Artificial Disc Replacement

Artificial disc replacement is a newer surgical procedure for relieving back or neck pain. An artificial disc replaces an intervertebral disc in the spine with an artificial one (also called a disc replacement, disc prosthesis or spine arthroplasty device). The artificial disc is meant to restore motion to the spine by replacing the worn, degenerated disk. This technology has been available in Europe since the late 1980′s. Artificial disk replacement gained FDA approval for use in the lumbar spine in the U.S. in 2004.

Fusion surgery remains the “gold standard” for treating back and neck pain. Although many people with back and neck pain find relief with a typical fusion everybody is different. If a patient is a candidate for an artificial disc, then replacing the disc with the artificial disc helps the patient maintain full motion which is not the case with a fusion. A normal healthy spine allows motion at each of the discs throughout the spine. Ideally, your surgeon would like to restore your spine to this normal state. Currently the treatment for many painful spinal conditions is fusion, which eliminates motion of the painful spinal segment. Artificial discs are designed to allow motion after surgery that is as normal as possible. Also with fusion, there is a possibility that the fusion of one part of the spine forces the discs and vertebra above and/or below to carry more load and motion. This may result in more wear and tear than normal. The artificial disc may significantly reduce this risk.

There are many artificial disc designs classified into two general types: total disc replacement and disc nucleus replacement. With a total disc replacement, all or most of the disc tissue is removed and a replacement device is implanted into the space between the vertebra. With a disc nucleus replacement, only the center of the disc (the nucleus) is removed and replaced with an implant. The outer part of the disc (the annulus) is not removed.

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Good candidates for disk replacement have the following:

• Back pain thought to be caused mostly from one or two intervertebral disks in the spine
• No significant facet joint disease or bony compression on nerves
• Not excessively overweight
• No prior major surgery in that area of the spine
• No deformity (scoliosis) (spondylosis)
• No instability at that level
• No instability at that level