views
Artificial Discs: A Promising Alternative to Spinal Fusion Surgery
The rise in back pain cases has been bringing about
the need for alternative treatment options to conventional spinal fusion
surgery. One such promising option that has been gaining traction is the
artificial disc replacement or artificial disc. Let's take a deeper look into
what artificial discs are, how they work as an alternative to fusion, and the
latest on their use and efficacy.
What are Artificial Discs?
These discs are made of an outer fibrous
ring called the annulus fibrosus that surrounds an inner gel-like substance
called the nucleus pulposus. As we age or due to injury, these discs can
degenerate leading to conditions like herniation or narrowing of the spinal
canal causing pain.
Artificial discs are metal and plastic prosthetic implants that are inserted
between two vertebrae to replace a damaged disc. They aim to restore the height
of the disc space and preserve normal spinal motion. The earliest artificial
discs were developed in the 1950s but lacked long-term durability. Modern
prosthetics consist of metallic endplates with a plastic or polyethylene
central core.
How Do They Work as an Alternative to Fusion?
Spinal fusion involves surgically fusing together two or more vertebrae,
usually with bone grafts and hardware like plates and screws, to eliminate
motion at the problematic segment and stabilize the spine. While effective for
pain relief, fusion removes spinal flexibility which can accelerate
degeneration at adjacent levels over time.
Artificial discs, on the other hand, are intended to maintain motion between
the vertebrae similar to a healthy natural disc. This helps reduce stress on
the facet joints and ligaments while preserving spinal functionality.
Proponents argue discs are able to more closely mimic the natural anatomy
compared to fusion for relief without sacrificing mobility long-term.
Latest Developments in Artificial Disc
Technology
Over the last two decades, Artificial
Disc prosthetics have advanced
significantly. Third generation devices feature improved materials like
cross-linked polyethylene that are more durable compared to earlier silicone and
metal-on-metal implants. Insertion methods with smaller incisions and
instrumentation have also facilitated less invasive procedures.
With growing clinical experience, disc replacements are now commonly used in
the lumbar or lower back region above and below the L4 and L5 vertebrae. Their
use in the cervical or neck region is also increasing though procedures there
present more technical challenges. Newer generation cervical discs feature
modular designs for customized placement. Biologic prosthetics utilizing
materials like collagen matrices are also under investigation.
Evidence on Efficacy and Outcomes
Several long-term randomized controlled trials comparing artificial discs
versus fusion have demonstrated disc arthroplasty can provide equivalent pain
relief with better functional outcomes and range of motion maintenance.
Systematic reviews and meta-analyses have also validated discs confer
advantages like reduced adjacent segment degeneration rates up to ten years
out. However more studies evaluating outcomes beyond 15-20 years are still
needed.
Complications like device migration or fracture requiring revision are reported
but uncommon. As with any surgical procedure, complications specific to disc
replacements include issues like nerve root injury. With proper patient
selection and surgical execution by experienced surgeons however, risks are
considered low. Ongoing registries are tracking long-term durability and
complication data on newer generation implants.
The Future of Artificial Discs
Overall artificial discs are an exciting advance that preserve spinal
flexibility. As material science and instrumentation evolves, discs have
potential for use in multi-level applications and in both cervical and lumbar
regions. Future prospects include biodegradable polymers, stem cell-seeded
designs and motion-preserving total disc replacements. Wider insurance coverage
amid growing evidence is also likely to increase patient access to discs over
fusion. With continued innovation, artificial discs offer promise to reshape
treatment algorithms for many spinal disorders traditionally addressed by
fusion.
In summary, artificial discs have emerged as a viable alternative to fusion
surgery with advantages in functionality and reduced adjacent segment effects
demonstrated now up to 15 years out. Improvements in biomechanics, surgical
techniques and long-term outcome data collection will further cement discs as
standard of care in carefully selected patients needing motion preservation. As
technology marches on, discs may help transform spine surgery outcomes for
years to come.
Get
more insights on- Artificial
Discs
Comments
0 comment