ACDR Surgery Aug 12, concerned with devices available
I've been dealing with cervical disc issues since early 2026, severe enough that I've spent 8 months working lying down. My April 2026 MRI shows large left-sided disc extrusions at C5-C6 and C6-C7 causing mild canal stenosis, ventral CSF effacement, direct indentation of the left ventral spinal cord, severe left neural foraminal stenosis, and compression of the exiting C6 and C7 nerve roots — plus a right paracentral protrusion at C7-T1 with minimal cord mass effect. No cord signal abnormality, but the mass effect and cord deformity are described as greatest at C5-C6 and C6-C7. Completed insurance-required PT with worsening symptoms, which cleared the path to a two-level ACDR with a surgeon at Duke Health on August 12.
Duke has only two institutionally approved devices: Mobi-C and Simplify. My surgeon has done high volume on Mobi-C but noted his practice has seen endplate subsidence issues with it, which is why Duke is transitioning toward Simplify. The problem is that transition is in its infancy — Simplify case volume at Duke is low, meaning my surgeon's personal experience with the device is limited. Compounding that, recent MAUDE database analyses (2024-2025) show Simplify now has the highest osteolysis rate among currently FDA-approved cervical disc devices — the only device previously ranked higher, the M6-C, was pulled from the market in February 2025. A 2025 retrieval study separately identified PEEK-ceramic bearing wear and titanium coating delamination as likely mechanisms — a failure mode that bench testing didn't predict and that tends to surface at the 5-7 year mark, exactly where Simplify sits today.
I previously got a second opinion from Virginia Spine Institute with Dr. Jazini and was genuinely impressed with him and his team. I'm now seriously considering switching back to VSI — out of network and significantly more expensive — specifically to access the ProDisc C Vivo. Its titanium coating bonds to a titanium alloy endplate rather than a PEEK substrate, making delamination far less likely than with Simplify. Its fixed-core ball-and-socket design also means articulation happens entirely at the bearing surface rather than at the implant-bone interface, distributing load more evenly across the endplate and avoiding the subsidence pattern seen with Mobi-C's mobile core. It has 225,000+ implants globally with a reported reoperation rate under 1%, and just received two-level FDA approval in October 2025. Has anyone navigated a last-minute surgeon switch specifically over device selection, or have a negative or positive experience with any of these devices?
I really would like to do what I can proactively to avoid a revision due to a device failure if possible.