The past, present and future of artificial disc replacement with Dr. Scott Blumenthal


Scott Blumenthal, MD, is a spinal surgeon at the Texas Back Institute. Dr. Blumenthal performed the first lumbar disc replacement in the United States. Additionally he has devoted his practice to the research and application of artificial discs.

Question: Why did you devote your practice to the research and application of artificial disc replacement?


Dr. Scott Blumenthal: It all started with the lumbar disc. When I first start practicing we recommended doing a fusion for a degenerative disk issues. We were using fusions to fix a worn out disc and patient's asked 'Why can't you just replace it like my hip or my knee?'


After 15 or 20 years of getting asked that question I looked into it and I learned about artificial discs. I learned about them from the company that brought the first artificial disc to the U.S. and I went over to Europe and got trained on them. Then I helped them prepare for the FDA trial.


We did the first one in March of 2000 or 16.5 years ago. Now we've done thousands. We're in the next generation of them now.


It has been pretty exciting to see and it has been very rewarding to be part of a lot of these trials. 


Question: What has been the biggest difference from that first procedure to what you do today?


SB: The patient experience is better. We've been able to broaden the application beyond the FDA trial and second and third generation instrumentation has made ease of implantation a lot better.


Question: What do you think the future holds for the artificial disc replacement market?


SB: It is two phases. For the cervical spine, I think the cervical artificial disc will become, if it hasn't already become the standard for a herniated disc. I think any surgical spine company is going to have to have them. It'll become more of a commodity product.


With the Lumbar spine, it doesn't have global insurance acceptance like cervical does. It has become sort of a niche market. It turns out that it almost seems to focus on centers of excellence. There are places around the US that do a lot and I think it'll be more of a center for excellence concept like the Center for Disc Replacement at the Texas Bone Institute


We still see a good volume of Lumbar, but I think across the United States it has gone to centers rather than being widely available in the community.


Question: What are some of the trends you're seeing from your research on artificial discs?


SB: Interesting enough, the decade of artificial disk research has kind of slowed down.


We just completed a trial for the M6, the number one selling cervical disc in Europe. I think that'll have a huge impact on the US, once it gets released. It is still a couple of years away.


But the preliminary results have looked very encouraging. The disc is next generation and I think it'll help a lot of people.


The M6 is really the first artificial disk that combines the standard motion that we measure on an x-ray, but it has a soft, load sharing, core. It has a compressible core, and it's as close to as anatomic motion that a disc can have.


No disc can absolutely mimic the motion, but this one has the ability to do the standard motions you measure on x-ray as well as the ability to load share and be compressed.


I think the big tagline or the big issue that I think the companies have fallen short on is to let the patients know that whether it's lumbar or cervical and you're advised to have a fusion, you should at least consult somebody who does disc replacement as well to see if you're a candidate for disc replacement.


Because if you're a candidate for both, most people when they hear the long term results will chose the artificial disc.


Learn more from Dr. Blumenthal at the 15th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference + The Future of Spine in June 2017!Click here for more information.

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