One spine surgery research study that I participated in - compared the post-operative results of cervical arthroplasty and arthrodesis on approximately 500 patients. The objective of this study was to compare any side effects of patients undergoing a cervical arthroplasty with the implantation of a Bryan Cervical Artificial Disc to those patients that underwent a spinal fusion.
In this study, of which there were 31 institutions where patients underwent spine surgery, there were 242 patients who received the Bryan Cervical Artificial Disc and 221 patients that underwent cervical discectomy and spinal fusion. Patients that participated in this study were over 21 years of age, had single level cervical degenerative disc disease causing radiculopathy or myelopathy as well as a few other clinical indicators. Once identified, these patients were evaluated before spine surgery and post-operatively at regular intervals beginning one and one half months following spine surgery up to 2 years.
This study concluded that both procedures are safe, and that there is not a significant difference in adverse effects with the newer arthroplasty procedure utilizing the Bryan Cervical Artificial Disc when compared to the traditional surgical option of spinal fusion.
To read the complete study,link here.
At Indiana Spine Group’s Back Talk continuing medical education symposium, as highlighted in a previous blog entry , there are two educational tracks that will be available for conference attendees on day one. In addition to the general track discussed in the prior blog, there is a more in-depth track entitled, More Specifics | Spinal Diagnostics and Treatment.
In this education track there will be a few sessions focusing on the diagnosis of spinal disorders and abnormalities. One session titled Spinal Imaging | Technology and Diagnosis, will be presented by Stephen Pomeranz, MD. Dr. Pomerance is a radiologist. In this session, Dr. Pomeranz will provide an in-depth look at spinal imaging technologies and highlight the latest developments in spinal imaging technology and their applications in spinal diagnostics. Additionally, using case studies, he will review radiological finds and diagnostic indicators.
The second session of this educational track will focus on The Electrodiagnostic Evaluation, and will be presented by physical medicine and rehabilitation specialist Dr. Shashank Dave. During his presentation, Dr.Dave will discuss the role and application of electromyography in the diagnosis of spinal disorders and diseases. Additionally, he will review case studies which utilize electromyography and identify specific diagnoses.
Another session presented for the in-depth track will focus on Diagnostic and Therapeutic Injections of the Spine. This will be presented by minimally invasive spine specialist John Arbuckle, MD. During this session Dr. Arbuckle will review and differentiate between the different type of therapeutic injections and will review the treatment efficacy of injections, the clinical protocols, indications and expected outcomes.
The last session of this continuing education track will highlight spine surgery, and is entitled Surgical Perspectives | Fusion vs Arthroplasty, presented by spine surgeon Rick Sasso, MD. During this session, Dr. Sasso will provide a detailed analysis of spinal fusion and arthroplasty and he will discuss motion preservation modalities for the treatment of generative disc disease. He will highlight lumbar and cervical artificial discs as well as review research studies and discuss patient selection, indications and expected outcomes.
While at the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS) in New Orleans, in addition to presiding as President of the Federation of Spine Societies spine specialty day, I also gave a few talks on cervical radiculopathy.
The first session that I moderated was on the current concepts in cervical radiculopathy. The objective of this continuing medical education session was to provide the most up-to-date information on the pathophysiology, diagnosis and treatment of cervical disc disorders, including the role of selective nerve root sleeve injections and artificial disc replacement.
Another session that I served as a faculty member for was the spine instructional course lecture entitled, “The Degenerative Cervical Spine: What You Need to Know.” This presentation provided an overview of cervical degenerative diseases and addressed the patient evaluation and treatment options, including anterior, posterior and non-operative options.
The American Academy of Orthopaedic Surgeons (AAOS) held their annual continuing medical education meeting in New Orleans, in early March. In addition to attending the annual continuing medical education meeting, I also had the honor of coordinating and hosting the spine specialty day. The spine specialty day presented a common forum by the Federation Societies, of which I am the president. The Federation Societies is comprised of four spine-focused organizations, and includes the Cervical Spine Research Society, North American Spine Society, Scoliosis Research Society and the American Spinal Injury Association.
A few of the educational objectives for the day included discussing the current conce
pts in the diagnosis and management of spinal disorders, and to review and update the clinical results and complications of the new technologies and concepts. The information was presented in the form of instructional presentations, discussions, papers and debates.
Highlighted topics were presented by each society within the Federation. During the day in the North American Spine Societies section, I presented a talk on cervical disc replacement, and for the American Spinal Injury Association I discussed spinal cord injury and the appropriate time for decompression.
For a detailed agenda of this spine specialty day, visit this link at the AAOS web site.
A recent blog entry highlighted articles about the cervical artificial disc, written by Dr. Rick Sasso - a spine surgeon with Indiana Spine Group.
In this spine wellness educational video, Dr. Sasso discusses cervical artificial disc; the indications, overview of surgical procedure and the advantages of this procedure.
In May 2009, the Bryan Cervical Artificial Disc received FDA approval. T
his approval was previously written about in Dr. Sasso’s blog. The cervical artificial disc provides an alternative spine surgical treatment for cervical degenerative disc disease.
Dr. Rick Sasso, a spine surgeon with Indiana Spine Group, has been a principal investigator in the studies with this spine surgical device – the Bryan Cervical Disc. A few of abstracts of his published research studies regarding the cervical disc are available on the U.S. National Library of Medicine / National Institutes of Health web site.
These include:
In October, I was a faculty member at the 8th Annual Symposium on “Innovative Techniques in Spine Surgery.” This continuing education meeting, hosted in Phoenix, addressed the innovative and emerging technologies of spinal surgery including; arthroplasty, minimally invasive procedures, motion sparring technologies and biologics. At this meeting I gave a talk on Lumbar Artificial Disc Replacement, and presented the results of the FDA studies for the Cervical Artificial Disc.
This education program was sponsored by the Organization of Spinal Teaching and Research. The purpose of this group is to facilitate education and discussion among spine care providers and industry and this organization includes leaders in the field of spine surgery and technology that utilize the most advanced and effective technology available for the treatment of spinal disorders.
A lot of patients ask me about the differences with arthroplasty (cervical artificial disc) and spinal fusion; as well as how does the cervical artificial disc work. A few years ago, I was interviewed by Barbara Lewis on Sound Medicine. This segment titled, “New Artificial Cervical Discs”, can be heard by visiting this link.
A few topics discussed during this interview included:
- Comparison of a spinal fusion to cervical artificial disc,
- More detailed information about the cervical artificial disc,
- Comparison of cervical artificial disc to artificial hip and knee,
- The future of cervical artificial disc.
In my prior blog entry, I talked about the Bryan Cervical Artificial Disc study that has recently concluded. To evaluate patient outcomes and functionality for this spine study, one measurement used was the neck disability index (NDI). With this assessment, patients provide a self-evaluation and answer a series of questions of how their neck pain affects their ability to manage everyday life.
Prior to surgery the average NDI score for patients in both the Bryan Cervical Artificial Disc group and the control group was 51. The average post-operative score in the Bryan group was 10, and for the control group it was 16.7Here is the
link to a NDI questionnaire.
Previously, I blogged about the research results of a spine patient study – which evaluated the clinical outcomes of patients who received a Bryan Cervical Disc compared to those that had a standard spinal fusion at 24-months post-operatively. I recently completed a new study, which evaluated these patients 48-months post-operatively. This study will soon be published.
In this study – the functional outcomes of patients at 48-months (4 years) following their spine surgery was evaluated. This study had two groups of patients – one group received a spinal fusion (Anterior Cervical Discectomy and Fusion - ACDF) and the other group received the Bryan cervical artificial disc prosthesis. This spine surgery was for the treatment of radiculopathy and myelopathy, after minimally invasive spine procedures were determined ineffective.
There were 47 patients enrolled in this spine study. Of this group, 21 were enrolled in the Bryan cervical disc arm of the study and their mean age was 40. In the group that received a spinal fusion (control group), there were 26 participants and their mean age was 43.
This study concluded that patients that received the Bryan Artificial Cervical Disc at 48-months, when compared to the control group:
- Had less neck and arm pain,
- Greater mobility,
- Less adjacent segment degeneration, and
- Lower secondary operation rate.
Once this study is published, I will provide the link to the results.
On August 28, I was interviewed by Barbara Lewis for a segment in the Business of Health. I was interviewed about the impact of back pain and back injuries in the workplace. Additionally, in this segment the advantages of newer spine surgery technology was discussed. Specifically, the recently FDA-approved Bryan Cervical Artificial Disc was discussed. A recent research study indicated that patients who underwent a Bryan Cervical Disc procedure - as compared to a spinal fusion, returned to work sooner. To read this complete study,
visit this link.
To see the Business of Health segment, visit
this link.
One unique session for “Back Talk”, the continuing medical education symposium sponsored by Indiana Spine Group, will feature a hands-on component. During this session, entitled Hands-On | Surgical Case Studies, attendees will have the opportunity to get a first-hand look at spinal instrumentation, cervical artificial disc implants and other surgical devices used during spine surgery. Spine surgeons Kenneth Renkens, MD, and Thomas Reilly, MD, will lead this discussion. As they review the technology, they will discuss spine surgery case studies including diagnoses, recommended surgical interventions and expected outcomes.
For more information about Back Talk, and a complete continuing medical education conference agenda, click here.
An article in Science Daily entitled “Artificial Disc Replacement As Good or Better Than Spinal Fusion, Study Suggests”, highlights a published study that I co-wrote.
In this article in Science Daily, co-author K. Daniel Riew, MD – a cervical spine surgeon at Washington University Orthopaedics and Barnes-Jewish Hospital, stated that one of the most important findings of the study was that people who received the Bryan Cervical Disc were able to preserve all of their motion.
I was recently interviewed for a news story that announced the FDA approval of the Bryan™ Cervical Disc. The Bryan Cervical Disc is an artificial disc used in cervical arthroplasty.
This story also appeared on their web site which generated a few reader’s comments/questions. This blog entry – will address some of those questions.
Blogger question: Can it be used in the lower back?
The Bryan Cervical Disc can only be used in the cervical (neck area) spine. There are two FDA approved artificial discs for the lower back (lumbar spine). They are: CHARITE Artificial Disc, approved by the FDA in 2004 and the ProDisc. Artificial lumbar discs are a surgical option for some patients who are being treated for degenerative disc disease or other related spinal conditions. These links provides more information about the artificial lumbar disc - (article one and article two).
Blogger question: Does this work for someone who has had a fusion done 10 years ago?
The answer to this is no. When a spinal fusion is performed, two bones are “fused” together; meaning that they are attached. In that this procedure is done with the goal of a permanency – it can not really be undone to have cervical arthroplasty performed.
In blog discussions about the cervical artificial disc, specifically the Bryan Cervical Disc, it was announced that this disc has now received FDA-approval. One key advantage of cervical arthroplasty and the Bryan Cervical Disc is that patients maintain their natural neck motion as compared to a spinal fusion. (Spinal fusion is the current standard spine surgical treatment for degenerative disc disease.)
A study that I participated in and co-authored, specifically evaluated the patient’s motion – comparing post-operative neck motion. Patients who received the Bryan Cervical Disc in cervical arthroplasty were compared to those that underwent a spinal fusion and anterior discectomy.
This study indicated that the patients that underwent the cervical arthroplasty procedure retained significantly more motion than those that received the spinal fusion. At 24-months the average range of motion for the patients in the cervical arthroplasty group was 7.95 degrees, as compared to 0.87 degrees for the patients in the spinal fusion group. Link here to read an abstract of this study, which was published in the Journal of Spinal Disorders and Techniques.
In a prior blog, the recent FDA-approval of the Bryan Cervical Disc ™ was announced. One of the advantages of this device and cervical arthroplasty, as a spine surgical treatment for degenerative disc disease, is that patients can return to work and their normal activities in a relatively short period of time. Generally, this time period is quicker when compared to a spinal fusion – which is the current standard spine surgical treatment to this newer procedure and technology. At this time, spinal fusion is the standard surgical treatment.
A study recently published in Neurosurgery, concluded that patients that underwent cervical arthroplasty returned to work on average about three months sooner than those patients that underwent a spinal fusion and cervical discectomy. The patients who received the cervical artificial disc returned to work in a median time frame of 101 days following their spine surgery (cervical arthroplasty) as compared to 222 days in the group that underwent the spinal fusion and cervical discectomy.
Recently,
Dr. Rick Sasso was interviewed by the Indianapolis Star. This story was about the Bryan Cervical Disc (cervical artificial disc), that was recently
approved by the FDA. Additionally, the first patient to receive the Bryan Cervical Disc in the United States was interviewed.
The Bryan Cervical Disc is used in cervical spine surgery as one of the cervical artificial disc options during arthroplasty. Arthroplasty is a new spine surgical treatment option for degenerative disc disease. To learn more about the Bryan Cervical Disc,
click here.
Here is a
link to the story on INDYSTAR.com - interviewing Dr. Rick Sasso.
A few weeks ago, Anne Marie Tiernon - news anchor with WTHR, interviewed me about the recent FDA-approval of the Bryan™ Cervical Disc. This story aired on June 9, and here is the link to this story.
As mentioned in previous blogs, I have been involved in the clinical trials for this device, and implanted the first Bryan Cervical Disc in the United States. This procedure was done at St.Vincent Hospital, and was performed with Kenneth Renkens, MD. Dr. Renkens is a neurosurgical spine surgeon, also with Indiana Spine Group.
Additionally, cervical arthroplasty patient Kevin Wacasey was interviewed in this story. Kevin received the first Cervical Disc in the United States in 2002. Today, he is doing great! He enjoys spending time with his teenage son, golfing, fishing and other hobbies.
In a recent blog entry, Indiana Spine Group announced the FDA approval of the Bryan™ Cervical Disc. This cervical artificial disc, provides spine surgeons an alternative device for implantation when performing cervical arthroplasty. In 2007, the Prestige Disc received FDA approval. In a recent press release, Dr. Rick Sasso stated that “The Bryan Cervical Disc more closely mimics natural spine disc movement with shock absorbing characteristics than a previously approved device.”
Indiana Spine Group is excited to announce that we are one of the providers of this latest technology. At this time, physicians with Indiana Spine Group are the only ones using the Bryan Cervical Disc in cervical arthroplasty in Indiana.
Dr. Rick Sasso, a spine surgeon with Indiana Spine Group, was a principal investigator in the clinical trials for the Bryan Cervical Disc. Additionally, Dr. Kenneth Renkens was an investigator in this trial. Dr. Renkens is a neurosurgical spine surgeon with Indiana Spine Group.
To learn more about the Bryan Cervical Disc, click here.
For more information or to schedule an appointment, call 317.228.7000 or
toll-free 866.947.7463.
On Monday, Anne Marie Tiernon - news anchor with WTHR, interviewed Dr. Rick Sasso about the recent FDA-approval of the Bryan™ Cervical Disc. This 
story aired on June 9, and here is the link to this story.
Dr. Rick Sasso, a principal investigator in the Bryan Cervical Disc clinical trial, implanted the first Bryan Cervical Disc in the United States. This procedure was done at St.Vincent Hospital, and was performed with Kenneth Renkens, MD. Dr. Renkens, also involved with this clinical trial, is a neurosurgical spine surgeon with Indiana Spine Group.
Addi
tionally, cervical arthroplasty patient Kevin Wacasey was interviewed in this story. Kevin received the first Bryan Cervical Disc in the United States in 2002. Today, he is doing great! He enjoys spending time with his teenage son, golfing, fishing and other hobbies.
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