NICE Interventional Procedure Guidance 143 Intervertebral Disc Replacement in the Cervical Spine

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NICE Interventional Procedure Guidance 143
Intervertebral Disc Replacement in the Cervical
Spine

• Mr.K.K.Lingutla, Mr.T.Friesem
• Mr.G.Reddy,Mr.A.Kasis
• Spinal Unit, North Tees

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INTRODUCTION

• Data overview prepared in Feb 2005.
• Specialist advise from BASS,BCSS.
• Indications
• 1.Degenarative disc disease.
• 2.Acute disc herniation.
• 3.Spondylotic Disease.
• 4.Conditons causing nerve root or spinal
  cord
• compression.
• Efficacy
• - Excellent in 65 patients with one level and
  77 in patients having two level ACDR in the
  largest series available.

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Demographics
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Length of Stay
Mean Length of Stay 1.4 days
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Communication with the patient

• Documentation of consent taken from the patient
• 100

• Documentation of discussion of risks and benefits
  with the patient
• 100

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Indications
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Procedure type
8
Pain
9
Neurology
10
Flexion/Extension
11
Complications
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Conclusions and Recommendations by NICE

• 10 year comparative data compared to cervical
  fusion may be necessary before efficacy is
  demonstrated.
• A small number of spinal units undertake this
  procedure.
• Reaudit with longer follow up reviews.

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Our Recommendations

• Re-Audit
• Quantitative measurement of disability scores and
  flexion extension angles.
• Publication in progress for Spine Arthroplasty
  Society
• Continue follow up