Total Disc Replacement: An Alternative to Fusion

For patients with symptomatic cervical disc disease, discectomy and fusion has been the standard intervention to address pain and weakness caused by a herniated disc or spondylosis.  Though a successful operation, fusion seeks to eliminate motion caused by segmental instability and can precipitate degeneration of the disc above and below the fusion.  A new procedure, being performed by Thomas A. McNally, M.D., orthopaedic surgeon, provides for total disc replacement (TDR) that preserves cervical spinal motion and reduces the risk of deterioration of adjacent structures.  TDR is designed to allow for removal of a diseased C3-C7 disc and restoration of disc height while maintaining movement in the affected vertebral segment.

The ProDisc-C implant, from Syntes Spine, is composed of top and bottom metal endplates with a plastic inlay that form a ball and socket.  A plastic ball attached to the bottom endplate enables the top endplate to move, contributing to proper flexion/extension, lateral bending and axial rotation.  The implant is available in a variety of sizes allowing the surgeon to precisely match the patient's anatomy.

According to Dr. McNally, though the recovery time for TDR is similar to that for fusion, patients are requesting TDR because of the potential for greater post-surgical freedom of movement.  Dr. McNally believes it is an option to discuss with patients who meet the criteria for the procedure.  Skeletally mature patients with one diseased or degenerated cervical disc, and who have not obtained relief from neck or arm pain for six weeks despite non-operative care can be considered.

Dr. McNally is the only physician in the Alexian Brothers Hospital Network and one of the few surgeons in the area qualified to perform this procedure.