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Pablo Pazmi ño, MD
Orthopaedic Surgery American Academy of Orthopaedic Surgeons Clinical Faculty Olympia Medical Center Cedars Sinai Medical Center Century City Doctors Hospital ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],M6 Artificial Disc
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Joint Facet Nucleus  Pulposus Right Nerve Root  Left Nerve Root As you can see here on MRI and CT scans the Facet joints end up looking like the buns of a hamburger. Its just the way the happen to look when they are sliced in this plane. We will show you this on some examples later Annulus Fibrosus Axial View of the Disc and Neural elements
Joint Facet Disc Right Nerve Root  Left Nerve Root Axial View
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[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Joint Facet Disc Right Nerve Root  Left Nerve Root Axial View
Joint Facet Disc Right Nerve Root  Left Nerve Root Next I will show you some MRIs  You will see this is a patient with a left sided herniation pinching off her exiting left nerve root
Joint Facet Disc Right Nerve Root  Left Nerve Root Axial Scans:
Cervical 7 Spinous Process Nerves 2-3 Disc 3-4 Disc 4-5 Disc 5-6 Disc 6-7 Disc
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[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
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[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
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[object Object],[object Object],Sir John Charnley at his lathe working on the first artificial joint
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[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],Annulus •  Ultra High Molecular Polyethylene (UHWMPE) fiber material • Intended to simulate native annulus & its performance • Designed to provide controlled physiologic motion in all planes and axes • Robust fiber matrix with multiple layers similar to native annulus
Sheath •  Designed to minimize tissue in-growth & debris migration • Allows for full range of motion Fixation •  Titanium endplates with tri-keel design • Titanium Plasma Spray (TPS) coated endplate • Low profile keel height (2mm)
[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Discover ADR Immediate and initial fixation is provided through 6 Lateral Teeth which notch into the subchondral bone of the vertebral bodies above and below the implant itself.
Prodisc ADR Immediate and initial fixation is provided through a keel which notch into the subchondral bone of the vertebral bodies above and below the implant itself.
M6 ADR Immediate and initial fixation is provided through a keel which notch into the subchondral bone of the vertebral bodies above and below the implant itself.
Prestige ADR Immediate and initial fixation is provided through interbody screw fixation which secure  into the subchondral bone of the vertebral bodies above and below the implant itself. Angled screws to resist pullout
[object Object],Microscopic view of bony ingrowth onto hydroxyapatite which provides for long term fixation  A human long bone cell growing on the surface of a hydroxyapatite ceramic foam. The presence of microporosity allows the cell processes to attach more readily.
[object Object]
Flexion / Extension Literature: Panjabi, White (1990) Prestige +/- 10 Degrees Prodisc +/- 20 Degrees M6 6 Degrees 20 ° Unlimited
Lateral Bending Literature: Panjabi, White (1990) Prestige +/- 10 degrees Prodisc +/- 20 degrees M6 6 degrees 15 ° Discover 42 °
Axial Rotation Literature: Panjabi, White (1990) 14 ° Unlimited
[object Object],Radius C L Lordosis ,[object Object],Disc Height ,[object Object]
[object Object],Radius C L Lordosis ,[object Object],Disc Height ,[object Object]
[object Object],Radius C L Lordosis ,[object Object],Disc Height ,[object Object]
Zero Profile Implant C L Lordosis Disc Height Heights: 3 Heights: 6mm, 7mm & 8mm 2 Footprints: Medium & Large
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Teamwork: All Procedures performed with both an Orthopaedic Spine Surgeon and a Neurological Surgeon
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Cervical Hybrid Arthroplasty by Pablo Pazmino MD

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  • 10. Joint Facet Nucleus Pulposus Right Nerve Root Left Nerve Root As you can see here on MRI and CT scans the Facet joints end up looking like the buns of a hamburger. Its just the way the happen to look when they are sliced in this plane. We will show you this on some examples later Annulus Fibrosus Axial View of the Disc and Neural elements
  • 11. Joint Facet Disc Right Nerve Root Left Nerve Root Axial View
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  • 17. Joint Facet Disc Right Nerve Root Left Nerve Root Axial View
  • 18. Joint Facet Disc Right Nerve Root Left Nerve Root Next I will show you some MRIs You will see this is a patient with a left sided herniation pinching off her exiting left nerve root
  • 19. Joint Facet Disc Right Nerve Root Left Nerve Root Axial Scans:
  • 20. Cervical 7 Spinous Process Nerves 2-3 Disc 3-4 Disc 4-5 Disc 5-6 Disc 6-7 Disc
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  • 32. Sheath • Designed to minimize tissue in-growth & debris migration • Allows for full range of motion Fixation • Titanium endplates with tri-keel design • Titanium Plasma Spray (TPS) coated endplate • Low profile keel height (2mm)
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  • 35. Discover ADR Immediate and initial fixation is provided through 6 Lateral Teeth which notch into the subchondral bone of the vertebral bodies above and below the implant itself.
  • 36. Prodisc ADR Immediate and initial fixation is provided through a keel which notch into the subchondral bone of the vertebral bodies above and below the implant itself.
  • 37. M6 ADR Immediate and initial fixation is provided through a keel which notch into the subchondral bone of the vertebral bodies above and below the implant itself.
  • 38. Prestige ADR Immediate and initial fixation is provided through interbody screw fixation which secure into the subchondral bone of the vertebral bodies above and below the implant itself. Angled screws to resist pullout
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  • 41. Flexion / Extension Literature: Panjabi, White (1990) Prestige +/- 10 Degrees Prodisc +/- 20 Degrees M6 6 Degrees 20 ° Unlimited
  • 42. Lateral Bending Literature: Panjabi, White (1990) Prestige +/- 10 degrees Prodisc +/- 20 degrees M6 6 degrees 15 ° Discover 42 °
  • 43. Axial Rotation Literature: Panjabi, White (1990) 14 ° Unlimited
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  • 47. Zero Profile Implant C L Lordosis Disc Height Heights: 3 Heights: 6mm, 7mm & 8mm 2 Footprints: Medium & Large
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  • 51. Teamwork: All Procedures performed with both an Orthopaedic Spine Surgeon and a Neurological Surgeon
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