Artificial Disc Replacement--Evolutionary Treatment for Degenerative Disc Disease

Essay by bhuittCollege, UndergraduateA+, October 2009

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Degenerative disc disease conservative treatment is the treatment I would recommend unless you are in severe pain. If your pain is severe then you may need surgery. There are different treatments for degenerative disc disease.

Degenerative disc disease occurs when an IVD becomes worn out because of aging or as a result of cumulative damage or trauma. With degenerative disc disease, the disc does not correctly cushion the vertebrae and distribute body weight. Discs can wear out, tear, bulge outward, or rupture causing pressure on the nerve roots that results in nerve impingement, inflammation, and pain. Nerve impingement can cause numbness and muscle weakness of extremities, sciatica, and even bowel or bladder problems. If this is left untreated, permanent nerve damage may occur. As discs wear down, bone spurs may form on the vertebrae in a condition similar to osteoarthritis. Disc back pain generally is mechanical in nature and is made worse by sitting, lifting, standing, jumping, or any activity that causes rotation of the spine.

About 50% of people older than 40 years of age have degenerative disc disease. If your pain is not severe, then conservative treatment maybe the right choice for your back pain, these are a few conservative treatments.

CONSERVATIVE TREATMENT FOR DEGENERATIVE DISC DISEASERest until the pain has decreasedMoist heat to the affected areaMuscle relaxant medications to treat pain-related muscle spasmsSteroid medications to relieve inflammation and painPhysical therapyIf these conservative treatments are unsuccessful then surgery is the next step. There are two types of surgery for degenerative disc disease.

Spinal fusion currently is the treatment of choice for patients with degenerative disc disease in the United States. In spinal fusion, the diseased disc is removed, and either bone via an iliac bone crest harvest or donor bone is placed in the space to create a bony fusion between the vertebrae. Often, pedicle screws, rods, are implanted to add stability to the spine. This method isolates and immobilizes the painful motion segment of the spine and also halts the degenerative process at that level. Although, spinal fusion is designed to limit the movement of the painful joint segment, it may lead to increased stress and motion in the disc above and especially below the fused area, often leading to an accelerated degenerative process in those areas. Many patients have pain relief after undergoing a spinal fusion. With a spinal fusion you may be out of work for a while. The normal recovery time is three to six months.

Artificial disc replacement offers an alternative to spinal fusion for treatment of degenerative disc disease. At these levels and is designed to preserve spinal motion and recreate the natural function of the disc. In Artificial disc replacement a 4-cm to 6-cm skin incision is made below the belly button using a left retroperitoneal approach. A vascular or general surgeon trained in spinal access usually provides spinal access and isolates the iliac vein and artery. After spinal access and visualization have been established, the orthopedic or neurosurgeon performs a complete discectomy at the designated level and uses special, long instruments to test the intervertebral space for proper size, placement, and lordotic angulation of the implant. The surgeon prepares the vertebral bodies for the endplates and uses a special inserting instrument to place the endplates in the space as the space is distracted. He or she uses an impactor to manually engage the teeth located on the endplates into the upper and lower vertebrae of the spine segment. The surgeon tests the polyethylene sliding core and then places it between the two endplates. The axial force of the body keeps the device in place. The radiology technologist performs fluoroscopy so that the surgeon can verify the correct position of the artificial disc in the AP and lateral planes. After surgery, the patient is discharged from the hospital on approximately the fourth day if there are no complications. With artificial disc replacement, the normal recovery time is only three to six weeks.

These are the different treatments for degenerative disc disease. I would recommend you try a conservative treatment first, unless you are in severe pain then you may need surgery. If you need surgery, I would recommend artificial disc replacement. The recovery time for artificial disc replacement is much shorter then a spinal fusion.

Work CitedBajnoczy, Susan. "Artificial disc replacement: evolutionary treatment for degenerative disc disease." AORN Journal 82.2 ( 2005): 191-204. General OneFile. Gale. Spartanburg Community College. Lib. 5 October .2009.