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ARTIFICIAL DISC NEWS

(SPINAL DISC REPLACEMENT)

PRODISC-L is second artificial disc approved

On August 14, 2006, the PRODISC-L Total Disc Replacement (made by Synthes) was approved by the U.S. FDA for use as a treatment for functionally disabling pain from lumbar degenerative disc disease.

As with the Charite disc, the FDA imposed some conditions for the PRODISC-L:
  1. Synthes Spine must conduct a five year study assessing the long-term safety and effectiveness of the disc
  2. Synthes is also required to complete an annual analysis and report any major adverse events (such as implant breakage).

Initially, only the surgeons who have been part of the Prodisc clinical trials are trained to implant the Prodisc, but Synthes plans to quickly start a comprehensive training program for other surgeons to learn how to do the procedure.

How does it work? The PRODISC®-L Total Disc Replacement consists of three parts:
  • Two metal (cobalt-chrome alloy) endplates that are anchored to the top and bottom surfaces of the spinal bones (vertebrae)
  • A plastic (ultra-high molecular weight polyethylene, or UHMWPE) inlay that fits between the two endplates

The plastic inlay and endplates help restore the natural distance between the two vertebrae (disc height). The top (superior) endplate can slide over the domed part of the inlay, which can allow movement at the level where it is implanted.

When is it used? The PRODISC®-L Total Disc Replacement is indicated for spinal arthroplasty in patients who:
  • are skeletally mature
  • have degenerative disc disease (DDD) at one level in the lumbar spine (from L3-S1)
  • have no more than Grade 1 spondylolisthesis at the involved level
  • have had no relief from pain after at least six months of non-surgical treatment

What will it accomplish? The PRODISC®-L Total Disc Replacement is used to replace a damaged intervertebral disc. The device may restore disc height, may reduce pain, and may allow movement at the level where it is implanted.

When should it not be used? The PRODISC®-L Total Disc Replacement should not be used in patients who have any of the following:
  • Active systemic infection or infection localized to the site of implantation
  • Osteopenia or osteoporosis defined as DEXA bone density measured T-score < -1.0
  • Bony lumbar spinal stenosis
  • Allergy or sensitivity to implant materials (cobalt, chromium, molybdenum, polyethylene, titanium)
  • Isolated radicular compression syndromes, especially due to disc herniation
  • Pars defect
  • Involved vertebral endplate dimensionally smaller than 34.5mm in the medial-lateral and/or 27mm in the anterior-posterior directions
  • Clinically compromised vertebral bodies at affected level due to current or past trauma
  • Lytic spondylolisthesis or degenerative spondylolisthesis of Grade > 1

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