Disc Replacement Surgery

I found a wonderful article by Dr. Spivak talking about disc replacement surgery. While I still see many spinal fusions being performed, disc replacement surgery has been gaining popularity over the last decade and is becoming more widely available for people who have suffered a back injury.
Please remember folks, I am not providing any type of medical opinion or recommending one surgery over another. I am ONLY providing you the information as I have found it so that you may read up on any issues or treatments that you may be facing.


Artificial Disc Replacement Surgery
By: Jeffrey M. Spivak, MD (taken from www.spine-health.com)

“Lumbar artificial disc replacement, also called total disc replacement, is indicated for the treatment of painful lumbar discs. The facet joints, which are paired and in the back of the spine at each disc level, must have little or no arthritic changes in order for the disc to be treated with artificial disc replacement, to minimize the risk of potential postoperative pain due to continued painful facet joint motion.

How is Lumbar Artificial Disc Replacement Performed?
Currently, artificial disc implants are designed to be placed into the disc space from the front and center position. To get there, the surgical approach is performed anteriorly (from the front), reaching the spine and disc working around the abdominal contents (retroperitoneal) from an incision at or near the front of the abdomen. Working behind the abdominal contents, the spine is reached by moving the major blood vessels that bring blood to and from the legs off to the side. These vessels are normally found directly on the front surface of the spine, and must be moved and protected in order to work safely on the spine. Because of these needs, a vascular or general surgeon commonly acts as co-surgeon with the spine surgeon during anterior spinal procedures such as total disc replacement.

Anterior interbody spinal fusions are commonly performed through this same approach.

What Artificial Disc Implants are Currently Available, and What are Their Differences?
The Charite artificial disc (Depuy Spine) was the first implant approved for lumbar disc replacement in the USA. It received approval by the Food and Drug Administration (FDA) for use in October of 2004. The Prodisc-L (Synthes Spine) has just recently received FDA approval (August 2006) and is just now being used clinically outside of the FDA research study. Both implants rely on metal-plastic (polyethylene) bearing surfaces.

· The Charite disc implant consists of three separate implant components, with an un-attached biconvex polyethylene central core between two metal concave implants attached to the bony endplates. The plastic center is free to move between both endplates, and moves in and out as the spine bends forward and back.

· For the Prodisc-L disc implant, the convex polyethylene component is fixed directly to the lower metal endplate component and articulates with the concave upper metal component like a ball-and-socket joint. The Prodisc implant is considered more intrinsically stable (“semi-constrained”) than the Charite design (“non-constrained”).


Two newer implants, not yet available clinically but well into their FDA trials, utilize all-metal constructs with metal-on-metal bearing surfaces and ball-and-socket configurations. These are the Maverick disc (Medtronic) and Flexicore disc (Stryker Spine). A number of other artificial disc implants are less far along in development and the FDA approval process.”

I hope you were able to take some valuable information from this article. Knowledge is power and I am always striving to provide injured workers with information to help them have a better understanding of the situations they are facing; whether it be a complex legal maneuver or information about medical care that they may be facing. Arm yourself with knowledge and, as always, be careful out there!

For more information on Virginia Workers Compensation, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.


Michele Lewane, Esq.