Artificial cervical disc replacement offered for neck and arm pain problems

September 23, 2005

(CHICAGO) - Rush University Medical Center is one of the few sites in the country selected to participate in a clinical trial for the Artificial Cervical (neck) Disc, the latest technology in the field. The objective of the study is to evaluate the safety and effectiveness of the Porous Coated Motion (PCM) Artificial Disc for treatment of degenerative disc disease compared to conventional anterior cervical discectomy and spinal fusion surgery.

Cervical disc degeneration is a common cause of neck and arm pain that can greatly impact quality of life. The disc is a flexible material between the vertebrae that holds the bones together while still allowing for movement. Because of the demands put on the disc, it sometimes can 'herniate' or wear down causing pain. If treatments, such as rest, medications, physical therapy and activity modification are not successful, the standard surgical treatment is to remove the disc and then use a graft of bone and plate with screws to fuse the two vertebrae together.

According to Dr. Frank Phillips, orthopedic surgeon at Rush and primary investigator for the PCM Artificial Disc trial, spinal fusion is a highly successful operation for relieving symptoms, but there are potential drawbacks over time. The permanent fusion of bone eliminates natural movement between the vertebrae resulting in increased stress on the discs above and below the fusion. This additional pressure may cause excessive wear and tear on the adjacent discs, which may lead to more pain and the need for additional surgery.

"The goal is to find an implant that can simulate the natural function of the cervical disc and restore the physiologic motion of the cervical spine," said Phillips.

The PCM Artificial Cervical Disc combines the use of metal and plastic, the same materials that have been in use for 30 years in hip and knee replacements, to mimic the function of the disc. The implant has two halves: an upper metal (Cobalt Chrome alloy) endplate, and a lower metal endplate to which a plastic (polyethylene) spacer is attached. The endplates are designed to bond with the neighboring vertebrae. The interface between the two halves is like a ball and socket, allowing the upper half to slide and rotate forward and backward relative to the lower half.

The surgical approach to implant the PCM device is the same as that used for cervical discectomy and fusion. A small incision is made in the front of the neck and the damaged disc is removed along with any other tissue that is compressing the nerve. After shaping the edges of the vertebrae to ensure a proper fit, the PCM Artificial Disc is inserted. The surgery lasts approximately one to two hours and most patients leave the hospital the following day. A soft collar is optional for comfort and there are few activity restrictions recommended for the first six weeks.

If the cervical device is demonstrated to be safe and effective and is approved by the FDA, Philips believes it will be more widely used than the artificial lumbar disc, which has already received FDA approval for use in the lower lumbar spine. " "The anterior surgical approach to the cervical spine is more straight forward than the approach in the lumbar spine. Spine surgeons have used this approach routinely for many years. As a result, if it became necessary to replace or revise the cervical device, there would be considerably less risk compared to revising a lumbar disc," said Philips.

Developed in consultation with leading cervical spine surgeons from the United States, Europe, and Brazil, the PCM Artificial Disc was approved by the FDA for US clinical trials in December 2004. Up to twenty centers across the country will participate in the prospective, randomized, controlled study.

Patients in the study will be randomly selected in a 2 to 1 ratio to receive either the PCM Artificial Cervical Disc surgery or anterior cervical discectomy and fusion surgery. Qualified participants must be between the ages of 18 and 65; have been diagnosed with disc degeneration or disk herniation in the cervical spine and have arm or shoulder pain and weakness or other symptoms or nerve compression. In addition, they must have been treated by a physician for more than six weeks for pain and symptoms. Patients will be required to return for follow-up visits at Rush for at least two years.

Dr. Edward Goldberg and Dr. Howard An, both orthopedic surgeons, are be co-investigators along with Phillips. All of the physicians on staff at Rush University Medical Center and members of the private practice group Midwest Orthopaedics at Rush.
For more information on this clinical call 1-888-DOC-DISC (1-888-362-3472).

Rush University Medical Center

Related Pain Articles from Brightsurf:

Pain researchers get a common language to describe pain
Pain researchers around the world have agreed to classify pain in the mouth, jaw and face according to the same system.

It's not just a pain in the head -- facial pain can be a symptom of headaches too
A new study finds that up to 10% of people with headaches also have facial pain.

New opioid speeds up recovery without increasing pain sensitivity or risk of chronic pain
A new type of non-addictive opioid developed by researchers at Tulane University and the Southeast Louisiana Veterans Health Care System accelerates recovery time from pain compared to morphine without increasing pain sensitivity, according to a new study published in the Journal of Neuroinflammation.

The insular cortex processes pain and drives learning from pain
Neuroscientists at EPFL have discovered an area of the brain, the insular cortex, that processes painful experiences and thereby drives learning from aversive events.

Pain, pain go away: new tools improve students' experience of school-based vaccines
Researchers at the University of Toronto and The Hospital for Sick Children (SickKids) have teamed up with educators, public health practitioners and grade seven students in Ontario to develop and implement a new approach to delivering school-based vaccines that improves student experience.

Pain sensitization increases risk of persistent knee pain
Becoming more sensitive to pain, or pain sensitization, is an important risk factor for developing persistent knee pain in osteoarthritis (OA), according to a new study by researchers from the Université de Montréal (UdeM) School of Rehabilitation and Hôpital Maisonneuve Rosemont Research Centre (CRHMR) in collaboration with researchers at Boston University School of Medicine (BUSM).

Becoming more sensitive to pain increases the risk of knee pain not going away
A new study by researchers in Montreal and Boston looks at the role that pain plays in osteoarthritis, a disease that affects over 300 million adults worldwide.

Pain disruption therapy treats source of chronic back pain
People with treatment-resistant back pain may get significant and lasting relief with dorsal root ganglion (DRG) stimulation therapy, an innovative treatment that short-circuits pain, suggests a study presented at the ANESTHESIOLOGY® 2018 annual meeting.

Sugar pills relieve pain for chronic pain patients
Someday doctors may prescribe sugar pills for certain chronic pain patients based on their brain anatomy and psychology.

Peripheral nerve block provides some with long-lasting pain relief for severe facial pain
A new study has shown that use of peripheral nerve blocks in the treatment of Trigeminal Neuralgia (TGN) may produce long-term pain relief.

Read More: Pain News and Pain Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to