March 1, 2023

Total Disc Replacement (TDR) Technology

What is prodisc Total Disc Replacement?

prodisc is a Total Disc Replacement (TDR) technology used for the surgical treatment of degenerative disc disease in the spine. It is an innovative procedure and an alternative to traditional spinal fusion surgeries that replace damaged or worn-out discs with an artificial disc implant.

prodisc is the only disc replacement system in the U.S. approved for two-level use in the lumbar spine. The procedure has been proven to restore and maintain spinal stability, preserve the natural motion of the spine, reduce the need for adjacent level reoperations, and reduce recovery time so patients can return to their normal activities sooner.

The very first prodisc implantation procedure occurred in 1990. Since then, the technology has garnered a lengthy clinical history and global usage, making it the world's most widely studied TDR procedure.

The prodisc design has been validated by over 225,000 device implantations and more than 540 published studies, with a reoperation rate of less than 1%, making it highly effective.

What is Degenerative Disc Disease?

The spinal column comprises rubbery cushions known as discs that sit between the vertebrae (bones) in your spinal column. These discs act as shock absorbers, and they help your body move comfortably as you bend and twist.

Degenerative disc disease is what occurs when the cushioning in your spinal discs wears down. When this happens, the bones can start to rub together, which can cause pain. As the wearing down of the discs also impacts the spacing in your spinal cord, it can also affect your range of motion.

The spinal discs naturally wear down as a part of the aging process. It is particularly common past the age of 40. Almost everyone will experience some form of disc degeneration as they get older.

However, some factors can increase a person’s chance of developing degenerative disc disease, which include:

• Obesity
• Frequent smoking
• Athletes that get injured often
• Anyone who experiences acute injuries
• Working a physically demanding job
• Biological sex, with women being at higher risk

What are the Symptoms of Degenerative Disc Disease?

The most common symptoms of degenerative disc disease are pain in the neck and back.

Specifically, this pain can:

• Worsen when sitting
• Worsen when bending, lifting, or twisting
• Feel better when walking or running
• Feel better when you change positions or when lying down
• Come and go, sometimes lasting for a few days to months at a time

Additionally, degenerative disc disease can result in numbness and tingling in the extremities and weakness in the leg muscles.

If you're considering total disc replacement with prodisc, search our directory to find a spine surgeon experienced in this motion-preserving procedure.

What is the Difference Between prodisc C and prodisc L Replacement?

Currently, two prodisc Total Disc Replacement procedures are available: prodisc C and prodisc L.

prodisc C Total Disc Replacement

prodisc C is for cervical Total Disc Replacement, which can treat C3 through C7 of the spine. The goal of prodisc C TDR is to maintain mobility at the affected intervertebral disc. It can also reduce extra loading on the adjacent discs.

The prodisc C TDR procedure has proven to be effective at treating individuals with upper extremity and neck pain, loss of function, and neurological symptoms.

prodisc L Total Disc Replacement

Prodisc L is nearly identical to prodisc C; only it is used for lumbar Total Disc Replacement, treating L3 through S1 in the spine. The prodisc L procedure has the same goals as prodisc C, with an overall goal of helping the patient return to an active life with better mobility and reduced symptoms.

With prodisc L, however, the procedure can be used to treat up to two consecutive lumbar spinal levels in the patient’s lower back.

Both prodisc prosthesis designs consist of two cobalt chrome plates with titanium coatings allowing bony ingrowth into the prosthesis. There is also a polyethylene core between the plates that allows for mobility in the ball and socket joint. All of the materials are clinically proven to be tolerated by the body, and different sizes are available to suit the patient’s anatomy.

How Does the prodisc Total Disc Replacement Procedure Work?

The prodisc Total Disc Replacement procedure is used to replace damaged discs in the cervical or lumbar spine with titanium-coated chrome plates that serve as artificial discs. This restores disc height by fixing the natural distance between two vertebrae, which helps reduce pain and restore the natural motion of the spine.

The prodisc design is based on two principles: a mechanism of action and post-operative fixation. The implant or prosthesis is a ball and socket design with a fixed center of rotation, which allows a natural range of motion while providing stability to the spine, thus reducing the need for reoperations at adjacent spinal levels.

Midline keels provide immediate post-operative fixation, ensuring the implant is secure so the patient can begin rehab and return to normal activities as soon as possible. The implant's surface is coated with a highly porous plasma titanium coating, allowing bony growth from the vertebra into the porous surface, which secures and fixates the implant long-term.

What are the Benefits of the prodisc Total Disc Replacement?

The prodisc Total Disc Replacement system is one of the most widely studied surgical procedure technologies due to its effectiveness.

Some of the many advantages of undergoing prodisc TDR include:

• 4x fewer reoperations
• 4x less likely adjacent level degeneration
• Restored range of motion
• Improved spinal stability
• Reduced pain
• Reduced neurological symptoms
• Faster return to active life

Who is prodisc TDR Best Suited For?

The prodisc TDR surgery is best suited for patients who:

• Are skeletally mature
• Have no spinal regrowth remaining
• Have degenerative disc disease causing pain and wear and tear on the spinal discs
• Have no more than 25% of affected discs slipping out of position
• Have seen no relief from pain after at least six months of non-surgical treatments

Prodisc TDR should not be used in patients with the following conditions:

• An infection at the planned implant site
• Osteoporosis or osteopenia with a T-score of less than -1.0
• An allergy or sensitivity to cobalt, chromium, molybdenum, polyethylene, and titanium
• Spinal stenosis
• Compression syndrome from a herniated disc
• Damage to the affected disc due to current or past damage
• A stress fracture in the spine
• Spondylolisthesis greater than Grade 1

Is the prodisc Total Disc Replacement Procedure Safe?

With numerous studies and trials, and a history of clinical data from over 13,000 patients, prodisc has been proven both safe and effective. A recent study conducted for prodisc L was one of the largest patient groups ever evaluated, which demonstrated the robust long-term clinical safety and effectiveness of one and two-level lumbar TDR.

The patients who underwent the procedure were followed, and according to the results, the patients had a reduction in disability and pain over time, with low rates of reoperation and adjacent-level surgery when compared to data from traditional fusion surgery.

How Long is the Recovery from prodisc Total Disc Replacement?

The recovery time for prodisc Total Disc Replacement is, on average, around three to five weeks. However, each patient’s individual experience during recovery can vary.

Because the prodisc implant design is immediately secure, many patients can return to light activities within one week. However, long-term fixation can take a little longer as the bone overgrows on the implant, and as such, some patients may not be able to return to full activity for up to three months.

That said, as the artificial prodisc implant means the vertebrae do not need to fuse together, recovery time is much shorter than with traditional spinal fusion surgery. Following surgery, you should follow your surgeon’s post-op instructions carefully to ensure the best chance of a speedy recovery.

Pain is usually minimal after surgery, and most patients can tolerate their discomfort with over-the-counter pain meds like ibuprofen or acetaminophen. But some may require low-dose opioids if they have a lower pain threshold.

Many patients are asked to undergo rehabilitation and physical therapy starting just a few weeks after surgery. This will aid in recovery and ensure you get the most out of your prodisc implant.

Talk to Your Doctor About prodisc Total Disc Replacement

30+ years of clinical data have proven prodisc Total Disc Replacement to be highly effective and a safe alternative to spinal fusion surgery. If you are suffering from degenerative disc disease and non-surgical treatments have not worked for you, talk to your doctor to see if you are a good candidate for the prodisc TDR procedure.