It was very interesting to see Suhuaro's surgery. I've seen many dozens of cervical ADR's implanted, including ProDisc-C, Mobi-C, and PCM; but this was my first Prestige experience. Regan is an excellent surgeon and it's always a pleasure to watch him work. He uses a microscope for the decompression step. This allows him to to do very careful and accurate work when working in the canal area.
The Prestige-ST disc is one of 2 cervical discs that started US clinical trials in 2002. Until ProDisc-C approval last December, the Prestige-ST and the Bryan were the only 2 cervical disc repleacements FDA approved. It's a ball and trough design, slightly different from the ball and socket of the ProDisc-C. Implantation is similar to the other discs I've watched.... access, discectomy, decompression, preparation of the endplates, trial implants, fine-tuning, insertion of the device, control xrays, close. The instrumentation was quite different. (My perceptions about the differences will contain too much speculation, so I won't write about these differences here.)
During the surgery, I went to the neurologist who was doing the interoperative monitoring and asked if he could see the nerve release occur on the electrophysiologic testing. "That's very interesting.. I'm not usually looking for that. Let me see", he said. A few clicks and key strokes later, he brough up the baseline emg's done as the surgery was just getting started, then overlayed the current values. "Here... her ulnar nerve was released."
It's so nice to see the pathology that was causing pain and to see validation that they are working in the right area. Based on her reductions in arm/hand symptoms, she has every reason to expect improvements. I look forward to hearing of her success.
All the best,
Mark
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