Dr. Ament and Amir Vokshoor, MD, debuted a 360-degree spine procedure combining Premia Spine’s Tops and Centinel Spine Prodisc-L implants. Dr. Jared Ament: It’s more than just the TOPs and disc replacement combo. If someone needs an artificial disc replacement, one of the biggest reasons they can’t get it is because their facets are bad. But like anything else in motion preservation, it’s a very interesting learning curve because it’s nuanced. How do we make an artificial disc or an artificial facet work that much better than just average?