Artificial disc replacement (ADR), the process of removing a damaged disc and substituting a prosthesis designed to function like a healthy natural disc, can be an effective alternative for spinal fusion surgery when conservative treatments have failed to alleviate pain. Although one term is used for the procedure, however, there are a range of different types of prostheses that can be used, depending on which part of the spine is affected and the patient’s individual circumstances, including whether they need multiple discs replaced.
In this article, we’ll review different design types for artificial disc replacements as well as cervical and lumbar discs currently on the market.
Though they come in different sizes and shapes, current designs of artificial discs come in four main types:
| Type | Description |
| Composite | Made up of several pieces, frequently two metal endplates separated by a polyethylene spacer |
| Elastic | Similar to a composite disc, as it is made up of two materials; this type has a polycarbonate urethane core that is deformable, so it mimics the viscoelastic properties of a natural disc |
| Hydraulic | Contains a dehydrated core that is compressed when implanted; when the gel-like core is hydrated, it provides space and mobility between the vertebrae |
| Mechanical | Made up of two articulating pieces that are either metal or composite metal and ceramic |
Many factors are taken into account when recommending a specific type of artificial disc, including the patient’s age, potential allergies to any disc materials, life expectancy of the disc, desired lifestyle and activity level of the patient, size of the disc necessary to accommodate the patient’s physiology, and the weight-bearing capacity of the disc. If a patient has been determined to be a good candidate for ADR, their spine surgeon will make a recommendation based on their individual circumstances.
A number of medical device companies offer different types of artificial discs and are continually innovating to refine their offerings. Currently available models include:
| Name | Materials and construction | Advantages |
| PRESTIGE® Cervical Disc | Titanium ceramic composite and titanium carbide; “ball and trough” design, with the upper part having a rounded edge that moves in a divot in the bottom section; endplates have two low-profile keels to secure it to the bone. | Design and composition give the disc durability and the ability to flex, extend, rotate, and side bend while maintaining the height, alignment, and curvature of the natural spine. |
| Mobi-C® Cervical Disc | Cobalt chromium molybdenum alloy; a mobile polyethylene bearing rests between two endplates, which are coated with titanium and hydroxyapatite to promote integration with the bone. | Design provides the device and spine good range of motion. |
| SECURE-C® Cervical Disc | Two cobalt chromium molybdenum alloy endplates with a polyethylene core inserted between. | Permits up to 15 degrees of motion nodding up and down (flexion-extension) and 10 degrees of motion tilting the head side to side (lateral bending). |
| Prodisc-C® Cervical Disc | Two cobalt chromium molybdenum endplates and one ultra-high molecular weight polyethylene inlay; while the inlay is technically separate, it is locked into the lower metal endplate so they function as a single unit after installation. Metal surfaces are coated with a titanium plasma spray to help hold the disc in place and promote bony growth. | Central keel is designed to resist natural forces on the spine and not alter natural loads on the facet joints. Technology has been in use and studied since 1990. |
| Prodisc-C® Vivo Cervical Disc | Composed of four pieces: endplates made of titanium alloy with a rough surface of pure titanium for bony ongrowth, a calotte insert of cobalt chrome alloy, and an inlay of ultra-high molecular weight polyethylene in a ball-and-socket design with secure teeth fixation to provide stability. | Designed to replace a diseased and/or degenerated intervertebral disc in patients with symptomatic cervical disc disease (SCDD). Resists shear forces and allows for flexion, extension, rotation and lateral bending. |
| Prodisc-C® SK Cervical Disc | Similar to the Prodisc-C® Vivo, but with low-profile keels for fixation instead of secure teeth fixation. | Low profile that allows “stacking” of the discs at adjacent spine levels, necessary for patients who have more than one damaged disc in need of replacement. |
| Prodisc-C® Nova | Composed of four pieces: two titanium alloy endplates, a cobalt chrome alloy calotte insert, and an ultra-high molecular weight polyethylene inlay | Combines a clinically proven ball and socket design with a simplified surgical technique and low-profile tri-keels that provide immediate fixation. |
| Simplify Cervical Artificial Disc | Made of polyetheretherketone and a mobile zirconia-toughened alumina ceramic core, with serrated endplates coated with titanium plasma spray on bone-contacting surfaces. | The use of MRI-safe materials allows patients to have MRI studies after installation, if necessary. The semi-constrained design allows for 12 degrees of flexion and extension as well as lateral bending and axial rotation. |
| Prodisc-L® Artificial Lumbar Disc | Made up of two cobalt chrome alloy endplates, each with a single keel, and one ultra-high molecular weight polyethylene inlay. Endplates are plasma-sprayed with titanium to help promote bone integration. | Approved for replacement at one vertebral level in 2005; approved to treat two-level disease in 2020. |
| activL® Artificial Lumbar Disc | Made up of two titanium-coated cobalt-chromium metal alloy endplates with a mobile ultra-high molecular weight polyethylene core. | Relative to other lumbar disc designs, the activL® has the lowest height and comes in a variety of endplate sizes to fit individual patient anatomy. Can be used in patients who have one level of degenerative disc disease at either L4/L5 or L5/S1. |
For patients suffering from neck and back pain caused by degenerating discs that has not responded to non-operative care, artificial disc replacement is a minimally invasive treatment option that can preserve range of motion, relieve pain, and make an active lifestyle possible again. Dr. Tiffany Rogers, a board-certified orthopedic doctor, can determine if you are a good candidate for ADR and help you understand your options for treatment, including the variety of prostheses available. To schedule your consultation, contact us here today.
Mike was barely able to walk. I did his surgery and now he’s traveling the world with his wife! That pic is from Africa, hiked up to see mountain gorillas…
I feel very blessed to have walked in to the office for a consultation with Dr Rogers. On that day upon review of my MRI report she determined that I needed emergency surgery due to extremely compressed spinal cord at C3/4. Now I knew it was compressed for some time but I avoided going to the surgeon because I was afraid to have surgery. She calmly explained the alternatives to not having the surgery and it was a no brainer. My symptoms had gotten really bad and I knew she was right. I trusted her judgement and I am so happy that I had the surgery. Almost immediately my symptoms improved!! All of the nurses and other doctors at Torrance Memorial praised her work also and she was very well respected. I would recommend Dr Rogers because not only was my surgery a success but she also showed great compassion for me because I was very sad to be in the hospital during the Holidays. To me this shows she cares about healing the whole person.
I have Dr Rogers to thank for the rest of my life. At 12 I was told by a specialist that I was born with a deformity in my spine which was causing slight scoliosis. At 20, I started experiencing back pain, constantly feeling the need to crack my back for some relief, tossing and turning all hours of the night, seeking massages. As I started to get older, the pain only increased. By 23, my back began to “lock” on me. I would bend over or lean forward and my nerves would pitch, causing me to not be able to move for a few seconds. At first I had kaiser insurance, the “spinal specialist” if you can even call her that said there was no possible surgery to fix my spine and back pain. She told me PT and epidural spinal injections were the answer….. (wrong, very wrong!) I got this run around with kaiser for 2 years!!!!
By 25, I was BEYOND frustrated and in pain, so my (now) husband put me on his insurance, and I was able to find Dr Rogers. She requested an MRI and X-rays, and saw what was wrong with my spine and what needed to be done. I needed a spinal fusion and decompression. She even referred me to a spinal specialist in LA, to get a second recommendation, and he agreed with everything she wanted to do for my surgery. I had full trust in Dr Rogers. She was always kind, always informative, and reassured me I was going to be alright. As a fellow athlete, she understood what I was sacrificing for this surgery. My love for playing soccer would have to come to an end post surgery due to the risk of blowing out another level of my spine. She was compassionate and again gave me reassurance I would eventually be pain free and be able to carry my own children which was the most important to me.
I underwent my lumbar spinal surgery with a spinal fusion and decompression August 2016. The pain and recovery I experienced post surgery was the most pain I’ve ever felt. Pain meds helped, but you really have to be dedicated to taking the vitamins Dr Roger recommends, and doing the amazing PT she prescribed. The PT was Pilates based, and it seriously did my recovery wonders.
By March 2017, I was ready to move to another state and went in for one last check up with Dr Rogers. She did another X-ray, and told me that my fusion looked so good and healthy , that I could start playing soccer again. Not competitively, but recreationally, and now I am nearly 2 years post spinal surgery, playing on 2 soccer teams, active in the gym, and my husband and I are trying to start a family.
I still experience soreness in my lower spine if I lift too heavy of objects the wrong way or work out too hard, but that is to be expected. I have been off any type of medication spine related for over a year now, and it’s nothing a little ice won’t cure. All in all I have a lot to thank Dr Rogers for. She saved my back.
Thank you so much Dr Rogers!!!!
Dr Rogers has been taking care of my back issues for years. It came to a point that I did need a major surgery. A fusion. I am so glad it was done. Just wished I’d done it earlier. My leg pain is gone, the back spasms are gone , feeling like my ribs were stabbing me is also gone and though I’m still healing I feel so much better. I am so grateful to Dr Rogers !! I would highly recommend her for spine issues. Forever thankful!! The staff is professional and friendly also.
Update!!
It’s been a year and a half since my back surgery with Dr Rogers and I’m doing great!! Thank you again Dr Rogers!!
There are two major factors in my thinking a doctors office is 5 stars… #1 is the office and staff itself… #2 is the moment you meet the doctor and how they present themselves to you. Being someone that’s had multiple surgeries, dealt with dozens of doctors and facilities… if these two are in line when you go on your first visit, you know the experience and the healing to come will be worth it.
I have to say, the offices, ease of getting there, parking… were amazing… the staff at the front desk (and on the phone for that matter) were some of the most engaging, informative and easy to deal with that I’ve ever encountered. They made it EASY for me to check in, etc… I was taken in at the exact time of my appointment (I did listen and get there 15 minutes early) and was escorted through, had X-rays and waited for Dr. Rogers…
The moment I met Dr. Rogers, I had faith that I was in the right hands. Her eye contact, the way she shook my hand, the way she listened… the deep understanding she immediately had for my symptoms and the journey I’ve been on for the last 10 years after of my spine surgery in New York… made me incredibly calm and gave me such peace.
I see her again next week, after a battery of tests… but I look forward to finding answers with this healing doctor and her colleagues and staff…
xoxox
I am writing this review on behalf of Dr. Rogers patient, Yolanda Phelps.
Dr.Rogers performed an anterior cervical disectomy and cervical fusion on me last Tuesday. I am home now and my recovery is going great. Dr. Tiffany Rogers was so caring, thorough, and made me feel so comfortable during this difficult procedure. She took very good care of me and I am so thankful for her help.
Also her PA Jeff was so kind and helpful as well. Thank you so much you two for everything!!
PS don’t waste time going through pain go to dr. Tiffany Rogers. She does all the bells and whistles!!
Dr. Rogers is Exceptional. I am a patient of hers. I was in extreme pain Christmas week. Doctor Rogers ordered an MRI. Diagnosis was dislocated shoulder. I called her office 12/27/18. Doctor called back. She asked if I could be in her office immediately. I saw her within 1/2 hour. She injected me with Cortisone.What a God given gift!
Dr. Rogers is obsessed with the ability to heal. She went above and beyond to releive my pain.
Thank you Dr. Rogers.
