Artificial disc offers new option for back pain

May 18 2005

Until recently San Diego residents with severe back pain from degenerative disc disease have had few options. But Oceanside resident Joan Steggell decided the traditional treatment, spinal fusion, was not the right choice for her. Instead she opted for an innovative new surgery at UCSD’s Thornton Hospital.

UCSD surgeon William Taylor, M.D., is one of only a few surgeons nationwide trained to replace diseased discs with implanted artificial discs. The artificial disc manufactured by DePuy Spine is made of metal and a movable high-density plastic center that, once implanted, is designed to help align the spine and preserve its ability to move. Spinal discs maintain the position of the spine, allowing patients to bend and twist. Unlike traditional fusion surgery where the surgeon accesses the spine from the backside, Taylor accesses the spine through an incision in the lower abdomen.

“By implanting an artificial disc instead of fusing the spine, the patient has more mobility after surgery,” said Taylor. “The patient doesn’t lose spinal function and is able to return to normal activities much more quickly because there’s no waiting for a fusion to heal.”

The disc was approved by the FDA in October 2004. Before then, Taylor says, when medical interventions such as physical therapy, exercise and pain medication failed, physicians turned to the traditional treatment for degenerative disc disease, spinal fusion surgery --which literally “fuses” two or more adjacent vertebrae together. Spinal fusion is the most common surgical treatment for low back pain; doctors perform over 200,000 procedures annually in the U.S. The procedure immobilizes the vertebrae, preventing further pain, but also limits range of motion. Recovery can take as long as six months, three of them in a back brace, while the vertebrae grow together to form one long bone.

Degenerative disc disease affects 10-12 million people nationwide, 30 percent of them over the age of 30. The disease occurs when the spinal discs deteriorate, losing moisture, height, and tissue integrity. The deterioration causes the vertebrae to rub against one another resulting in severe pain. The natural aging process, low back strain, chronic or repetitive trauma, and the daily stresses of sitting, bending, twisting and bad posture cause the painful condition, which can last indefinitely unless corrected.

The procedure has been available outside the United States since 1987 and has been performed on more than 7500 patients. Although artificial replacements have commonly been implanted in knees and hips, this is the first FDA approval of such a device for spinal discs.