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34 SPINE DEVICE & INNOVATION cervical disc replacement is another for the right patients. "With cervical disc replacement, everyone tries to compare it to fusion but they are really different procedures for different patients," says Dr. Coric. "It allows you to treat a younger, more active patient population who present with more isolated, one- or two-level cervical disc disease." ere are currently seven FDA ap- provals for cervical artificial discs and new generations of technology will soon become available on the market. e procedure gained a Category I CPT code for one-level cervical disc replacement earlier this year and more surgeons are adopting it. Dr. Coric and his team are actively involved in studying the M6 disc from Spinal Kinetics; it's one of the most popu- lar discs in Europe and now could expand into the United States. "It's a next-generation disc with a compressibility component for better quality motion," says Dr. Coric. "ere are parts of the disc that mimic the annulus and nucleus, so there is more sophistication of the devices." ere are also new discs, such as the Simplify Disc, with PEEK and ceramic components, that could come to trial this year and have advantages for imaging in patients with the disc. "e technology is evolving and more patients want artificial discs as op- posed to fusion, if possible," he says. Spinal cord injury Spinal cord injury treatment is also evolving into the biologics realm. Dr. Coric and his team are involved in the InVivo clinical trial for the Neuro-Spinal Scaffold for patients with traumatic spinal cord injury. Currently, surgeons are limited in treating spinal cord injury patients, but with the new InVivo technology surgeons open the dura and insert the implant in the substance of the damaged spinal cord. e implant is a resorbable polymer to provide biomechanical support for the cord. Only three patients have under- gone the surgery so far with between six and nine month follow ups. However, two of the three patients (66 percent) improved their AIS grade by one month aer surgery, typically only 5 percent to 6 percent of patients with complete spinal cord injury improve an AIS grade by one month post-in- jury. "It's exciting because there is this huge area of catastrophic injuries and very little we can do besides stabi- lization," says Dr. Coric. "But now we can implant the polymer into the substance of the spinal cord to provide some mechanical support. It's early on, but we're doing the human trials focused on trying to positively affect the actual site of spinal cord injury. ese results are preliminary, but you can envision somewhere down the line combining the biological treat- ment with mechanical treatment for a better solution." n There are several regenerative procedures moving through the process and it's exciting because it's a minimally invasive way to repair the disc. -Dr. Domagoj Cordic " " subscribe at www.beckersspine.com/e-weekly.html e-weekly spine review