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There has been much talk in the media recently about a developing technology for back pain sufferers - artificial discs. Artificial discs have been designed to replace discs in the spine that are damaged due to severe degenerative disc disease. Like hip, knee, and other joint replacement surgeries, artificial discs may prove to be the answer for people with certain types of spinal conditions. While artificial discs have been used in Europe for the last 10 years, currently none are available in the US except in special investigational trials at a small number of centers.
What are artificial discs?
As the name implies, artificial discs resemble normal human discs. Healthy human discs serve as cushions between the spinal vertebrae, to absorb stress and shock from movement and to protect the vertebrae from grinding against one another. These intervertebral discs degenerate as part of the normal aging process. As they degenerate, the discs can flatten, causing nerve impingement, inflammation, and pain. Disc degeneration can also cause pain as the vertebral bones begin to press against one another. This pain is exacerbated by motion, such as bending, twisting and lifting.
Artificial discs are designed to fit into the damaged disc space in order to restore disc height, improve mobility and flexibility, and eliminate pain. There are several types of artificial discs. The discs are made of surgical grade metal (such as stainless steel or titanium). Some also include a soft, pliable inner material made from polyethylene.
Why are they used?
Degenerative disc disease is a common ailment that affects 40-50% of the over-40 population. Disc degeneration is usually treated with non-operative care, such as bed rest, pain management, and physical therapy. However, when conservative treatments fail, patients with severe degenerative disc disease often need fusion surgery to increase stability and strength, restore height, and reduce pain. This type of surgery involves removing the degenerated disc, harvesting small pieces of the patient's own bone (taken from other parts of the body, such as the pelvis) and using it to fuse together damaged vertebrae. The procedure may also include the use of special spinal instrumentation to help facilitate the fusion.
The use of artificial discs may be an alternative to fusion surgery. Instead of removing discs and fusing vertebrae together, the damaged discs will simply be replaced with artificial discs.
Who can benefit from artificial discs?
Patients with severe degenerative disc disease in either the cervical or lumbar spine, especially if accompanied by spinal cord compression, would benefit from artificial discs. However, since not all patients are suitable for this technology, assessment by a skilled spinal surgeon is essential.
What are the current concerns about artificial discs?
The use of artificial discs in other countries allows us to conclude that they are safe to implant. In addition, early results from the current clinical trials in the United States are promising. However, there are still questions that remain unanswered. What happens to the discs over time? How long do they last? Will they wear out? Will they need to be replaced? Further study is still needed before we have answers to these questions.
On the horizon
The use of artificial discs is an exciting area of study and gives the promise of a new and better treatment option for degenerative disc conditions. At the San Diego Center for Spinal Disorders (SDCSD), we remain optimistic that they will prove to be a useful tool for spine surgeons. However, we also know that this technology will not be the answer for everyone. As with any new technology, misinformation abounds and patients should not be swayed by exaggerated claims they may hear in the media.
At our practice, we only adopt new technologies and techniques when their safety and quality are clearly proven. However, once these technologies have been deemed successful, we are at the forefront of providing them for the benefit of our patients.