The FDA approved the use of an artificial disc replacement (ADR) in October 2004. In this report orthopedic surgeons review when and why to use the ADR. Early results and complications with the ADR are presented.
A large number of adults suffer painful symptoms from damage to the discs as a result of the aging process. Most are treated successfully with physical therapy, pain medications, and anti-inflammatory drugs. Weight loss is also advised.
Spinal fusion is often the last treatment offered. Fusions result in lost motion and breakdown of the discs next to the fusion. The ADR is used in the small number of patients who still have low back pain after conservative care has failed but before fusion.
Patient selection and surgical technique are described in this article. The surgeon’s skill implanting the ADR is important to a successful outcome. Doctors Shuff and An explain why. Damage to any of the nearby blood vessels can lead to failure. Other possible problems with the ADR are also discussed.
The authors conclude that the success of ADR today depends on the strength of the bone, spinal alignment, and patient motivation. In time the ADR will be improved so that fewer problems occur. More people will be able to take advantage of this new treatment for chronic disc-related low back pain.