What type of symptoms would a patient have to have for you to consider them as a candidate for the PRESTIGE® Cervical Disc?
A patient who presents with a single level cervical disc herniation or cervical degenerative disc disease at C3, C4, C5, C6 or C7, with associated arm pain, tingling or numbness, and has failed to respond to conservative therapy, is a candidate for Artificial Disc Replacement.
What are the potential benefits for a patient who receives the PRESTIGE® Cervical Disc?
The main benefit of using an Artificial Cervical Disc is preserving the motion and natural balance of the spine. Rarely is a cervical problem just one level. With an artificial disc, the adjacent segment will absorb less impact.
What are the potential risks for a patient who receives the PRESTIGE® Cervical Disc?
There are risks associated with any surgical procedure. The risks for a cervical surgery include but are not limited to: inter operative complications, infection, bleeding, hardware failure, hoarseness, paralysis, and death.
What type of conditions does the PRESTIGE® Cervical Disc replacement surgery treat?
The Artificial Cervical Disc may be a treatment option for patients who have single level Cervical Degenerative Disc Disease or Cervical Herniations C2-C7. Normally the patient will also have corresponding radiculopathy (shooting pain, numbness, tingling) in their arm.
How might the PRESTIGE® Cervical Disc impact the patient’s outcome?
The patient’s symptoms should be resolved with either an Anterior Cervical Disectomy and Fusion (ACDF) or a Cervical Artificial Disc Replacement. The advantages of a PRESTIGE Cervical Disc over an ACDF are: motion preservation, and the shorter recovery period. Patients return to their normal life activities a couple of weeks after surgery.
What is the PRESTIGE® Cervical Disc made out of? Is it a material that’s been used in people in the past?
The Prestige Disc is constructed of stainless steel. Stainless steel has been used in various orthopedic medical devises for many years and has been deemed safe.
How is the PRESTIGE® Cervical Disc implanted? Is it a familiar technique?
The Prestige Disc is implanted using the same surgical procedure as an Anterior Cervical Disectomy and Fusion. Instead of using bone graft for a fusion, an artificial disc is placed between the vertebra.
What type of pain will patients have after cervical artificial disc surgery?
There is minimal pain with an Anterior Cervical Discectomy or an Artificial Disc Replacement. There may be some muscle soreness or some difficulty in swallowing. Patients are up and around within a day or two, and the pain usually resolves itself within a couple of weeks.
How large is the scar from a cervical artificial disc surgery? Where will the scar be?
The scar for an Anterior Cervical Disectomy with Artificial Disc placement is approximately one inch horizontally. The incision is made in a natural skin fold, and meticulously closed for an excellent cosmetic outcome. This picture was taken one year post-op. Click on the picture to enlarge it.
How long will the patient be in the hospital after cervical artificial disc surgery?
The length of stay will vary for an Artificial Cervical Disc Replacement surgery. In some cases the surgery can be done as an out patient procedure. In other cases, the patient may stay overnight in the hospital.
Do I have to do anything special after cervical disc surgery, like wear a soft neck collar?
A soft collar is not mandatory for patient’s’s who have had an Artificial Cervical Disc Replacement surgery.
How soon are patients typically able to return to normal activities after cervical disc surgery?
After an Artificial Cervical Disc Replacement surgery, a patient may return to limited activity within a week of having surgery. Normal activities are resumed within a month, and all restrictions are lifted at 3 months post-operatively.
Why do you choose to use the PRESTIGE® Cervical Disc over the standard of care you use now?
The Artificial Cervical Disc is an excellent option for the right patient with the right diagnosis. The advantage of the Artificial Cervical Disc is the opportunity to preserve motion, and reduce the possibility of adjacent segment degeneration.
What are the differences between cervical disc replacement and lumbar disc replacement?
The lumbar artificial disc replacement is a very controversial procedure that I rarely recommend. The diagnosis and indications for lumbar and cervical surgeries are completely different. The cervical artificial disc is indicated for nerve pain, has a high success rate, and a low complication rate. If a revision is necessary, there are no bridges burned by performing an Anterior Cervical Disectomy and using an Artificial Disc. If there is any type of complication from the lumbar disc, the revision surgery is always life threatening.
Will my insurance company pay for the PRESTIGE® Cervical Disc?
Aetna is covering the Artificial Disc. Other insurance companies such as Cigna, TriCare/TriWest, Writers Guild, and Workman’s comp are approving the procedure. Although the disc is FDA approved, Blue Cross and Blue Shield of California are not covering the devise at this time.
What should I do if my insurance company does not pay for the PRESTIGE® Cervical Disc?
We will make every attempt to obtain approval for the Prestige Artificial Disc procedure. If the insurance company does not approve the Prestige Disc, the first step is to appeal the decision. Other options include paying for the procedure, waiting if medically advisable, or pursuing a fusion surgery.
After spine surgery, do I need antibiotics before getting my teeth cleaned?
According to a joint study by AAOS (American Association of Orthopedic Surgeons) and the American Dental Association. At this time antibiotics are recommended for two years following an implant procedure. Notify your dentist when scheduling an appointment. The dentist will prescribe the recommended antibiotic if necessary.
After a spinal fusion, will the instrumentation in my body set off the alarm at the airport?
It is recommended, but not mandatory that you advise the TSA officer of an implanted medical devise. With the current screening system, patients have not reported setting off the alarm. With the advent of full body scanners, this may change.
Should I donate blood before surgery?
There are pros and cons in donating blood prior to surgery. Generally, Dr. Pashman does not require patient’s to donate blood prior to a surgical procedure. More information can be found here.