Lumbar Disc Replacement
There are a wide variety of new products, procedures and techniques currently in development to enhance spine surgery, and many spine surgeons believe that artificial disc technology holds real promise for significantly improving the standard of care for many patients. Published study data from the Charite trial, as well as interim comparative data from the larger ProDisc investigational study centers demonstrate improved VAS and Oswestry functional scores in arthroplasty patients. They suggest earlier return to work with better lumbar motion as compared to the control fusion group.
Traditionally, spinal fusion surgery (rather than artificial disc surgery) has been the treatment of choice for individuals who have not found pain relief for chronic back pain through conservative treatment (such as physical therapy, medication, manual manipulation, etc), and have remained disabled from their occupation, from their activities of daily living, or simply from enjoying a relatively pain-free day-to-day existence.
In the United States, over 200,000 spinal fusion surgeries are performed each year. While there have been significant advances in spinal fusion devices and surgical techniques, the procedure does not always work reliably. For example: In a review of 4,454 patients in 78 reports, Bono and Lee found the average fusion rate was 85%, and the average clinical success rate (pain reduction) was 75%. They also found that a successful spinal fusion takes a relatively long time (3-24 months, average 15 months) for healing and recuperation, and causes adverse effects on adjacent levels over time.
Premature degeneration at adjacent levels of the spine (Transition Syndrome) remains one of the more vexing problems facing spinal surgeons when advising relatively young people to consider lumbar fusion surgery.
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