Forward progress

Cervical disc replacement procedure helps

By Jimmy Mincin, jmincin@altoonamirror.com
One small step for medical professionals, a giant leap for patients living in pain.

Dr. Charles J. Harvey

of Blair Orthopedic Associates and Sports Medicine, Altoona, performed a new cervical disc replacement procedure on Feb. 18 at Altoona Regional Health System using the first artificial disc approved for this type of surgery by the Food and Drug Administration.

It marks the first time the surgery was performed in Blair County, according to Blair Orthopedic Associates.

The new artificial disc, called the Prestige Cervical Disc Replacement, is inserted into the neck using a similar procedure that surgeons use when performing a spinal fusion, Harvery said in a release. The procedure, called cervical disc arthroplasty, showed successful neurological outcomes in recent clinical trials that compared it to cervical discectomy and spinal fusion procedures.

The doctor said the ‘‘revolutionary new surgery’’ offers an alternative to patients who want to eliminate neck pain while preserving the motion and natural balance of the spine.

“In a spinal fusion, patients receive a cervical discectomy (surgical removal of an injured or herniated disc from the spine) and fusion using a bone graft and a plate,” he said. “A disc replacement eliminates the need for both the bone grafting and the plate. Instead, there’s a metal ball and a trough at the bottom that allows the bone to slide back and forth with normal motion.”

Rarely is a cervical problem just one level, he said. With an artificial disc, the adjacent segment will absorb less impact. It’s also less invasive and has a quicker recovery time.

‘‘In a fusion, we’re putting a bone in and wedging it between two other pieces of bone,’’ he said. ‘‘Bone has to heal to bone, and it takes six months to solidify. With the new procedure, there is no piece of bone and no fusion, so there is no waiting for the bone to heal. Once the incision on the neck heals, you’re healed.’’

In the U.S. clinical trial of Prestige, patients who received the disc showed improved neurological success at 24 months and improved overall success, according to www.newmilford hospital.org. The clinical trial is the largest randomized controlled study involving 541 patients.

Prestige was approved by the FDA on July 16.

Harvey performed the new surgery on Valerie Gooden, a 47-year-old licensed practical nurse at J.C. Blair Memorial Hospital, Huntingdon. She suffered a herniated disc in her neck in December that caused severe neck and shoulder pain. By January, the pain became so bad she had to leave work.

‘‘Cortizone injections did nothing,’’ she said. ‘‘I tried conventional treatments, even steroid injections, but nothing worked. I did a lot of research on my options, and one of the things I looked into was the artificial disc replacement. When Dr. Harvey suggested it, I told him I knew all about it from the Internet. He thought I’d be an ideal candidate because I had no special health problems, such as diabetes, that would complicate the procedure.’’

Harvey told Gooden he would attempt the surgery, and if it didn’t work, he would have to do a spinal fusion.

Goodman’s pain-free, fully mobile life today tells of its success.

‘‘There’s no pain at all. I’m ready to go back to work,’’ she said. ‘‘The only thing holding me back is the incision in my neck has not fully healed yet, and because of that, I’m still susceptible to possible secondary infections at the hospital.’’

Gooden wasn’t prescribed a physical therapy regimen, and said the artificial disc should be ‘‘good with wear and tear for the next 40 years.’’ She described the surgery as ‘‘complication free.’’

‘‘They just went in there, took the herniated part of the disc out, then stabilized it with the artificial disc,’’ she said. ‘‘I have all the mobility back in my neck. Once the incision is healed up, I’ll have absolutely no restrictions.’’

Her husband Barry, 40, was amazed with the results.

‘‘The recovery time for this is just phenomenal,’’ he said. ‘‘It wasn’t a lay down on the couch for days type of thing. We’re both very active with our three children, so the surgery didn’t really hamper a lot. I think it’s a great procedure.’’

Harvey doesn’t think it will be long before the procedure supplants fusions altogether.

‘‘In five years, I don’t think we’ll be seeing anybody’s neck being fused for single-level disc surgeries,’’ he said. ‘‘This surgery is revolutionary because of the motion factor. When you go from fusing someone’s spine to allowing it to move, that’s a great leap forward.’’

Mirror Staff Writer Jimmy Mincin is at 946-7460.