Spinal Disc Replacement In India
Traditional spinal surgery often uses a lumbar fusion procedure to eliminate motion at a spinal joint that has worn out. By fusing the joint, the back pain caused by the worn out joint is often alleviated. Unfortunately, spinal fusion has associated complications, among the most concerning that it can accelerate arthritis of nearby joints. A new treatment called a lumbar disc replacement has been developed to address this problem.
Lumbar disc replacement is similar to other types of joint replacement (such as hip and knee replacements). The concept is similar that the surgeon is removing a damaged joint, and replacing this with a metal and plastic implant.
The challenge has been to develop a suitable replacement for the intervertebral discs. The replacement must not only be safe to implant, reliable and long lasting, it also must have the ability to mimic the complex range of movement required of a disc implant. Efforts to find a solution to these challenges have been ongoing for more than 40 years.
Several artificial disc replacements for both the neck (cervical) and back (lumbar) spine are currently being offered to appropriate candidates at select U.S. centers.
The Cedars-Sinai Spine Center is the only major medical center facility on the West Coast involved in the Food and Drug Administration-approved study to implant, evaluate and study two new revolutionary artificial disc implants – the Bryan and the Charité SB-III artificial discs for the neck and the back, respectively. Cedars-Sinai spine surgeons have successfully implanted more than 200 devices for the treatment of degenerative disc disease.
Which Is Better?
The bottom line is that no one really knows. Lumbar disc replacements are much less commonly performed than fusion procedures. Also, people have only had disc replacements for a few year, so no one really knows how well these implants will hold up over time. Finally, there is not enough data to really know if disc replacements will prevent arthritis of neighboring joints over the years.
Spinal fusion, however, has well known potential disadvantages, including : –
- Loss of motion and flexibility
- Permanently altered motion characteristics and biomechanics
- Potential for accelerated degeneration of the discs above and below the fused level that can lead to more pain and the need for more surgery
Artificial disc replacement offers a reversible, viable alternative to fusion that possibly avoids the accepted shortcomings of fusion. By inserting an artificial disc instead of performing spinal fusion, there is the possibility of reducing damage to nearby discs and joints. This is because artificial disc replacement allows for motion preservation, near normal distribution of stress along the spine and restoration of pre-degenerative disc height.
Bryan Cervical Artificial Disc in India
The surgical procedure to implant a Bryan cervical artificial disc is similar in approach and technique to traditional cervical spine surgery that has been used for more than five decades. A small incision, usually less than an inch long, is made in the skin of the neck just off the midline of the spine. Vital structures like nerves, arteries and the esophagus (the tube that connects the mouth and the stomach) are gently pulled out of the way so the surgeon can have access to the spine.
The disc is removed using a microscope and surgical instruments made for this purpose. Once the disc has been safely removed in its entirety, the empty disc space is prepared by milling or shaping the endplates (bottom of each vertebrae) to incorporate the Bryan cervical artificial disc replacement. The artificial disc is placed while the disc space between the two vertebrae (the bones of the spine) is held open.
Once firmly in place, tension is taken off the vertebral bodies above and below compressing the artificial disc and holding it in place. Both surfaces of the Bryan cervical artificial disc are made of porous beaded titanium metal that will incorporate and encourage bony ingrowth for long-term stability. The metal endplates surround a polyurethane core and saline cushion. Care and restrictions following surgery, as well as potential complications, are similar to those that occur with spinal fusion.
