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May 31, 2002

Contact:
Debbie Neufert
Media Relations, LHSC
519-685-8500, ext. 74772

North American first in neurosurgery

(LONDON, Ontario) The first artificial cervical disc replacement on this continent has been completed at London Health Sciences Centre (LHSC). This latest innovation provides another avenue for patients with a disc herniation in their neck to ease their pain and maintain mobility. The announcement was made at a news conference today at LHSC.

Unlike the current treatment of cervical fusion surgery, where the vertebrae are fused, an artificial cervical disc replacement involves removing the bad disc and replacing it with an artificial one. The benefit to patients is that they continue to have a range of movement in their neck - something that is not possible with cervical fusion surgery. The artificial cervical disc also shows strong potential to prevent accelerated degeneration of adjacent discs.

Cervical disc disease affects approximately 50 per cent of the population. A cervical disc herniation can be caused by degeneration of the disc, injury or heavy lifting. Discs are gel-like cushions that act as shock absorbers between each of the bones of the spine. A cervical disc herniation can cause compression of adjacent nerve endings connected to the arm which can cause pain and possibly weakness or numbness in the arm. Most people respond to non-surgical treatments, but for those who don't, an artificial cervical disc is a new option for relief.

Dr. Neil Duggal, neurosurgeon at LHSC, and an assistant professor in the department of Clinical Neurological Sciences at the University of Western Ontario successfully implanted an artificial cervical disc on two patients March 7, 2002. Both patients are pain-free and continue to respond well to the surgery.

Dr. Duggal says, "This surgery shows great promise for patients, and I believe artificial cervical disc replacement may be the standard treatment for a select group of patients within ten years." However, Dr.Duggal does caution that while the artificial cervical disc is an option for some patients, it is not a cure-all for chronic neck pain. It is for treatment of severe arm pain resulting from a disc herniation in the neck.

Greg Stott of Ontario was the first patient to have an artificial cervical disc replacement in North America. Stott suffered with persistent arm pain and increasing weakness in his arm for four years. Stott says, "I still can't believe the difference the surgery has made. I have been without pain since the operation. I have full strength in my arm again and the numbness and tingling is gone."

Dr. Vincent Bryan, an American neurosurgeon, created the Bryan™ Cervical Disc System.

The disc is manufactured by Spinal Dynamics Incorporated of Seattle, and distributed outside of the United States by Medtronic Sofamor Danek based in Memphis, Tennessee.

London Health Sciences Centre (LHSC) is an acute-care hospital, and one of the largest teaching hospitals in Canada. It has more than 7,300 physicians and staff, and provides care annually for more than half-a-million patients in London, as well as Southwestern Ontario, and beyond.

London Health Sciences Centre (LHSC)
First artificial disc replacement in North America - Fact Sheet

• On March 7, 2002, LHSC became the first hospital in North America to insert an artificial cervical disc into two patients. Both patients are pain-free and continue to respond well to the surgery.
  
  
• Artificial cervical disc replacement is an innovative option to treat a disc herniation in the neck that has not responded to non-surgical treatment. The surgery involves removing the disc and replacing it with an artificial one.
  
  
• The benefit of artificial cervical disc replacement is that it allows a patient to continue to have a range of movement in the neck. It also shows strong potential to prevent accelerated degeneration of adjacent discs.
  
  
• The artificial cervical disc replacement is made of a polyurethane or plastic core and two metal end plates. It comes in various sizes to accommodate different anatomies.
  
  
• Cervical disc disease affects about 50 per cent of the population.
  
  
• The majority of patients with a disc herniation in the neck get better after several months of non-surgical treatment such as medication, massage therapy and physiotherapy. However, for those who do not respond to non-surgical treatment, cervical fusion surgery can be the next step in treatment.
  
  
• Cervical fusion surgery involves using a portion of bone from the hip to fuse the vertebrae. However, fusion can limit a patient's neck movement, and up to 15 per cent of patients require a second surgery because the fusion has accelerated degeneration of adjacent discs.
  
  
• Discs are gel-like cushions that act as shock absorbers between each of the vertebrae of the spine. As people get older, these discs begin to degenerate.
  
  
• A disc herniation in the neck can be caused by degeneration of the disc, injury, or heavy lifting.
  
  
• A disc herniation in the neck occurs when a portion of the disc pushes out of its location and presses on adjacent nerve endings connected to the arm. The result is overwhelming pain in the arm, and possibly numbness, weakness and tingling in the arms.
  
  
• A disc herniation in the neck can also cause compression of the spinal cord, which can lead to difficulties with balance, walking, dexterity and bladder function.
  
  
• Patients need a referral from their family physician.
  
  
• Artificial cervical disc replacement was first performed in Belgium in January 2000. Since that time over 500 patients, outside of North America, have had an artificial cervical disc replacement.

Photographs

This is a model of the artificial cervical disc which was first inserted into a patient in North America at London Health Sciences Centre (LHSC) on March 7, 2002.

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