Artificial Discs as an Alternative to Spinal Fusion
Patients receiving an artificial disc replacement in comparison to patients who underwent a cervical discectomy and fusion surgery had better outcomes at 12 and 24 months, such as:
Maintained motion in the neck similar to the motion they had before surgery
Maintained or improved motor function, sensory function, and deep tendon reflexes
Greater improvement of neck pain
Lower rate of additional surgery on the same segment and on adjacent segments in the spine
Returned to work an average of 16 days earlier
Stress on the spine can lead to damaged or degenerated spinal discs, which can cause chronic pain. Oftentimes, this is treated by removing the disc and fusing the two vertebral segments together. While this intervention can result in pain relief, it also results in more limited movement and potentially more stress on other parts of the spine.
The Spinal Research Foundation studied the outcomes of artificial disc replacement in both the lumbar* (low back) and cervical (neck) spine. SRF saw improved clinical outcomes with the use of the cervical artificial disc replacement. When compared to cervical fusion surgeries, the study showed that the artificial disc had greater success in maintaining or improving motor function and reducing neck pain. This study highlighted a potential alternative treatment for patients who wish to keep their level of motion in the neck, while still reducing pain.
*The lumbar artificial disc was pulled from clinical trials by its manufacturer due to patent infringement.
Summary of artificial disc
Back pain can be managed in many different ways, including non surgical and surgical interventions. A commonly used surgical intervention is spinal fusion. However, artificial disc replacement is a potential alternative treatment for patients with pain due to compromised intervertebral discs. Artificial disc replacement is a surgical procedure that replaces a disc that is causing back or neck pain with an artificial disc that does not compromise the natural structure of the spine.
The idea behind artificial disc replacement is to preserve the motion in the spine, while removing the source of pain (a damaged or diseased disc). The artificial disc is designed to mimic the normal function of a spinal disc. The Spinal Research Foundation was part of crucial clinical trials for two different artificial discs: an artificial lumbar disc replacement, the Maverick, and an artificial cervical disc replacement, the Prestige. However, the Maverick artificial lumbar disc was pulled from clinical trials and international markets due to patent infringement.
The Prestige Cervical Disc was the first artificial disc to be approved by the FDA for use in the cervical spine. In clinical studies, patients with the Prestige system maintained motion in the neck similar to the motion they had before surgery at 24 months after the surgery. Patients with fusion surgeries often have more limited motion due to a segment of their spine being fused, so getting pain relief while maintaining freedom of motion through artificial disc replacement is a good outcome for patients.
In addition, when compared to a group that got anterior cervical discectomy and fusion (ACDF), the patients with the artificial disc treatment had a higher rate of neurological success: maintaining or improving motor function, sensory function, and deep tendon reflexes. The improvement of neck pain was greater in the patients with the artificial disc replacement. Other good outcomes from using the cervical artificial disc are as follows:
– Patients with the artificial disc replacement had a lower rate of additional surgery on the same segment.
– The rate of surgery on adjacent segments in the spine was significantly lower compared to patients that received the fusion surgery.
– Patients with the artificial disc returned to work an average of 16 days earlier than patients that received the cervical fusion.
Researchers concluded that cervical artificial disc replacement gave the benefits of cervical fusion in terms of pain relief, while avoiding the drawback of causing adjacent spine segments additional stress.