Why is this procedure being performed, why is it necessary?
Degenerated intervertebral discs accumulate lactic acid causing pH levels to fall as low as 5.75 and this lactic acid alters cellular activity by down-regulating proteoglycan and up-regulating enzymes that degrade the extracellular matrix. A low pH impairs the ability of proteoglycan to bind water thereby causing the disc to degenerate. The degeneration continues until it sometimes becomes painful and ultimately requires injections and other conservative pain management interventions. When the pain management no longer works the disc continues to degenerate until fusion is required to alleviate the pain and restore the disc height. Intradiscal surgery like FehrFix is undertaken before it gets to the stage where fusion is required, potentially saving a larger operation.
What is the purpose of the implant?
The FehrFix implants (there are up to five that are implanted) introduce a hydrophilic material to the disc nucleus increasing the volume of fluid in the nucleus thereby restoring the pH to natural levels and restoring the elasticity and height of the disc. This serves to reduce the pain of the patient and slowing the degeneration potentially to a level where fusion may not be required in the future
What is the cost of this implant?
The FehrFix procedure kit list price is £1,695 and this includes all of the implants needed to do one level plus all of the instruments needed for the approach, introduction and implantation
Is it a stimulator?
This is not a stimulator. It is up to 5 implants placed in the disc nucleus to restore disc height and pH levels, reducing pain and disc degeneration, thereby delaying or avoiding a fusion
Has it been recommended by NICE? AND What clinical evidence is there?
The FehrFix implants have not been available in the UK for long and data is still being collected. There are two patient series of 13 and 17 patients, showing pain relief of 77% and 88% respectively. The experience in Germany and Europe is somewhere near 300 patients with zero complications and similar lain relief as seen in the two patient series
What is the catalogue number for this implant?
The catalogue number is 600-1020-5-S