Total Disc Replacement
Disc replacement surgery is an appropriate treatment option for patients with degenerative disc disease who have ongoing lower back pain that does not respond to conservative treatments. In this procedure, a surgeon replaces the diseased disc with a synthetic one. This alleviates pain by relieving the pressure the diseased disc was exerting on the nerve. Disc replacement surgery, however, is not currently a viable treatment option for all degenerative disc disease patients. The procedure is currently limited to patients with single level disease. For those that are eligible, total disc replacement offers mechanical stability, restored mobility to the spine, and significant pain relief.
Disc replacement, pioneered in France and Germany, has been performed in Europe for the past two decades. In the US, the FDA’s Orthopedic and Rehabilitation Devices Panel just recently recommended the use of total disc replacement utilizing Link SB Charité Intervertebral Prosthesis, an artificial disc, to treat degenerative disc disease. To date, 7,000 patients have been successfully treated with the CHARITÉ Artificial Disc, which is available in more than 30 countries throughout the world.
The CHARITÉ Artificial Disc is made of two metal endplates and a polyethylene core that allows for motion and function very much like a normal disc. The Charité Artificial Disc was designed to restore disc space height, to restore motion segment flexibility, to prevent disc degeneration at adjacent segments, to reduce or eliminate pain from motion or from nerve compression, and to improve the patient’s functional activities. It was designed to be biocompatible and durable. It has a life span of 40 years (85 million cycles).
The surgical approach is typically through an anterior retro-peritoneal route. Patient positioning is important so that radiographic confirmation of the implant position can be seen easily by the surgical team. Factors critical for a good result using the Charité are proper patient selection, selecting the correct prosthesis size, and proper prosthesis positioning with the CentreLine Instruments.
Lumbar spinal fusion surgery using metal implants, bone or fusion cages is performed to treat a degenerated disc. This procedure helps reduce back pain, but limits a patient’s range of motion and may unnaturally stress adjacent anatomy. Spinal fusion is performed on more than 200,000 people each year in the United States. The CHARITÉ Artificial Disc is intended to provide an alternative to lumbar spinal fusion surgery.