Artificial Disc Replacement:
Is It the Answer?

The latest advance in spinal surgery is called artificial disc replacement surgery. It's still considered experimental by the FDA. Most of the research behind it has been done in Europe. But it may be the Next Big Thing in surgically treating chronic back pain.

If you are considering surgery as a last resort—and that is the only time to consider an operation—is this new procedure right for you?

First, An Anatomy Lesson

Many of you already know this, but for those who don't, let me talk a bit about the anatomy of the spine. It's important to understand the basic anatomy so you can really appreciate treatment options like this.

The spine is made up of vertebrae, which are the blocks of bone that provide the support and structure of the spine. Between the bones are spinal discs, which act like cushions or "shock absorbers" between the vertebrae.

Spinal discs are made up of two parts. The outside of the disc is a strong, fibrous material called the annulus fibrosus. This hard outside part makes contact with nerve fibers or pain receptors in the spinal column.

Inside is a jelly-like substance called the nucleus pulposus. It is made up mostly of water and proteins. And that's where degenerative disc problems arise.

As you age, the amount of water in the disc naturally decreases. This can cause the disc to flatten out and even develop tears or cracks in the hard outer part, which can cause pain. The inner jelly material can bulge out and press against the outside, which can also stimulate the pain receptors.

Replacing the Disc

As with artificial knees and hips, artificial discs replace the degenerative disc. In theory, it should also preserving motion and flexibility better than traditional spinal fusion surgery.

The artificial disk most commonly used was approved in 2004. It's made of two metal plates with teeth to anchor the implant between the bones. Between the two plates is a polyethylene core. A metal ring surrounds the outside. To implant it, the surgeon makes an incision through the abdomen to remove the degenerative disc replace it.

Who Can Have the Surgery?

Only a small percentage of patients are candidates for artificial disc surgery:

A Host of Complications

So, does it work? Because the procedure is so new, long-term results won't be known for some time. The FDA did conduct a small study of 120 patients and found that 70 percent of cases reported good-to-excellent results.

Other studies conducted in Europe found similar results, with success rates or patient satisfaction rates between 60 percent and 80 percent.

Sounds good, but as with all surgeries there are lots of potential land mines.

In addition to the usual complications associated with undergoing any surgery and general anesthesia, the complications associated with artificial disc replacement may include: