Mobi-C Artificial Cervical Disc Replacement

Who Should Receive a Mobi-C?

The Mobi-C Cervical Disc:

  • Is for adults; the vertebrae must be mature (estimated age range 21-67 years).
  • Takes the place of one or two damaged cervical disc(s) next to each other (adjacent segment) from levels C3-C7.
  • Is for patients with arm pain and/or neurological symptoms such as weakness or numbness with or without neck pain.  The damaged disc may be irritating the:
    • Spinal cord (myelopathy) or nerve roots (radiculopathy).  This can cause a loss of feeling, loss of movement, pain, weakness, or tingling down the arm and possibly into the hands.
  • Disc damage needs to be proven by the Center for Disc Replacement Surgery at AOR’s review of CT, MRI, or X-ray imaging.  Images of the neck should show at least one or the following:
    • Inner disc squeezing through the outer disc (herniated nucleus pulposus)..
    • Degeneration of the spine from wear and tear (spondylosis).  There may be boney growth (osteophytes) on a vertebrae.
    • Loss of disc height compared to the levels above and below.
  • Is for people who have not responded to non-surgical and conservative care.  You should either have:
    • Tried at least six (6) weeks of other medical treatments such as physical therapy and medicine before considering having surgery; or
    • Have signs or symptoms that your condition is getting worse despite other medical treatments.
Will Dr. Idema and Her Team Recommend Mobi-C Surgery For Me?

Non-surgical treatment and a conservative approach, such as physical therapy, injections, and possibly a neck brace, will be prescribed first by Dr. Idema and her team.  If these treatments do not relieve your pain or dysfunction, you and your doctor may determine that you are a candidate for a cervical artificial disc replacement.  Dr. Idema and her team will discuss the risk and benefits of surgery using the Mobi-C to treat your condition.  Surgery with the Mobi-C may help to stop your pain and other problems from a damaged cervical disc.

What Are the Benefits of Surgery With the Mobi-C?

This patient information describes many possible problems.  These facts are given to help you make the right choice about artificial disc replacement surgery.  There are many good reasons, however, to choose your artificial cervical disc surgery with the Center for Disc Replacement Surgery at AOR in addition to the Mobi-C helping to end or lessen your pain and discomfort.

Surgery with the Mobi-C:

  • Will replace your worn out disc(s).
  • May help to keep neck movement.
    • Bending forward-to-back
    • Bending side-to-side
    • Turning left-to-right
  • May match disc height to the levels above and below.  This can help to un-trap nerves.
  • May lessen your neck and/or arm pain.
  • May lessen any arm tingling.
  • May help you return to your normal life of work, family, and fun.
What Are the Expected Outcomes and Benefits of Mobi-C?

If order to be used in the the United States at one or two adjacent levels, Mobi-C went through major testing and review with the Food and Drug Administration (FDA).  In the US study, 234 patients were treated with Mobi-C and 105 patients were treated with ACDF (anterior cervical discectomy and fusion).  Some of the study results at five (5) years after surgery are described below.  The clinical benefit beyond five years has not been measured.  Ask the Center for Disc Replacement Surgery at AOR for more details about the clinical study and its results.

Who Should NOT Receive a Mobi-C? (Contraindications)

If you have any of the following, you should NOT have surgery with the Mobi-C:

  • An active whole body (systemic) infection, such as pneumonia.
  • An infection at the surgery site, such as skin rash or infected cut.
  • A known allergy to what Mobi-C is made of:  cobalt, chromium, molybdenum, titanium, hydroxyapatite, polyethylene, and other trace elements.  Talk to the Center for Disc Replacement Surgery at AOR if you have a metal allergy.
  • Damaged cervical vertebrae from an accident (trauma) at the level of the surgery.
  • An unhealthy shape (deformity) of the cervical vertebrae at the level of the surgery.  Deformity could be caused by an inflammatory disease where the vertebrae swell or grow together and limit movement, such as anklyosing spondylitis and rheumatoid arthritis.
  • A cervical spine that shows an unhealthy amount of extra movement (instability).  This can be measured by X-rays taken from your side when the spine is still and bending.
  • Low bone mineral density, such as osteoporosis or osteopenia (defined as DEXA scan with bone mineral density T-score < -1.5).  This condition could increase the risk of bone breaking or cause the implant to loosen.
  • Severe disease or degeneration in the joints in the back of the cervical vertebrae (facet joints).
Preparing For Your Mobi-C Surgery

Follow the Center for Disc Replacement Surgery at AOR’s directions when getting ready for your surgery.  Ideally, we have agreed to undertake Dr. Idemas’ *PreHabilitation recommendation prior to your surgery.  Here is a list of examples of things to-do before your surgery.

  • Check that your medicine(s) you are taking will still be OK to take after having surgery on your neck.
  • Take time before going to the hospital to arrange your life for after surgery.  *Please refer to Dr. Idema’s PreHab Program*
  • You will likely be told NOT to eat or drink the night before your surgery.
  • Ask Dr. Idema and her team what you can expect from surgery.
What Happens During Mobi-C Surgery?

In the operating room:

  • You will lie on your back on a table and be put into a deep sleep state of general anesthesia.  Once asleep, your neck area will be washed again and a clean and sterile sheet will be taped around your upper torso and neck area.
  • An incision is made on your neck. Dr. Idema and her team will move the muscles, the airway (trachea), the esophagus, and blood vessels to the side.  This makes a “tunnel” to your spine.
  • Using a special X-ray (fluoroscopy), your doctor will pass a thin needle into the damaged discs to check the levels for surgery.
  • Dr. Idema and her team will remove the damaged discs and put in the Mobi-C.  Fluoroscopy may be taken during surgery to check Mobi-C placement.
  • The muscle and skin incisions will be sewn together with surgical sutures.  A small bandage or biologic glue will be placed across your incision.
  • While asleep, you will be moved to a new area (PACU or Recovery Room).  Nurses and staff will check your vital signs and if you are in pain, you may be given medicine.  Once awake, you will be stabilized and if all of the discharge criteria is met, you will be discharged safely to home.
What Happens After Mobi-C Surgery?

Ask Dr. Idema and the Center for Disc Replacement Surgery at AOR to describe how you may feel and what you will need to do after your surgery.  Replacing your discs with the Mobi-C is a major surgery.  Getting better will take some time so please be prepared for your recovery and have expectations.  How fast you get better will depend on a number of different variables but will also depend on your age, your general health, and the reason for your surgery.  Dr. Idema will recommend that you participate in the *AOR Prehabilitation* program to better enhance your recovery and experience.  As with any surgery, it is extremely important to follow the Center for Disc Replacement Surgery at AOR’s direction before, during, and after surgery.

Here are some examples of directions to follow after surgery.

Please check with Dr. Idema and her team about her specific directions:

  • Sit, stand, and walk the night after surgery
  • Neck collar instructions following your surgery
  • Medication instruction for both pain, nausea, and any other required medications
  • Clean bandages and bandage change following your surgery.
  • Post-operative appointments for incision wound checks, post-operative X-rays, and other entities
  • Post-operative therapy and movement to include when to start physical therapy.
What will my surgery incision look like?

The incision will be a short incision in the front (anterior) portion of your neck.  Dr. Idema will make the cut in a line you already have in the skin on your neck.  The incision generally heals so that it is difficult to see.

When can I shower after Mobi-C surgery?

You will need to keep your incision site clean and dry immediately following surgery.  Please check with the Center for Disc Replacement Surgery at AOR as to when you can take a shower or bath as well as dressing instructions.

When can I drive after Mobi-C surgery?

Check with the Center for Disc Replacement Surgery at AOR for specific directions.

Will my Mobi-C affect travel through airport security?

It is very unlikely that the metal in the Mobi-C will set off airport security detectors.  However, the Transportation and Security Administration (TSA) rules state, “TSA Security Officers will need to resolve all alarms associated with metal implants.”

How Does Mobi-C Surgery Compare to Fusion?

Before cervical artificial discs were available, most often a patient would get an anterior cervical discectomy and fusion (ACDF).  In this fusion surgery, Dr. Idema and her team will remove the unhealthy disc(s).  The empty disc space is filled with a bone spacer or metal/plastic implant.  The implant helps to match the disc height to the levels above and below.  Restoring the disc height can help to remove pressure on the nerves and/or spinal cord.

The goal of an ACDF is to minimize movement at the level of the damaged disc and to allow formation of a fusion.

Both a fusion and Mobi-C artificial disc surgery:

  • Replace the damaged disc(s)
  • Try to match a healthy disc height and to help un-trap any nerves.

Only the Mobi-C implant:

  • Tries to maintain “normal” neck movements
  • Fits entirely within the disc space