Intervertebral Mobile Cervical

Disc Prosthesis
D-Motion & D-Active
Surgical Techniques

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Contents

Introduction

Implant Overview

Instrument Overview

Surgical Technique

1. Preparation and Approach

2. Endplate Preparation
3. Implant Size Selection
4. Implant Insertation
5. Final Construct

Implants Size

Instrument Set

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Introduction
Norm Cervical Disc Prosthesis D-Motion, D-Active is designed to ensure the best adaptation to the
anatomic variations of patients and implanted from anterior approach technique. The goal is to place a
cervical disc during the intervertebral spinal surgery and to control the hernia and degenerative disc
disease occurring in the spinal segments

Implant Overview
The rationale for motion preservation by disc replacement with D-Motion, D-Active and D-Flex
Titanium after anterior cervical discectomy is to diminish long-term morbidity secondary to adjacent
segment degeneration. This procedure can be readily applied in patients presenting with neurologic deficit,
radiculopathy or myelopathy because the approach and anterior spinal cord decompression are identical
for anterior cervical disc replacement and traditional Smith-Robinson cervical decompression. In addition,
the application of more complex spinal osteotomies, revision of pseudarthroses and deformity correction
are much more applicable to the cervical arthroplasty procedures. D-Motion, D-Active are an attractive
alternate to arthrodesis for management of disc degeneration and herniation in the cervical spine. The
advantages of this system include preservation of normal motion and biomechanics in the previous
cervical spine and reduction of adjacent-segment degeneration. Other potential advantages include faster
return to normal activity and elimination of the need for bone graft and associated donor site morbidity.
a. D-MOTION and D-ACTIVE CERVICAL DISC PROSTHESIS
 The physical structure of the device consist titanium alloy inferior and superior pieces
 Provide saving of time and facility with applicant method.
 Tin coating avoid wear and polyethylene
 Toothed surface with pin or blade

Fig. 1 D-Motion and D-Active Cervical Disc Prosthesis

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Instruments Overview

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Surgical Technique
1. Preparation and Approach
The patient is positioned in the supine position on a radiolucent operating table. The patients’
neck is supported by a cushion in a neutral position. The procedure is performed under general
anesthesia. (Fig. 3)

Fig: 3 Supine Position

2. Endplate Preparation
The use of a CDP016 Caspar distractor might be useful: first the cervical distraction pins are positioned
using the CDP015 Pin screwdriver for CDP017 Pin. (Fig. 4) They should be inserted in the middle of the
vertebral bodies’ over- and under-lying the discal space to be treated and parallel to the endplates. All the
threads of the pins should be engaged in the vertebral bodies. After removing the screwdriver, the cervical
distractor can be slid onto the pins. (Fig. 5)

Fig: 4 Pin and Pin Screw Driver

Fig: 5 Caspar Ecator and Pins

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The vertebral plates should be prepared and cleaned carefully with a curette .When the discectomy is
complete, remove the superficial layers of the cartilaginous endplate to expose bleeding bone. This can be
accomplished with a CDP014 Raps. (Fig. 6)

Fig: 6 CPC007 Raps

3. Implant Size Selection

The disc prosthesis sizing is determined by selecting the trial that provides the most satisfactory fit in the
prepared disc space. The selection of the trials are depends on the height, width and depth of the
intervertebral space. The several different disc Prosthesis Trials and gradual trials are available in the set.
The heights can be checked by the laser-marking. They range from 5mm to 8mm. (Fig.7)

Fig.07 CDP003-CDP007 Trials and CDP008-CDP13 Gradual Trials

The appropriate trial carefully Insert into the disc space. The trial should pass into the distracted disc space
without excessive force. (Fig: 8)

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 Fig:8 Trials

4. Implant Insertation

The chosen cage is loaded onto the CDP001 Cage Holder.

Fig. 9

Insert the cervical cage into the disc space. (Fig. 9) If necessary, CDP018 Hammer can be used to help to
insert advance into the intervertebral disc space. Release the distractor and remove all instruments (Fig. 9.

5. Final Construct

Check the position of the cages using C-arm. The optimal position of the Disc Prosthesis is centered
within the periphery of the vertebral end plates. The anterior edge of the Disc Prosthesis will be
approximately 2 mm behind the anterior edge of the adjacent vertebrae, depending on the size of the
vertebrae. (Fig.10)

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Fig. 10 View Of The Positioned Disc Prosthesis

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Implant size

D - ACTIVE DISC PROSTHESIS

CODE PRODUCT NAME SIZE
NCD12-05 Norm Intervebral Mobile Cervical Disc Prosthesis Poly Ethylene Insert [12,05]
NCD12-06 Norm Intervebral Mobile Cervical Disc Prosthesis Poly Ethylene Insert [12,06]
NCD12-07 Norm Intervebral Mobile Cervical Disc Prosthesis Poly Ethylene Insert [12,07]
NCD14-05 Norm Intervebral Mobile Cervical Disc Prosthesis Poly Ethylene Insert [14,05]
NCD14-06 Norm Intervebral Mobile Cervical Disc Prosthesis Poly Ethylene Insert [14,06]
NCD14-07 Norm Intervebral Mobile Cervical Disc Prosthesis Poly Ethylene Insert [14,07]

D - MOTION DISC PROSTHESIS

CODE PRODUCT NAME SIZE
NCD1205 Norm Intervebral Mobile Cervical Disc Prosthesis Titanium [12,05]
NCD1206 Norm Intervebral Mobile Cervical Disc Prosthesis Titanium [12,06]
NCD1207 Norm Intervebral Mobile Cervical Disc Prosthesis Titanium [12,07]
NCD1405 Norm Intervebral Mobile Cervical Disc Prosthesis Titanium [14,05]
NCD1406 Norm Intervebral Mobile Cervical Disc Prosthesis Titanium [14,06]
NCD1407 Norm Intervebral Mobile Cervical Disc Prosthesis Titanium [14,07]

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Implant Set

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Norm Tıbbi Ürünler İth. İhr. San. Ve Tic. Ltd. Sti
Nasuh Akar mah.1403 Sok.No:3 Balgat 06520 Ankara, TURKEY
T: +90 312 284 00 80 F: +90 312 285 30 93

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