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.
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 forpatient’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 Total Disc Replacement. Other insurance companies
such as Cigna, TriCare/TriWest, Writers Guild, and Workman's Comp are reviewing
the procedure on case by case basis. Blue Cross and Blue Shield of California
are not covering the procedure at this time. The explaination of benefits
can be found here.
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.
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