Age, genetics and everyday wear-and-tear of routine activities eventually can contribute to damage and degeneration of the discs that cushion the bones of the spine (the vertebrae). To treat degenerative disc disease, doctors usually begin with conservative (nonsurgical) medical treatment. When conservative therapy fails, other approaches, possibly including surgery, may be recommended. Currently, the gold standard for surgical treatment of problematic degenerative disc disease is spinal fusion. This procedure attempts to permanently lock two or more spinal vertebrae together so they cannot move except as a single unit. This may alleviate pain in a motion segment.

Artifical Disc Replacement Candidates

One of the most common reasons for a total ankle replacement is rheumatoid arthritis. Other conditions that may call for total arthroplasty include osteoarthritis, a severe bone fracture or complications from previous ankle surgery. Symptoms of these conditions include severe pain and difficulty moving the ankle joint. Because the ankle is a weight-bearing joint, these conditions can make it difficult for a person to have a normal life.

The best candidates for total ankle replacement are those who are older than 50, not overweight and not extremely active. It's possible to hike, ride a bicycle or even ski after a total ankle replacement. But people who are runners or do heavy labor are not good candidates for ankle replacement. People who have diabetes, nerve problems in their legs or poor circulation also are not good candidates.

Artificial Disc Replacement Alternatives

There are multiple conservative and minimally invasive treatment options available to manage symptomatic degenerative disc disease. However, if surgery is indicated the surgical treatment of choice has traditionally consisted of a lumbar spinal fusion.

Spinal Fusion 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 has been developed as an alternative to spinal fusion, with the goal of pain reduction or elimination, while still allowing motion throughout the spine. Another possible benefit is the prevention of premature breakdown in adjacent levels of the spine, a potential risk in fusion surgeries.

Artifical Disc Replacement Outcome & Benifits

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.

Disc replacement allows a more rapid return to activities than occurs after fusion surgery. Fusion patients have limited activities during the time required for the bone graft to grow into a solid mass. Because one of the goals of artificial discs is motion, patients are encouraged to return to motion early, although at a gradual progression. Although artificial discs offer several advantages over fusion, this is a relatively new technology with no long-term randomized, controlled clinical study results. Fusion has a long-standing record of success in permanently correcting problems in the fused motion segment. Discuss both options thoroughly with your health care provider before deciding which procedure is best for you.

Artificial Disc Replacement Overview

In both traditional disc surgery and artificial disc replacement the procedure begins by removing the gelatinous disc between the vertebrae.

Once the disc is removed, two metal plates are pressed into the bony endplates above and below the space now vacated by the disc. Metal spikes hold these plates in place on the bone. Eventually bone will grow over and around the metal plates. A plastic spacer made of a polyethylene core is put between the plates. The patient's own body weight compresses the spacer after the surgery is complete. The device allows for six degrees of freedom.

Artificial Disc Replacement Recovery

Recovery from artificial disc replacement and care afterwards are much like that for other anterior approaches to lumbar spine surgery. In some cases, recovery is faster than for a traditional fusion surgery. There is less pain from the procedure and fewer complications in general. The materials used in artificial disc replacements are similar the materials used in routine hip and knee replacement surgery. The materials are designed not to cause sensitivities once in the body.

Artificial Disc Replacement Possible Risks

In addition to the potential complications associated with undergoing surgery and general anesthesia, the complications associated with artificial disc replacement may include breakage of the metal plate, dislocation of the implant, and infection.

To help minimize complications associated with the implant itself, proper selection of patients and size of implant is very important. Patients may also not improve following the procedure and may require additional surgery. Finally, like joint replacement surgery, artificial implants may fail over time due to wear of the materials and loosening of the implants. Therefore, long term studies that track the life span of the implants are needed.