Intervertebral disc arthroplasty
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An intervertebral disc arthroplasty is a neurosurgical procedure consisting in the replacement of a damaged intervertebral disc (previously removed through a discectomy procedure) with a synthetic prosthesis; it also goes under the common name of "artificial disc replacement".
Intervertebral disc arthroplasty is an alternative to vertebral fusion procedures, which also aim to preserve vertebral stability, but limit the range of movement. The insertion of an artificial disc allows to retain the original physiologic makeup of the spine, and is expected to avoid premature breakdown of fused vertebrae (a known long-term complication of vertebral fusion surgery).
Clinical use
Intervertebral disc arthroplasty has been used for over a decade in many countries, and especially in Europe and Japan, and performed at one or two levels at the same time. On the other hand, it is not yet widely available in the United States of America, where only two brands of artificial discs have been FDA-approved for use, and only to replace a single disc at a lumbar level (either L4/L5 or L5/S1): these are Charite by DePuy Acromed and ProDisc by Synthes (the latter was investigated by Jack Zigler). A third brand (Prestige) has been tested in a U.S. clinical trial for cervical arhtroplasty, and patients have been found to show "improved neurological success at 24 months and improved overall success".[1] Two-level disc replacement is even rarer in the United States.
Partial intervertebral disc arthroplasty
Intervertebral disc arthroplasty is usually performed to replace one or more whole intervertebral disc ("full" disc replacement), but partial replacement techniques are also under development to replace only the nucleus pulposus (the central, softer portion of the intervertebral disc).
External links
- Spine patients around the world discuss artificial disc replacement (moderated by the Arthroplasty Patient Foundation)
- Columna Homepage A new and innovative approach to minimally invasive disc replacement.
- FDA approves artificial discs
- Video of artificial disc surgery at Google Video
Surgery, Nervous system: neurosurgical procedures | |
|---|---|
| Skull, brain, and cerebral meninges | Craniotomy - Decompressive craniectomy - Lobotomy - Hemispherectomy - Ventriculostomy - Anterior temporal lobectomy |
| Spinal cord and spinal canal | Spinal cord and roots (Cordotomy - Rhizotomy) - Intervertebral discs (Discectomy - Intervertebral disc annuloplasty - Intervertebral disc arthroplasty) - Vertebral bones (Laminotomy - Laminectomy - Laminoplasty - Corpectomy - Facetectomy - Foraminotomy - Vertebral fusion - Vertebral fixation) - Lumbar puncture |
| Cranial and peripheral nerves | Ganglionectomy - Nerve block |
| Sympathetic nerves or ganglia | Endoscopic thoracic sympathectomy |
| Other | Axotomy - Hypophysectomy - Vagotomy |
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
