jayeParticipantFebruary 11, 2021 at 8:38 amPost count: 1
Hey Dr., a fellow chiropractor here in Alberta Canada asking a question on behalf of a patient who needs C4-5 and 5-6 discectomy, and who has elected to have replacement as opposed to fusion. Generally good/normal spinal curvatures. Their surgeon has good experience using both M6-C and Prodisc Implants (I believe a Prodisc Vivo was the specific model). This patient has asked me if either of these devices is superior. I obviously don’t have the experience to answer. I have a few other patients who have the M6 who are happy, but in doing a brief search there appears to be a few fairly concerning failures where the artificial annulus has ruptured. While the Prodisc does not offer the “normal” functional motion of the M6, it’s simplicity may offer superior longevity and/or reduced risk of failure. As I know you are likely experienced with both devices, could you offer any “informal” information I might pass on to help this patient make their decision? Thanks in advance.Donald Corenman, MD, DCModeratorFebruary 14, 2021 at 11:38 amPost count: 7849
Pleasure to discuss this subject with you. The M6-C ADR (artificial disc replacement) has only been approved for 2 years so the longevity for this disc is still in question. In some respects, it is similar to the Bryan disc from Medtronics where there is an artificial annulus with shock absorption capability, missing on strict metal on metal or metal on plastic discs. I did previously think that for ADRs that shock absorption was important (more so for the lower back than the neck due to the higher load bearing capacity in the lower back) but have changed my opinion on this somewhat.
The complexity of the shock absorption capability also means more chance for increased wear characteristics due to the constant load on these fibrous parts replacing the annulus of the disc. This might mean that there is a higher chance for failure due to the complexity of the ADR.
All ADRs most likely will eventually fail over long periods of time due to wear and bone/metal interface failure or auto fusion. I still implant cervical ADRs in about 15-20% of patients who need cervical surgery and use the Prestige LP disc but many ADRs are similar to that ADR and would be acceptable. I tell all my implant patients that they should plan to have a conversion to a fusion in 15-20 years.
Dr. CorenmanPLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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