The PCM Cervical Artifical Disc: Another Option for Treatment of Cervical Disc Degeneration?
Cervical disc degeneration is a common cause of neck pain that can also involve significant neurological signs and symptoms. The cervical disc is the soft, flexible material between the bones in the spine. Degeneration of the disc can contribute to the development of disc herniation, spinal stenosis, and other conditions that present as pain, numbness, tingling, and or weakness in the neck, arms, or shoulders. Physical examination combined with imaging studies such as X-Ray, MRI and possibly CT Scan, can help identify which particular condition is causing the symptoms. Some conservative treatment options might include activity modification, physical therapy, chiropractic manipulation, ice, heat, and analgesics.
If that proves unsuccessful, there are two common surgical procedures used to treat symptomatic cervical disc degeneration or herniation. The first involves excision of the herniated portion of the disc in order to relieve the pressure on the adjacent nerve root. The second option, spinal fusion, involves complete removal of the disc, decompression of the nerve root followed by placement of bone graft or a metal interbody cage device to help maintain or reestablish the normal height of the disc space. Spinal fusion eliminates the motion between the two vertebrae, providing improved stability and alignment. The addition of a cervical plate may be used to promote fusion between the two vertebrae. While these surgical treatments are often effective, the success rate of spinal fusion has proven highly variable. As with any procedure, there can be complications, one of which is concern about adjacent level degeneration following fusion. This occurs because forces across the spine are no longer distributed in the same fashion. More stress is transferred to the discs above the fused segment, potentially causing degeneration of that disc.
A third and altogether different option is now available at the NeuroSpine Center of Wisconsin under a clinical study protocol. The PCM (Porous Coated Motion) Cervical Artificial Disc is an investigational device that does not have FDA approval for use outside of a clinical study. The device is designed to replace the diseased disc and provide support for the vertebrae while at the same time, preserve normal spinal motion. Essentially, it may serve as an alternative to spinal fusion for some patients who have a diagnosis of cervical radiculopathy or myelopathy due to cervical disc degeneration or herniation. The purpose of the study is to evaluate the safety and effectiveness of the PCM Artificial Disc for treatment of degenerative disc disease compared to conventional anterior cervical discectomy and fusion. Dr. Peter F Ullrich MD is one of twenty primary investigators of this device in United States and the only investigator within the state of Wisconsin.
The PCM implant is comprised of upper and lower metal endplates made of cobalt chrome alloy. A plastic (polyethylene) spacer is attached to the lower metal endplate. These are the same materials found in hip and knee replacements. The metal endplates bond with the vertebrae, and the area between the two endplates functions like a ball and socket, allowing the upper half to slide and rotate forward and backward. The surgical approach to implant the PCM device is the same as that used for an anterior 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. The edges of the bones are shaped to ensure a proper fit and the PCM Artificial Disc is inserted in the disc space. The procedure generally takes between 1-2 hours and the patient is typically discharged by the following day. A soft collar is optional for comfort and there are a few activity restrictions recommended for the first 6 weeks.
Patients who meet the strict criteria for enrollment in the study and consent to participate, will randomly receive either the PCM Artificial Disc or a cervical fusion procedure using bone graft and a plate/screws. Follow-up will continue for a minimum of two years during which the patient’s progress will be studied.
For comprehensive information pertaining to the diagnosis and treatment of spinal problems including cervical degenerative disc disease and disc herniation, we recommend visiting www.Spine-Health.com. This site also contains information about other clinical trials being conducted throughout the country.
For more information call 920-882-8200 or 1-888-231-5236