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Figure 1. Lumbar Artificial Disc
Artificial disc replacement has been developed as an alternative to spine fusion. The introduction of the total disc replacement aims to relieve patient symptoms while preserving motion at the operative spinal level. The advantage of preserving motion is to minimize the stress at adjacent levels and thereby decrease the risk of degeneration of the adjacent segment.
Currently artificial disc replacement can be used for the lumbar or the cervical spine. Many different models have been developed. The majority consists of two metal plates that have teeth to anchor the implant onto the bone of the vertebral bodies. Between the two plates is a metal core or a plastic core made up of polyethylene that allows for motion. Figure 1 shows a lumbar artificial disc replacement. Figure 2 shows a cervical artificial disc replacement.
Figure 2. Cervical Artificial Disc
The clinical diagnoses for lumbar artificial disc replacement include symptomatic degenerative disc disease and post-discectomy syndrome. Post-discectomy syndrome is persistent back pain following previous surgery to remove a herniated disc. For cervical artificial disc replacement, the diagnoses include cervical radiculopathy (where the nerve root is compressed) and cervical myelopathy (where the spinal cord is compressed).
The technique to insert an artificial disc (whether in the neck or low back) is routine and safe. For the cervical spine it involves going from the front of the neck. For the lumbar spine, it involves going through the abdomen. The procedure begins by removing the gelatinous disc between the vertebrae. Once the disc is removed, two metal plates are pressed into the bony endplates above and below the space now vacated by the disc. Metal spikes hold these plates in place on the bone. Eventually bone will grow over and around the metal plates. In between the metal plates is a metal or plastic core made of a polyethylene. Figure 3 shows the artificial disc placed in the spine.
Figure 3. Artificial Disc Placed in Spine
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