|
To fuse or not to fuse that is the question
|
|
The intervertebral disc, or the shock absorber between the vertebral bodies, can be
a source of significant back pain. In patients who have longstanding back pain that
does not respond to conservative care, fusing the disc, or welding the two vertebral
bodies together, have been traditional approaches. An interbody fusion, which means
fusing the disc space between the vertebral bodies, is a traditional means for
eliminating the back pain by stopping the motion between the two vertebral
bodies.
|
|
|
But recently, spine surgeons have asked the question, can we eliminate the pain but
preserve the motion? The artificial disk replacement (ADR) is placed between the
vertebra to eliminate pain but preserve motion. Sounds good, but is it? Although the
artificial disc has been available in Europe and utilized more commonly in the 1990s,
it is considered experimental in the United States. Currently, experimental trials
comparing the traditional fusion to the artificial disc are being performed in the
United States to try to answer the question, is an artificial disc as good as, or
better than fusing the same area?
|
|
The artificial disc must meet many demands – the materials must provide motion
and stability and last under normal wear and tear circumstances of daily life. Since
human beings come in different sizes and shapes, different sizes of artificial discs
must accommodate these differences in human dimensions. Currently four different
mechanical configurations of artificial discs are being evaluated: composite, hydraulic,
elastic and mechanical. Which design will prove superior to the others awaits the longer
tem follow-up of patients who have had the artificial disc implanted.
|
|
|
Under current circumstances, the artificial disc remains an experiment waiting for
a conclusion.
Words © 2002 William Dillin, M.D.
|
|
