New to forum - What cervical disc to choose?
 

Hi, my name is Chuck and this is my first post. I have a herniated c5/c6 disc, with corresponding nerve compression, that started bothering me in January 2012. The pain advanced very quickly - as such, I went through all my conservative options (PT, massages, traction, anti-inflamatory med's, steroid injections, etc...) in a couple months ultimately talking with four doctors who all agreed the only real option I had was surgery (ACDF or ADR depending on who you talk with). I'm sold on ADR as my best option and as such, my research led me to the Spinal Kinetics M6-C. I've been waiting since May of this year for their US clinical trial to get started and have finally realized that it just isn't going to happen (too many hoops to jump through). So, I've backed up, done more research, and now need to decide between the Prestige and Pro-disc C. I was thinking the Pro-disc C was better but have been reading a lot about "heterotopic ossification" (auto fusing I think) and it seems HO affects most discs (ProDisc-C, Kineflex, Bryan, PCM, Mobi-C, M6) to some extent or another but doesn't seem to affect the Prestige (due to it's mounting methodology - anterior phalanges).

So getting to the point, who had ADR with either the Prestige or ProDisc-C and why did you decide one way or the other? Short-term / Long-term results?

I've been the happy owner of a Prodisc at C5-6 for just short of one year. Adding a naproxen tablet to the morning vitamins is an easy way to help prevent HO.

I'm not 100% pain free and probably never will be as the original nerve damage is 14 years old, but the ADR made an immediate improvement in pain level and neurological function. The radiculopathy was such that I couldn't keep my arm down. It was perpetually cocked up as if I was about to shake hands with someone.

Hi,

I had Prodisc-c Nova by Dr. Bertagnoli in 4/2011. I had a long recovery but I continue to do better and better. I chose Prodisc over M6 for the same reason as someone else here mentioned for choosing prestige: I am an engineer and simplicity of design combined with long track record of both materials and design won me over. Today the M6 has more (mostly good) results out there, so it would be a tough call. I was also hesitant on getting a disc that lets body fluids in (from the vent holes) but the fluid circulation is not constant. I am not a biologist, but I figure there may be more unknowns besides mechanics on M6.

If I understand correctly, the Prestige you are able to get in US is different from what they use in Europe today (Please correct if I`m wrong). The one with FDA clearance has no keels as Prestige LP, which they use in Europe has. This might affect its success regarding HO. Someone might have a better insight on this. Also, the US version of Prestige is metal on metal, which has its pros and cons.

I would be careful with long term NSAID use (naproxen etc.) just for the fear of HO. NSAIDs have many negative side effects, perhaps gastric problems being the biggest. One must weigh the risks vs. benefits individually. That being said, I use Arcoxia (a more stomach "friendly" NSAID) regularly to be able to be active with my remaining frozen shoulder, which I developed pre-op. I do take a daily dose of pantoprazol to protect my stomach from my remaining medication.

Obviously, Laura chose the Prodisc for both of her cervical ADRs; as you can see in her signature. That's our opinion. On the other hand, there is a pretty steady flow of people here who've posted problems with the Prodisc, primarily at C56, and basically accuse it of being too mobile. I'd read up here before you decide on the Prodisc. That said, Laura controls her hypermobility problems with occasional prolotherapy, which is a lot simpler to deal with than a non-functional or poorly designed ADR. Your decision is going to be a matter of balancing risks and what you're willing to do for continuing care and lifestyle modification, even if you have a completely successful surgery.