But is this procedure right for you?
In this article, we look at the pros and cons of artificial disc replacement surgery for chronic degenerative disc disease.
What You Should Know About Artificial Disc Replacement
Dr. Michael Hasz, spine surgeon at the Virginia Spine Institute, discusses five points on performing the artificial disc replacement surgery and what’s in store for the procedure over the next few years.
Michael Hasz, MD, FACS, is a spine surgeon at The Virginia Spine Institute in Reston and was among the first spine surgeons to perform an artificial disc replacement as part of a Food and Drug Administration trial approximately 10 years ago. Now, the Synthes ProDisc is approved for market use but it is still a foreign procedure for many surgeons around the country. Dr. Hasz discusses five points on performing the artificial disc replacements and what’s in store for the procedure over the next few years.
1. Appropriate indications for artificial disc replacements. Not all patients will benefit from artificial disc replacements, and it is important for surgeons to recommend the appropriate patients for this procedure. “It makes a huge difference for patients with the right indications and expectations,” says Dr. Hasz. “The people who benefit from artificial discs currently are those with one-level disc disease who have failed non-operative treatment.”
Patients usually undergo three to six months of physical therapy and receive epidural injections before resorting to surgical intervention. To qualify for artificial disc replacement, a surgeon must identify the disc as the source of the patient’s pain. The patient can’t have arthritis, osteoporosis, spondylolisthesis or any other condition that might cause unsteadiness in the spine. “As long as they don’t have any gross instability, we will be able to perform the artificial disc replacement that allows patients to maintain motion in their backs,” he says.
2. Performing the procedure. The artificial disc replacement using ProDisc is a minimally invasive anterior procedure where the surgeon makes a small incision along the bikini line. The surgeon works through the front of the patient’s body to access the spine without disrupting any muscle. “This approach allows surgeons to go through a tissue plane they can dissect easily to access the spine,” says Dr. Hasz. “We then use small retractors so we can see the area we want to see. With less disruption, the patient is often able to go home the day after surgery.”
Once the surgeon has access to the disc space, the damaged disc is removed and the disc space is mobilized and. The surgeon uses an X-ray while inserting the artificial disc to make sure it’s placed in the correct spot. Surgeons must be more precise in the artificial disc replacement procedure than with fusions because if the disc is slightly misplaced, it could cause major complications for the patient.
“You want to have the artificial disc in the right position so the spine will pivot correctly,” he says. “The ProDisc is designed to be motion preserving; not to provide more motion than the patient had before. In theory, it will protect the spine above and below the artificial disc because the back will be allowed the same range of motion as before. There has been a lot of work done to create a disc that moves as similarly to the normal disc as possible.”
3. Insurance coverage for the procedure. Even though insurance companies don’t reimburse well for the disc replacement, there are several cost-saving factors to the procedure that may encourage broader coverage in the future. For example, patients undergoing conservative treatment without good results may spend several months receiving the same treatment when they might benefit from a one-time surgical procedure that would cost less in the long run.
(Read full article)
Artificial Disc Replacement Video
The Spine Institute in California has done more PRODISC® artificial disc replacement (ADR) surgeries than any other institution in the US. What is it? The FDA Approved PRODISC®-L Total Disc Replacement is an artificial intervertebral disc made from m…
What Patients Are Saying About Artificial Disc Replacement on Twitter
@KeithOlbermann Had 2-level artificial disc replacement surgery on S1-L5 & L4-L5 by Dr. Rick Delamarter at Cedars-Sinai. I’m fixed!
By 62miles at 08/17/2011 20:07
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Patients’ Guide To Artificial Disc Replacement
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