dascor trial

[dylan t g]

I am meeting with dr regan to discuss the dascor trial

If anyone has any information it would be helpfull

I am wondering about expulsion / herniation /

I can still work and function normally about half the time

the problem is the disc height

If I could maintain the height when working I would be ok - I think

does anyone know what the viscosity (hardness)

of the polymer is once it is cured?

[dylan]

the polymer is about the harness of a pink eraser. It was originally solid, but after a trial of ten people in china they found that it compacted the endplates, causing damage and pain. The two year trial in europe of 60 people was successfull and it is CE approved there (FDA equvilant). Dr Regan is going to give me the paper to review. My discogram results were satisfactory enough to be included in the phase I trial of the dascor. Regan considers this to be the best nucleus replacement to date because the ballon does a nike air thing, and restores some disk height (nucore does not). It is also resistant to expulsion because unlike the raymedica, the dascor goes in as a liquid and then becomes solid making it possible for the incision in the annulus (5mm) to be smaller than the implant - and it also hardens to the shape of the individual disk cavity. I have surgery set for fed 15th. I think it is a good move because if it does not work a revision into an adr would not be difficult

[chasswen]

dylan
best wishes to you in your upcoming procedure i surely hope this gives you some relef.
chuck

[sharman]

I am very interested in this technology, prosthetic disc nucleus (PDN), and will be interested to hear any wisdom from Dr Regan, as well as your own experiences and thoughts.

I agree that the injection of a substance that cures in the disc, rather than the more intrusive procedure necessary to implant other types of PDNs, is a big advantage of Dascor.

There are two issues with all disc prostheses: How well does it work, and what are the risks? In the risk analysis, a big issue is how you get the thing into your back. The Dascor is indeed good in that regard.

What does Dr Regan says the Dascor PDN will do for you pain-wise? You say that disc height is your problem (tho you presumably still have decent height, or you wouldn't be a candidate for PDN, right?). How is poor disc height creating your pain?

Certainly in DDD, we know the nucleus degenerates, but the nucleus has no nerve supply, so the relationship between the degenerated nucleus and pain is not easily apparent to me. Does PDN work by restoring/preserving height? Is it removal of the diseased nucleus material that relieves pain? Is it restoration of the mechanical properties of a healthy nucleus--the shock absorbing cushion?

The reports I have read about PDNs (largely from the manufacturers and surgeons, so grain of salt) claim significant and long-lasting pain relief. Reportedly, the handful of patients implanted successfully 10 years ago are still doing well. The reason (again, according to a manufacturer) that PDNs didn't gain quicker acceptance was the unacceptable rate of surgical failure of the first devices. Hopefully, the newer designs and procedures have fixed these problems. FDA trials--as you know!--are just now starting this country, and I see a number of companies introducing new designs. So maybe there is some validity to it all. I surely hope so. Good luck to you, and keep us posted.

[dylan]

I have a two part problem, and this is a two part surgery -
a discectomy, and the implant.

1 - I have a broad disc bulge (posterior) which is pressing on the descending l4-l5 nerves bilaterally.

2 - I have decreased disk height which causes the exiting l5-s1 nerves to be pinched by the foramina.

I consider this to be mechanical back pain. Pain and sciatica only occurs during/after lifting, prolonged sitting or standing - otherwise I am mostly pain free.

the implant increses the height theoretically taking pressure off the posterior bulge, and opening the foramina allowing the l5 nerves to exit unimpinged.

The role of the discectomy is to make room for the implant, and also
to clean of some of the left over garbage. As far as decompression it is unclear to me because I think that
they don't want the implant to migrate back into the bad spot while it is still liquid. When I asked the intern this, he said they do try and stay away from the disc bulge during discectomy. This is purly speculation and I will investigate further.

Regan did a dasor about three weeks ago and she is doing great.
the europe trial followed 60 people around for a year who had it,
and few complications were reported.

The short term risks are very minimal.
In the long term I would imagine further degeneration the annulus, and possible migration / annulus prolapse. Expulsion is a low risk because of the small incision to the annulus and, the concave shape of the vertebra endplate VS. the convex shape of the implant (individually fitted).

This sounds good to me because it is a minimally invasive surgery that is easy to revise. If I get ten productive years out of it - it will be worth it

Regan talked about doing the discectomy from the front (anterior)
-- I will ask him, but I am curious - are they done endoscopically (very minimally invasive) now days,
or is it laparoscopic (a little more invasive)??

[sharman]

I can certainly see how this helps with pain resulting from pressure on nerve roots--both how the device will help, and how the device will counter possible complications from the discectomy, which will relieve the pressure caused by the herniation. That makes perfect sense to me for sciatica. But I've never understood how a disc bulge/herniation is a factor in back pain, tho I read some reports of discectomies helping with back pain too. The patient that Regan has already implanted, did she experience relief of back pain symptoms too?

[nurse4kids02]

How did your surgery go? I had the dascor surgery through dr. regan on february 1st....