Update on Artificial Disc Replacement (Research Article)

The main objective of an artificial disc replacement is to replace a painful disc while maintaining the natural anatomical structure of the spine. The procedure is being developed as an alternative to lumbar spine fusion.

In the U.S., clinical trials for use of artificial discs have just started and the FDA approval process is expected to take approximately two to four years.

[Editorial note: As of July 2009, the FDA has approved two artificial discs for use in the general patient population for lumbar artificial disc replacement at a single vertebral level: the Charite disc (made by DePuy) and the ProDisc-L (made by Synthes). The FDA has also approved three artificial discs for cervical artificial disc replacement: the Prestige® Cervical Disc System (made by Medtronic), the ProDisc™-C (made by Synthes), and the Bryan® Cervical Disc System (also made by Medtronic).]

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The medical community is closely following the clinical trials for other artificial disc technologies, and many spine surgeons are anticipating that artificial discs will become as advanced as other commonly used orthopedic replacement products, such as artificial hips.

Theoretical Benefits of Artificial Disc Replacement

Currently, spine fusion surgery is designed to stop the motion at a painful motion segment by removing the disc and fusing the bones together.

However, removing the disc and the motion at a vertebral segment changes the mechanics of the back (which is designed for motion and flexibility) and transfers stress to the adjacent vertebral segments. Over time, the increased stress on the rest of the spine tends to lead to degeneration at those levels, which in turn can cause a recurrence of low back pain.

With artificial discs, the theory is that replacing the damaged disc with a product that is structurally similar will maintain the natural mechanics of the spine. Like a natural disc, the goals of a prosthetic disc are to:

  • Function as a "shock absorber" in the low back
  • Share the stress applied to the low back (through normal motion, such as bending, twisting, sitting).
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