Artificial Disc Replacement

Artificial disc replacement is a medical procedure in which degenerated discs in the spine are replaced with artificial ones. The procedure is primarily used to treat chronic, severe low back pain from degenerative disc disease.

Presently the standard of care for chronic pain from a degenerated disc is a spinal fusion surgery. This involves fusing two vertebrae together to remove motion in that segment of the spine, thus reducing or eliminating pain associated with the motion. The artificial disc has been developed with the goal of reducing or eliminating the pain while still allowing motion in that segment of the spine, thus retaining the original physiologic makeup of the spine. Another theoretical advantage of the artificial disc is that it should prevent premature breakdown of adjacent levels of the low spine, which is currently a potential risk of spine fusion surgery.

Artificial disc surgery is relatively new in the U.S. but has been used in many countries (mainly in Europe) for many years. In the U.S., only two brands of artificial disc have been approved for use in the general patient population: the Charite artificial disc, which is manufactured by DePuy Acromed, and the ProDisc, manufactured by Synthes. A number of other anterior artificial discs are currently in various phases of development and testing.

The ProDisc has completed clinical trials and has received FDA approval for use in the lumbar spine and general patient population. The first surgeon to perform a ProDisc artificial disc surgery in the United States was Jack Zigler, a spine surgeon at the Texas Back Institute in Plano, Texas, on October 3, 2001. The ProDisc is also in clinical trials for the cervical spine and should receive FDA approval soon.

In addition to total disc replacement, some companies are also working on developing products and methodologies to replace just the inner portion of the disc, called disc nucleus replacement. These new techniques would allow for posterior insertion and a potentially shorter surgery with fewer complications.