- Anatomy of The Spine
- Back Pain in Children
- Caring for your Spine
- Emerging Spinecare Trends
- Evaluation of Spinal Disorders
- Exercise and The Spine
- Intervention - Spinal Disorders
- Intervertebral Disc
- Non Surgical Options
- Nutrition and Spinecare
- Options for Spine Treatments
- Pregnancy and Back Pain
- Prevalence of Spine Disorders
- Sleep and the Spine
- Spinecare Introduction
- Spinehealth and Disease
- Surgical Interventions
- Treatment with Medications
- Understanding Back Pain
Spinecare Topics
Intervertebral Disc
Artificial Disc Relacement
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Artificial Disc Relacement
Who should have an Artificial Disc?
The most successful and common form of treatment for disc disorders is conservative non-operative care. The chiropractic physican is playing an increasing important role in the non-operative care of the spine. Not everyone who is a candidate for disc surgery is a good candidate for disc replacement. The indications for disc replacement will vary for each type of implant. The indications for disc surgery include but are not limited to intractable discogenic pain, a disc herniation which compromises spinal nerves and/or the spinal cord, severe degenerative disc changes with loss of disc height and related pain. Typically, surgery is not considered for disc-related pain unless the pain has been present for more than 6 months and an adequate trial of non-operative care such as chiropractic treatment, physical therapy, medication, injections, and activity modification has been performed. The MRI is usually the test which is used to best identify the problems associated with disc disease. Other tests include CT, myelography and discography.
There are a number of conditions, which may prevent an otherwise good candidate from having a disc replacement procedure. These risk factors include the presence of spondylolisthesis (slippage of one vertebrae over another), thinning of the bone called osteoporosis, vertebral body fracture, a spinal tumor, history of the development of excessive scar tissue, a bleeding disorder, allergy to the materials in the device, obesity, severe arthritis of the spinal joints, pregnancy, chronic steroid use and autoimmune disease. Also, total disc replacements in the low back are usually performed by going through the abdomen. An individual may not be accepted as a surgical candidate if they have had extensive abdominal surgery or if there is any condition in the abdomen, which may increase the risk for surgical complications.
The indications for a total disc replacement versus a nucleus implant will be different. The type of artificial disc to use, will depend on many factors including the condition which is being treated and the integrity and health of the neighboring spinal segments.
There are risks associated with all surgeries including disc replacement. The complications associated with disc replacement are similar to those of other spine surgeries. The risks include but are not limited to infection, implant rejections, nerve damage, injury to nerves, injury to blood vessels, the development of painful and restrictive scar tissue, intraoperative stroke, drug mediated complications such as anaphylaxes. Long term risk include breakage of the device, dislodgement of the device, abnormal wear of material within the device, failure of adjacent bone, post-operative chronic pain, and the immune rejection of the device. As with any spine surgery there is a risk for the development of new signs or symptoms. Anyone who is a candidate for this procedure must discuss the risk and benefits associated with the procedure in detail. It is also wise to obtain a second and in some case a third opinion before making a final decision.
Artificial Cervical Disc
The artificial cervical disc has been used fairly extensively in Europe and is gaining favor in the United States. The theoretical advantage of the use of an artificial disc includes the preservation of joint motion after decompressive discectomy. It will also provide stabilization of the involved spinal segment without requiring total immobilization or fusion of the spinal segment. An artificial disc also helps to preserve the space between adjacent cervical vertebrae. This maintains the openings along the side of the spine where the spinal nerve travels. The preservation of some motion at the site of surgery will also help reduce damaging compensatory stress placed upon adjacent spinal segments which could lead to accelerated degenerative changes. There is promise for the use of the artificial cervical disc to manage degenerative cervical disc disease.
The most successful and common form of treatment for disc disorders is conservative non-operative care. The chiropractic physican is playing an increasing important role in the non-operative care of the spine. Not everyone who is a candidate for disc surgery is a good candidate for disc replacement. The indications for disc replacement will vary for each type of implant. The indications for disc surgery include but are not limited to intractable discogenic pain, a disc herniation which compromises spinal nerves and/or the spinal cord, severe degenerative disc changes with loss of disc height and related pain. Typically, surgery is not considered for disc-related pain unless the pain has been present for more than 6 months and an adequate trial of non-operative care such as chiropractic treatment, physical therapy, medication, injections, and activity modification has been performed. The MRI is usually the test which is used to best identify the problems associated with disc disease. Other tests include CT, myelography and discography.
There are a number of conditions, which may prevent an otherwise good candidate from having a disc replacement procedure. These risk factors include the presence of spondylolisthesis (slippage of one vertebrae over another), thinning of the bone called osteoporosis, vertebral body fracture, a spinal tumor, history of the development of excessive scar tissue, a bleeding disorder, allergy to the materials in the device, obesity, severe arthritis of the spinal joints, pregnancy, chronic steroid use and autoimmune disease. Also, total disc replacements in the low back are usually performed by going through the abdomen. An individual may not be accepted as a surgical candidate if they have had extensive abdominal surgery or if there is any condition in the abdomen, which may increase the risk for surgical complications.
The indications for a total disc replacement versus a nucleus implant will be different. The type of artificial disc to use, will depend on many factors including the condition which is being treated and the integrity and health of the neighboring spinal segments.
There are risks associated with all surgeries including disc replacement. The complications associated with disc replacement are similar to those of other spine surgeries. The risks include but are not limited to infection, implant rejections, nerve damage, injury to nerves, injury to blood vessels, the development of painful and restrictive scar tissue, intraoperative stroke, drug mediated complications such as anaphylaxes. Long term risk include breakage of the device, dislodgement of the device, abnormal wear of material within the device, failure of adjacent bone, post-operative chronic pain, and the immune rejection of the device. As with any spine surgery there is a risk for the development of new signs or symptoms. Anyone who is a candidate for this procedure must discuss the risk and benefits associated with the procedure in detail. It is also wise to obtain a second and in some case a third opinion before making a final decision.
Artificial Cervical Disc
The artificial cervical disc has been used fairly extensively in Europe and is gaining favor in the United States. The theoretical advantage of the use of an artificial disc includes the preservation of joint motion after decompressive discectomy. It will also provide stabilization of the involved spinal segment without requiring total immobilization or fusion of the spinal segment. An artificial disc also helps to preserve the space between adjacent cervical vertebrae. This maintains the openings along the side of the spine where the spinal nerve travels. The preservation of some motion at the site of surgery will also help reduce damaging compensatory stress placed upon adjacent spinal segments which could lead to accelerated degenerative changes. There is promise for the use of the artificial cervical disc to manage degenerative cervical disc disease.
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