Artificial Disc Surgery An Option For Select Patients

Main Category: Back Pain
Article Date: 08 Aug 2005 - 0:00 PDT

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If you are one of the estimated 65 million Americans who suffer from low back pain every year, you may be a candidate for back surgery. However, it is important to keep in mind that about 90 percent of individuals with low back pain do not require surgery. Most people can alleviate their pain through nonsurgical methods, according to the American Association of Neurological Surgeons (AANS). However, if you are one of those individuals who have tried everything else to no avail, you should educate yourself about the different types of procedures being done, including a new technology called the artificial disc.

Artificial disc surgery is an alternative to spinal fusion surgery, a common operation performed on about 200,000 people a year with degenerative disc disease in the lower back (lumbar spine). Spinal fusion surgery creates a solid union between two or more vertebrae to help strengthen the spine and alleviate chronic back pain. There are many types of spinal fusion surgery, as well as many types of instrumentation used to secure the fusion. The spine is accessed either through the back or abdomen, depending on the procedure.

"While this new technology is very promising, not everyone with intractable low pack pain is a candidate for artificial disc surgery. To be considered a candidate, you must meet very specific criteria," said Christopher Shaffrey, MD, a spine surgeon and AANS spokesperson. You must have disc degeneration in only one disc in the lumbar spine, either the disc between the fourth and fifth lumbar vertebrae or the disc between the fifth lumbar vertebra and the sacrum. You must have undergone at least six months of treatment, such as physical therapy, pain medication, or wearing a back brace, without showing improvement. You must be in overall good health with no signs of infection, osteoporosis or arthritis. If you have degeneration affecting more than one disc, or significant leg pain, you are not a candidate for this surgery. If you have had prior back surgeries, you may still be considered a candidate.

The CHARITə Artificial Disc, a product of DePuy Spine, a Johnson & Johnson Company, was approved by the Food and Drug Administration in October 2004. The disc consists of a plastic core between two chrome plates that lock into the spine. According to Johnson & Johnson, the materials should be able to withstand 80 years of wear and tear. However, there is much debate among the medical community about this, as the long-term durability of the disc is relatively unproven, even in Europe, where it has been used since 1987. In comparison to spinal fusion surgery, potential benefits of this technology include quicker recovery time, more spine mobility after surgery, less stress on adjacent discs, and no need to harvest and use a bone graft.

During surgery, an incision is made in the abdomen. Through this opening, the affected disc is removed and replaced. Since this device was approved by the FDA, more than 2,000 surgeons have undergone thorough training directly from DePuy Spine in the installation of the artificial disc. Several thousand of these surgeries have been performed in the United States. Many patients have reported very good short-term results. However, people should be aware that, like with any other surgical procedure, there are serious risks involved. "In several cases, the artificial disc slipped out of place for undetermined reasons, and this is a significant cause for concern," stated Shaffrey. When this occurs, the patient needs emergency surgery to remove the disc, and this surgery can be life-threatening due to the potential for blood loss and other complications. On the other hand, if patients who have undergone spinal fusion surgeries find that they need another operation, such revision surgeries are generally far less problematic than those after artificial disc surgery.

Potential complications after artificial disc surgery:

-- Need for additional surgery
-- Allergic reaction to the implant materials
-- Bladder problems
-- Bleeding; may require a blood transfusion
-- Blood vessel problems other than bleeding
-- Death
-- Implants that bend, break, loosen or move
-- Incision problems
-- Infection
-- Male sexual dysfunction
-- Pain or discomfort
-- Paralysis
-- Side effects from anesthesia
-- Slow intestinal movement
-- Spinal cord or nerve damage
-- Spinal fluid leakage
-- Tears of the dura (a layer of tissue covering the spinal cord)

Some of the potential risks of artificial disc surgery are common to many other types of surgery, in particular back surgeries. Long-term patient monitoring is essential to properly assess how effective and safe artificial disc surgery is in comparison to spinal fusion surgery. "While the artificial disc is groundbreaking, new technologies are already in the pipeline that may have the potential to improve upon this surgical technique," added Shaffrey.

To find out more information about neurological disorders or to locate a qualified neurosurgeon in your area, visit: www.NeurosurgeryToday.org. For a camera-ready version of this release, please visit: neurosurgerytoday.org/media/cam_ready.asp.

Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 6,800 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. All active members of the AANS are certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons (Neurosurgery) of Canada or the Mexican Council of Neurological Surgery, AC. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system, including the spinal column, spinal cord, brain, and peripheral nerves.

American Association of Neurological Surgeons (AANS)
5550 Meadowbrook Dr.
Rolling Meadows, IL 60008
United States
http://www.aans.org

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