     
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