ADR

  • About Products:You will find from the main competitors, information related to the range of Cervical Artificial Discs.
  • About Version: V.1 (February 2013)
  • About Companies:Alphabetically listed.
  • About Comments: Please send a mail to the following address: spinemarketgroup@gmail.com
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1.-What Is an Artificial Disc?
An artificial disc is a prosthetic device inserted between the vertebrae to replace a natural spinal disc. It is designed to preserve mobility throughout the treated vertebral segment.
When non-surgical therapies fail to provide relief from acute disc herniation,the doctor may recommend spine surgery. The goal of surgery is to remove all or part of a damaged disc (discectomy), relieve pressure on the nerves and/or spinal cord (decompression), and to restore spinal stability and alignment after the disc has been removed. Traditionally, spinal fusion has been the gold standard for surgically treating disc herniation or degenerative disc disease. Using bone grafts and instrumentation, such as metal plates and screws, this procedure fuses, or creates a bond between, two adjacent vertebrae. This will ideally stabilize the spine segment and provide pain relief. This procedure has been successful in many patients. However, spinal fusion results in loss of motion and flexibility in the treated vertebral segment.
The artificial disc replacement is an alternative to spinal fusion. This is a type of joint replacement procedure, or arthroplasty, that involves inserting an artificial disc into the intervertebral space after a natural cervical disc has been removed.The device is designed to preserve mobility within the disc space and throughout the treated vertebral segment. It is designed to function like a joint, providing motion (flexion, extension, side bending, and rotation) and alignment (height and curvature) of a natural disc.

2.-The Market 
(December 2012)In less than a month, the US Food and Drug Administration (FDA) recently approved three spine PMAs, two for cervical disc replacement devices, and there are two more cervical discs in the queue for near-term PMA approval. All of this activity suggests the $122 million US cervical disc market is about to gear up.The cervical disc market has been relatively quiet in recent years, but recent FDA approvals have once again started to get the artificial disc market moving. The first two cervical discs, the Prestige (Medtronic) and ProDisc-C (Synthes) and the Bryan (Medtronic), were approved by the FDA in 2007 and 2009, respectively. However, no new cervical discs were approved until this year. Between September and October 2012, the FDA granted two new cervical discs premarket approval (PMA), with two other discs expecting approval soon.
Unlike traditional spinal fusions, artificial discs preserve motion and flexibility in the affected area of the spine. Companies and academics have spent years generating data on clinical efficacy and complication rates for cervical disc arthroplasty compared to anterior cervical discectomy and fusion (ACDF), and results of these studies were a hot topic at this year’s 2012 North American Spine Society (NASS) meeting.
One study presented at NASS compared reoperation rates for 51 patients undergoing anterior cervical fusion and 84 patients who received a cervical total disc replacement in one of six different randomized IDE trials. Each trial used a different disc (ProDisc-C, KineflexC, Mobi-C, Neodisc, Discover, or Advent), and the study demonstrated significantly reduced reoperation rates overall for patients undergoing cervical disc replacement compared to fusion (6.0% vs. 17.6%; p < 0.05).
Multiple studies have shown similar outcomes for reoperation rates as well as for improved clinical outcomes with cervical disc arthroplasty compared to fusion, and this growing body of evidence for cervical discs led to a number of new devices entering the market. Technology Insights neuroscience researchers discussed these trials during the recent teleconference roundup highlighting presentations at the NASS Annual Meeting.
Sources:Medtech Insight (http://www.elsevierbi.com), The Advisory Board (http://www.advisory.com).

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COMPANIES&PRODUCTS


1.- AESCULAP: Cervical Disc Actif C




Description
Activ® C is the cervical disc prosthesis for a motion preserving treatment of degenerativ cervical disc disease. It is indicated for light to moderate degeneration of cervical disc with light to moderate changes of the disc, vertebral endplates, osteophytes and/or with fresh herniated disc. The specific motion pattern, physiological center of rotation and the shape of prosthesis-plates ensure the best possible adaption to natural anatomy and biomechanics of the patient for a fast reduction/elimination of pain/neurological deficits and a longterm preservation of motion patterns and the protection of adjacent levels.

Advantages
1.- Safe anchorage and prevention of vertebral body splitting by the combination of spikes and keel and specific technique of keel preparation.
2.- Improved primary stability and fast ingrowth fo bone cells through Plasmapore® coating
3.- Fast and safe bonding between bone and prosthesis surface
4.- Natural motion pattern through shape and type of inlay/prosthesis, analogy between motion patterns of facet joints and prothesis
5.- Good conformity with anatomy of vertebral body and improved primary stability by anatomical shape of prosthesis plates
6.- Safe and easy application in cases with narrow disc space through small height of prosthesis
7.- Flexible use in different grades of degeneration through specific designs
8.- Low risk of complication by safe materials and simple surgical technique

Indications
1.- Motion preserving treatment of degenerativ cervical disc disease.
2.- Light to moderate degeneration of cervical disc with light to moderate changes of the disc, vertebral endplates, osteophytes and/or with fresh herniated disc.
3.-Age is limited by the maturation of epiphysis in young adults and the bone and healing quality in higher age.

Properties
  • Primary stability by a combination of spikes and keel 
  • Secondary and primary stability by Plasmapore® coating 
  • Radius of inlay adapted to mean values of normal distribution of anatomy 
  • Anatomical shape of prosthesis plates 
  • Smallest height with 5 mm 
  • Different designs for indications with light to moderate degeneration 
  • No risk for split of vertebral bodies 
  • Solid materials (Cobalt-Chrome-Molybden/high molecular Polyethylene) 
  • Easy preparation for keel 
  • Easy handling

2.- ALPHATEC:Cervical disc Discocerv®


Advantages

1.-Motion preservation
2.-Disc height restoration
3.-Primary and secondary stability
4.-Mechanical strength
5.-Respect of patient’s anatomy
6.-«Traditional» cervical approach

Properties
  • Optimized design : Convex upper and lower plates to comply with the anatomical curvature of the disc space 
  • Security: Bi-directional grooves to avoid antero-posterior and lateral migration of the titanium plates 
  • Safe and Secure Implant: 
    • - Ceramic-on-ceramic bearing offers 
    • - Excellent biocompatibility
    • - The lowest wear rate
    • - Non-toxic wear particles
    • - Prevention from osteolysis
    • - Proven experience 
  • Mobility: Angulation of 9° in the sagittal and coronal planes to preserve the physiological amplitude of a normal disc
  • Controlled movement: Perfect joining of the inferior and superior ceramic parts so as to facilitate prosthesis mobility 

3.-AMEDICA:Cervical Disc Altia



Description
The ALTIA® TDR-C Cervical Disk is made of MC2 silicon nitride, a twenty-first century ceramic used in jet engines, race cars and even the space shuttle — high stress conditions requiring exceptional strength, durability and reliability. Amedica has patented this technology to create the Valeo Cervical Disk, a device that, like all of our silicon nitride implants, is designed to offer unheralded imaging compatibility, appears ghost-like under X-ray and fluoro, and displays no CT or MRI artifacts.Its patented double saddle articulation geometry, with +/- 3 degrees of axial rotation and built-in soft-stop, will enable the surgeon to support spinal movement while providing fixation and structure. The cervical disk will come sterilized and pre-packaged.

Advantages
  • Made of MC2 silicon nitride
  • Imaging compatible on X-ray and fluoro, with no CT or MRI artifacts
  • Patented double saddle articulation geometry
  • +/- 3 degrees of axial rotation
  • 15° of flexion/extension
  • Built-in soft-stop

4.-AXIOMED:Freedom® Cervical Disc

AxioMed® Spine Corporation (www.axiomed.com) announces the commercial introduction of its Freedom® Cervical Disc in Europe with a successful implantation in Switzerland. The Freedom Cervical Disc received CE Mark in 2012. AxioMed will also conduct a multi-center Freedom Cervical Disc study as a post-market assessment of the total disc replacement device for the treatment of cervical degenerative disc disease. The study’s clinical results are expected to be used in support of a future Investigational Device Exemption (IDE) application to the U.S. FDA and to support regulatory approval in other markets outside of the EU.




5.-DEPUY-SYNTHES: Discover 


Description
The DISCOVER® Cervical Arthroplasty Disc Replacement System is an advanced, unconstrained prosthesis that is designed to perform, as near as possible, the normal functional movements of the patient’s neck, following surgery for symptomatic cervical disc disease. Restoration of motion may also result in long-term patient benefits by reducing the risk of adjacent disc disease – an acknowledged complication associated with fusion. The implant’s overall geometry and optimal core of rotation coincide with normal FSU anatomy, creating kinematic agreement between implant and facets, in both flexion and extension. This minimises stresses within the implant and may reduce its long-term wear potential, which is of particular significance for younger, more active patients.


6.-DEPUY-SYNTHES: Prodisc-C



Description
The ProDisc-C Total Disc Replacement system is composed of spinal implants designed to relieve neck and arm pain associated with symptomatic cervical disc disease (SCDD).​

Key Features & Benefits

1.-Allows potential for controlled and predictable segmental motion
2.-Motion patterns are similar to the motion patterns of an intact spine*
3.-Zero-profile implant
4.-Ball and socket implant design
5.-Proven CoCrMo/UHMWPE articulation
6.-Central keel provides immediate secure fixation to vertebral bodies
7.-Available in 18 sizes:6 footprints,3 heightS-




7.-GLOBUS MEDICAL:SECURE®-C Cervical Artificial Disc







In September 2012, the SECURE-C became the first cervical disc to receive FDA approval since 2009. The disc is comprised of cobalt-chrome endplates and a central polyethylene core, and is indicated in skeletally mature patients for reconstruction of the disc at one level from C3-C7 following single-level discectomy for certain conditions. Globus Medical received approval for its product following positive results of a prospective, randomized IDE study comparing the safety and effectiveness of the SECURE-C to ACDF.

Description
The SECURE®-C Cervical Artificial Disc is a motion-sparing technology designed as an alternative to fusion. Through its unique selectively constrained design, SECURE®-C is designed to allow up to ±15º motion in flexion-extension and up to ±10º motion in lateral bending. The design is intended to allow unlimited axial rotation and to permit sagittal plane translation of ±1.25mm. Clinical study data demonstrate statistical superority of SECURE®-C ACDF in terms of overall success, subsequent surgery, and patient satisfaction.

Advantages
  • Motion Preservation: SECURE®-C is designed to allow motion through its novel selectively constrained design, which provides articulation and sagittal plane translation. 
  • Optimal Fit: SECURE®-C is available in two sagittal profiles (0º & 6º lordosis) and a range of footprints and heights to fit the disc space and curvature of the spine. 
  • Streamlined Technique: Exclusive instrumentation allows device placement in three basic steps: Trial - Chisel - Insert

8.-LDR SPINE:Mobi-C®disc prosthesis


Description
The controlled mobility of the mobile insert is the foundation of the Mobi-C®disc prosthesis. This second generation artificial disc was designed by a team of surgeons specializing in spinal arthroplasty.
Mobi-C has a unique, reliable and patented implantation system: the « Plug &Fit » technology.
It provides you with an ease of use and modularity unequaled in the domain of cervical arthroplasty while preserving the core philosophy of Mobi-C: the resoration of physiological biomecanics with a controlled mobility insert.

Features
1.-Restoration of physiological mobility Brochure
2.-Controlled mobility:Encourages restoration and respect of the Instantaneous center of rotation for a return to physiological mobility of the intervertebral disc.
3.-Reduces the stresses on the bone/implant interface and the posterior facet joints.
4.-Provide control:The inclined shape of the lateral teeth facilitates the introduction of the device while ensuring a reliable anchorage to the dense peripheral vertebral plate.
5.-The controlled mobility reduces the stresses on the bone/implant interface therefore eliminating the need for invasive vertebral anchorage and preserves vertebral endplate integrity. This enable multi-level arthroplasties and arthroplasties adjacent to segmental fusions.
6.-Thin Cobalt Chrome endplates feature a roughened titanium surface and hydroxyapatite coating to encourage bony on-growth for long term stability. The biomechanics of the prosthesis, associated with the Cobalt Chrome and polyethylene articulation provide optimal wear characteristics.

Advantages
  • Enhanced reliability:No-intra-operative handling of the implant, Mobi-C is delivered assembled and maintained between two clamps. This new sterile packaging guarantees minimal, but controlled handling of the implant while shortening operating time.
  • Secure control:The clamps made out of PEEK-Classix®, for one-time use, are radio-transparent in order to optimize and simplify intra-operative control of implant positioning. In addition, they ensure perfect control of the implant in rotation before releasing.
  • Simplified instrumentation:The Mobi-C « Plug & Fit » instrumentation has been designed in order to provide a single implant-holdercompatible with all implant sizes. Its ergonomics renders implantation intuitive while offering the benefits of millimetrics adjustment for optimal and controlled positionning of the prosthesis.
  • An extended range, adapted to anatomical conditions:Mobi-C « Plug & Fit » is the first cervical disc prosthesis that allows depth adaptation for each implant width in order to optimize:
  • Coverage of the vertebral endplates and the Prosthesis positioning.The posterior chamfers simplify implantation and help diminish the risk of secondary impaction.

9.-MEDTRONIC: Prestige


Description
The Prestige® Cervical Disc offers surgeons treating patients with radiculopathy and myelopathy related to cervical disc degeneration an alternative to spinal fusion surgery. Constructed of stainless steel in a unique, two-piece ball-and-trough configuration, the device is designed to maintain motion at the treated vertebral segment.

1.-The Prestige Cervical Disc treats a diseased or damaged disc and is designed to maintain motion. Made of stainless steel, the device has two articulating components (a ball on top and a trough on the bottom) that are inserted into the disc space and attached to the vertebral bodies on either side. The Prestige Cervical Disc was designed to allow for the following motions: flexion/extension and anterior/posterior (AP) translation, lateral bending, and unconstrained axial rotation.

2.-The Prestige Cervical Disc is available in a variety of sizes to accommodate patient anatomy. While many factors contribute to the longevity of a cervical artificial disc, the Prestige disc has undergone significant testing to verify the safety and adequate durability of the device.

3.-The Prestige® Cervical Disc is a two-piece, articulating, metal-on-metal device that is inserted into the intervertebral disc space at a single cervical level using an anterior approach. The device is manufactured from wrought type 316 stainless steel (ASTM F-138) and consists of two metal plates that function via a ball-and-trough mechanism. The superior component of the implant contains the ball portion of the mechanism, and the inferior component incorporates the trough portion. The flat portion of each component, which contacts the vertebral end plate, is roughened through a grit blasting process.

4.-Each component is affixed to the vertebral body by two bone screws through an anterior flange. The bone screws are held in place by a lock screw mechanism. In the implanted disc, the bone screws are divergent in the cephalic/caudal direction and convergent in the medial/lateral direction.

5.-The device assembly was designed to allow the following motions ex vivo: a minimum of 10° motion off the neutral position in flexion/extension and lateral bending, unconstrained axial rotation, and 2 mm of anterior/posterior translation.

Indications
The Prestige Cervical Disc has been indicated by the U.S. Food and Drug Administration (FDA) in skeletally mature patients for reconstruction of the disc from C3-C7 following single-level discectomy for intractable radiculopathy and/or myelopathy. The device is implanted through an open anterior approach. Intractable radiculopathy and/or myelopathy should present with at least one of the following items producing symptomatic nerve root and/or spinal cord compression which is documented by patient history (eg, pain [neck and/or arm pain], functional deficit, and/or neurological deficit), and radiographic studies (eg, CT, MRI, x-rays): 1) herniated disc, and/or 2) osteophyte formation.


10.-MEDTRONIC: Bryan


The BRYAN® Cervical Disc System for the treatment of single-level cervical disc disease (radiculopathy and/or myelopathy).The BRYAN® Disc is one of two clinically proven artificial cervical discs in the Medtronic portfolio. More than 20,000 BRYAN® Disc implants have been sold worldwide since January 2000 when the first surgery was performed in Europe using the original instrument set that was developed by Seattle neurosurgeon, Dr. Vincent Bryan.The Bryan cervical disc (made by Medtronic Sofamor Danek) is composed of a plastic (polyurethane) center with titanium endplates. It is designed as a one piece device that allows unconstrained motion. The Bryan cervical artificial disc is unique in that there is a flexible membrane that surrounds the nucleus (the inner portion of the disc) that is filled with a lubricant. This membrane is designed for two purposes: to contain any wear debris that forms and to prevent any soft tissue in-growth. This disc is designed to allow a normal range of motion of the neck


11.-NUVASIVE:PCM® Cervical Disc

Just one month after SECURE-C received its PMA, the FDA granted approval for NuVasive’s PCM cervical disc. This disc is also composed of cobalt chrome endplates and a central polyethylene core, and is indicated for use in skeletally mature patients for reconstruction of a degenerated cervical disc at one level from C3-C4 to C6-C7 following single level discectomy for certain conditions.
The two-year results of PCM’s IDE trial, conducted at 23 investigational sites across the United States, demonstrated non-inferiority for PCM compared to fusion in all primary and secondary endpoints.

Description
The PCM® Cervical Disc is designed to replace the diseased disc, providing support for the vertebrae while allowing for movement of the joint. The PCM Cervical Disc consists of the following parts: an upper metal (cobalt chromium molybdenum alloy) endplate, and a lower metal endplate to which a plastic (polyethylene) spacer is attached. These materials are the same as the ones used for most spinal and orthopedic devices. Several device sizes are available to best fit the disc space.
The PCM, which stands for Porous Coated Motion (made by Cervitech) consists of a cobalt-chrome alloy with UHMWPE (Ultra High molecular weight polyethylene) This represents a metal on polyethylene articulation. The outside coating of the disc consists of a titanium/calcium phosphate double coating attached to a serratus surface. This design allows for a press-fit fixation as well as the ability for bone in-growth, which helps keep the disc securely in place.5 The PCM cervical artificial disc is designed to match the natural contour of the uncovertebral joint. It allows for minimal limitations of range of motion and minimal constraint.


12.-RANIER:Cadisc™-C


Description
The Cadisc™-C is a next generation intervertebral disc implant designed to restore height and functionality to degenerate discs in the cervical spine. Like the Cadisc™-L device, the cervical disc is a single unit polymeric device with no articulating surfaces and has material properties, including a graduated modulus, which aim to mimic the biomechanical properties of the natural cervical disc. The implant is designed to conform to the contours of the vertebral endplates. By utilising the natural topography of the vertebral bodies, the innovative design aims to reduce the amount of surgical preparation necessary at the implantation site and promotes maximum stability and resistance to migration.

Key Features
  • Its unique, graduated modulus design mimics the natural disc form
  • It has physiological, progressive bending stiffness
  • There are no metallic endplates or articulating wear surfaces
  • It possesses a mobile centre of rotation for load-sharing biomechanics
  • Conformable endplates to help reduce stress-shielding
  • It has good X-ray and MRI visualisation

Advantages

  • Radiolucent implant with minimal CT or MRI artifacts &
  • Biocompatible implant (PEEK-OPTIMA®)
  • Composed of low wear rate PEEK-OPTIMA® from INVIBIO® (benefit: minimal debris & minimal risk of site inflammatory effect)
  • Provides stable fixation to the endplates with both cams & HA coating
  • Preservation or ROM at single and multiple levels*
  • Rotating cams for superior fixation
  • Hydroxyapatite coating for improved fixation
  • Radiolucency to reduce radiographic artifacting



13.-Signus Spine:Rotaio



Description
The aim of ROTAIO is to replicate the natural movement of a healthy disc. The solution: a variable centre of rotation,enabling physiological facet-guided movement. This ensures that the emphasis is not merely on maintaining movement, but in particular on the quality of movement of a natural disc. However complex the joint kinematics of ROTAIO, the surgical technique nevertheless remains simple.
ROTAIO is implanted by the ‘gold-standard’ Smith-Robinson technique as a single component without additional preparative surgical steps. ROTAIO can therefore be described in a single phrase: Implantable like a cage – moves like a disc.ROTAIO offers not only rotation, flexion/extension and lateral flexion, but also the possibility of uncoupled translation. In this way, ROTAIO optimally reproduces the natural centre of rotation and thereby provides physiological, facet-guided, segmental movement. ROTAIO is implanted «in one piece» with no additional preparative steps.



14.- SPINEART® :Baguera®C

Description
In line with its philosophy of simplifying technical surgeries, Spineart®’s cervical disc prosthesis, the Baguera®C, is easily implanted with its compact set of high quality instrumentation.
The device has now been used for over 3000 procedures and benefits from many unique features. Most notably theBaguera®C is the world’s first pre-assembled unit with each implant provided pre-sterilised and pre-loaded on to a radiolucent holder.The titanium plates reduce artefacts under the MRI and allow for a postoperative control. The plates are coated with Diamolith. This improves conductivity of the PE nucleus and eliminates the risk of wear debris.

Advantages

  • Anatomical shape
  • The sloping anatomical shape of the implant allows for an easy insertion and a perfect fit between the vertebral endplates.
  • Pre-assembled device 
  • Primary stability
  • The porous titanium coating as well as the 3 upper and lower fins guarantee primary stability of the device and prevent it from being expulsed or rotated.
  • Compact set
  • The set includes 4 instruments and a lockable cervical distractor.
  • Radiolucent holder:Allows for both, verification of the implants anterior positioning and confirmation of the fitting accuracy.
  • Guided mobile nucleus:Prevents excessive constraints on the facet joints. The mobility is controlled to respect rotational movements.
  • Shock absorption:The shape of the inferior plate and the PE nucleus enable absorption of shocks and vibrations, 10 times more than a flat surface design.

Features

  • Sizes: AP-Lengths: 13 mm, 14mm &16 mm;Widths: 16 mm – 18 mm with 1 mm increments;Heights: 5 mm – 7 mm with 1 mm increments
  • Materials of manufacture:Inferior and superior plates are made of Titanium alloy TA6V4ELI, biocompatible to ISO 5832.3.Nucleus consists of High density polyethylene, biocompatible to ISO 5834.2
  • The surface of the Baguera®C endplates is coated with a thin Diamolith® layer, a Diamond like-Carbon coating. Diamolith® is a material with a high degree of hardness, which avoids wear debris and improves conductivity of the PE insert.



15.-Spinal Kinetics:M6-C Artificial Cervical Disc


Description
The M6 artificial cervical disc offers an innovative option for artificial cervical disc replacement because of its unique design which is based on a natural disc’s qualities.Engineered to replicate your own disc, the M6 is the only artificial disc that incorporates an artificial nucleus (made from polycarbonate urethane) and a woven fiber annulus (made from polyethylene). The M6 artificial nucleus and annulus are designed to provide the same motion characteristics of a natural disc.Together, the M6’s artificial nucleus and annulus provide compressive capabilities along with a controlled range of natural motion in all 6 degrees of freedom along each vertebra. This “natural” motion is designed to provide the freedom to move your neck naturally while minimizing the stress to adjacent discs and other important spinal joints.The M6 has two titanium outer plates with keels for anchoring the disc into the bone of the vertebral body. These outer plates are coated with a titanium plasma spray that promotes bone growth into the metal plates, providing long term fixation and stability of the disc in the bone.

Features
To accommodate the various anatomical ranges, the M6-C artificial cervical disc is available in a variety of heights and endplate footprints.
* 2 Heights: 6mm, 7mm
* 4 Footprints: Medium, Medium Long, Large, Large Long


16.-Kineflex Disc


Description
Kineflex Disc technology is second-generation disc technology, offering a mobile bearing design to enable translation in addition to articulation. Each natural vertebral disc in the spine allows motion of the adjacent vertebrae in articulation (side-to-side and front-to-back bending), translation and rotation. Kineflex Disc technology offers a semi-mobile core, which allows for articulation, rotation and limited translational movement of the adjacent vertebrae to conform more closely to the natural motion of the spine. The proprietary retention ring of the Kineflex Disc prevents core expulsion and limits translational motion of the core.

Advantages

  • The Kineflex Disc has a range of motion of ±12° in the flexion-extension (forward and backward) direction and ±12° in the lateral (side to side bending) direction. The Kineflex Disc also allows for unconstrained rotational movement and translational movement within limits defined by a specially designed retention ring.
  • The Kineflex Disc endplates are designed with primary and secondary fixation mechanisms that secure the implant within the vertebral body.
  • The Kineflex Disc features a metal-on-metal design of cobalt chrome molybdenum (CCM) alloy with titanium (Ti) plasma spray coating on the osseointegrating surfaces of the endplates. Both the inferior and superior endplates have serrated surfaces and keels (fins) to facilitate endplate fixation. Primary fixation is achieved through interaction of the keels and serrated endplate surfaces with vertebral bone in a press fit configuration. Secondary fixation is achieved through bone on-growth to the titanium plasma spray endplate coating and bone in-growth through transverse holes in the keel.


17.-Stryker:Cervicore

The Cervicore (made by Stryker Inc) is a metal on metal cervical disc made of cobalt chrome. It has a saddle shaped design to match the contour of the cervical vertebral body. The base plates have a titanium spray that allows for bony in-growth as well as three spikes for fixation. After the Cervicore device is inserted, screws are placed through anterior flanges to promote primary fixation of the artificial disc to the bone.






















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