Artificial Disk Replacement

Artificial Disk Replacement

Artificial Disk Replacement

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Have you been told you need an Artificial Disk Replacement?  Usually,  it means you have had neck or back pain, and have not improved with conservative treatments.  Assuming you have had appropriate treatments, but still have significant pain, artificial disk replacement may be an option for you.

But,  there are certain questions you need answered before having the artificial disk replacement procedure.

1.  Is it for my back or my neck?   Of course there is a lot of research being done on this subject.  I can say that often times,  you can find research supporting almost every position.  But, in general,  the general trend supports the theory that cervical (neck) artificial disk replacement has better outcomes that lumbar (back) artificial disk replacement.  Again,  there are many theories on why,  but the most common sense way to look at this is in terms of the original reason why we have  disks in the first place.  Disks are structures necessary to allow our spine to move our bodies, while allowing a conduit for our nerves to get from our brain to the respective body part.  As you know,  these nerves allow you to control your body functions including your muscles,  and ability to feel things.  The disks are the flexible part of your spine that allows movement, while protecting the nerves.  The disks act as shock absorbers, spacers and ligaments.

The disks in the neck need only to support the weight of the head,  But,  the disks to the lower back, must support the whole body, as well as take the stresses associated with movements of the legs.  In plain English,  the lumbar disks see alot more stress, and forces than the cervical disks.  That is why there is much more back pain than neck pain.  In this same line of discussion,  cervical artificial disk replacement is often more successful than lumbar artificial disk replacement.

2.  Are the facet joints of that particular level normal?  When you perform a standard artificial disk replacement,  you are replacing the disk structure to the front of the functional spine unit.  But,  we need to understand the motion associated with the disk, also must be coupled with motions of the two  facet joints on the back of the functional spine unit.    If you have deteriorating facet joints, or pain from those joints,  artificial disk replacement may not be your best option.

3.   Is the procedure covered by your insurance?  Artificial disk replacement is still considered experimental, or is a non-covered benefit for certain insurance companies.  Also,  not all the artificial disk replacement devices have received FDA clearance.  Please make sure you understand these issues in reference to your particular recommended artificial disk replacement.

4.  While there is some supporting data,  long term (greater than 15 years) data is still lacking.  Make sure you understand your options should the artificial disk replacement procedure is not successful.

5.  Based on my personal experience as a Spine Surgeon,  cervical artificial disk replacement shows good promise, and I am hoping long term data will show that use of these devices will decrease the development of adjacent level disease.  Lumbar disk replacement has been very successful in the hands of a few of the most  experienced artificial disk replacement surgeons.  If you are considering a lumbar artificial disk replacement,  consider seeing a surgeon with the most experience in your community.

Citations

  • Resnick DK. Long-term kinematic analysis of cervical spine after single-level implantation of Bryan cervical disc prosthesis: a review. Spine J. 2013 Jun;13(6):635-6. PubMed PMID: 23747195
  • Lehmberg J, Meyer B. Anterior cervical discectomy and implantation of an artificial disc (Prestige, Medtronic). Eur Spine J. 2013 Mar;22(3):675-7. PubMed PMID: 23430100

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Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
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