Table 3

Study patient inclusion and exclusion criteria. Reprinted with permission from Gornet MF, Burkus JK, Shaffrey ME, Argires PJ, Nian H, Harrell FE: Cervical disc arthroplasty with PRESTIGE LP disc versus anterior cervical discectomy and fusion: a prospective, multicenter investigational device exemption study. J Neurosurg Spine. 2015 Jul 31:1-16. [Epub ahead of print] PMID: 26230424.22

INCLUSION (ALL)EXCLUSION (ANY)
  • Cervical degenerative disc disease defined as intractable radiculopathy and/or myelopathy with at least one of the following items producing symptomatic nerve root and/or spinal cord compression that is documented by patient history [(e.g., pain, functional deficit, and/or neurological deficit radiographic studies (e.g., CT, MRI, x-rays, etc.)]:

  • herniated disc

  • osteophyte formation

  • One level requiring surgical treatment

  • C3-C4 disc to C6-C7 disc level of involvement

  • Unresponsive to nonoperative treatment for approximately six weeks or has the presence of progressive symptoms or signs of nerve root/spinal cord compression in the face of continued nonoperative management

  • No previous surgical intervention at the involved level or any subsequent, planned/staged surgical procedure at the involved or adjacent level(s)

  • Is at least 18 years of age, inclusive, at the time of surgery

  • Preoperative Neck Disability Index score ≥30

  • Has a preoperative neck pain score of ≥20 based on the Preoperative Neck and Arm Pain Questionnaire

  • If a female of child-bearing potential, patient is not pregnant, at the time of surgery

  • Is willing to comply with the study plan and sign the Patient Informed Consent Form

  • Has a cervical spinal condition other than symptomatic cervical disc disease requiring surgical treatment at the involved level;

  • Documented or diagnosed cervical instability defined by dynamic (flexion/extension) radiographs showing:

  • Sagittal plane translation > 3.5 mm or

  • Sagittal plane angulation > 20°

  • More than one cervical level requiring surgical treatment

  • Has a fused level adjacent to the level to be treated

  • Has severe pathology of the facet joints of the involved vertebral bodies

  • Previous surgical intervention at the involved level

  • Has been previously diagnosed with osteopenia or osteomalacia

  • Has any of the following that may be associated with a diagnosis of osteoporosis (if “Yes” to any of the below risk factors, a bone density scan will be required to determine eligibility):

    • Postmenopausal non-Black female over 60 years of age and weighs less than 140 pounds

    • Postmenopausal female that has sustained a non-traumatic hip, spine, or wrist fracture.

  • Male over the age of 70

  • Male over the age of 60 that has sustained a non-traumatic hip or spine fracture

  • If the level of BMD is a T score of -3.5 or lower (i.e., -3.6, -3.7, etc.) or a T score of -2.5 or lower (i.e., -2.6, -2.7, etc.) with vertebral crush fracture, then the patient is excluded from the study

  • Has presence of spinal metastases

  • Has overt or active bacterial infection, either local or systemic

  • Has severe insulin dependent diabetes

  • Has chronic or acute renal failure or prior history of renal disease

  • Has fever (temperature > 101°F oral) at the time of surgery

  • Has a documented allergy to stainless steel, titanium, or a titanium alloy

  • Is mentally incompetent (If questionable, obtain psychiatric consult)

  • Is a prisoner

  • Is pregnant

  • Is an alcohol and/or drug abuser as defined by currently undergoing treatment for alcohol and/or drug abuse

  • Has received drugs which may interfere with bone metabolism within two weeks prior to the planned date of spinal surgery (e.g., steroids or methotrexate), excluding routine perioperative anti-inflammatory drugs

  • Has a history of endocrine or metabolic disorder known to affect osteogenesis (e.g., Paget's Disease, renal osteodystrophy, Ehlers-Danlos Syndrome, or osteogenesis imperfecta)

  • Has a condition that requires postoperative medications that interfere with the stability of the implant, such as steroids. (This does not include low dose aspirin for prophylactic anticoagulation), excluding routine perioperative anti-inflammatory drugs

  • Has received treatment with an investigational therapy within 28 days prior to implantation surgery or such treatment is planned during the 16 weeks following Artificial Cervical Disc-LP implantation

  • CT = computed tomography, MRI = magnetic resonance imaging