Artificial Disc Replacement to Treat Neck and Back Pain

Millions of Americans grapple with sore necks and aching backs every day, particularly as they grow older. One culprit: degenerative disc disease, which is part of the natural process of aging and affects everyone to some degree. As the discs in our neck and spine begin to wear out, they become less flexible – resulting in pain and stiffness.

Rick B. Delamarter, M.D., of The Spine Institute at Saint John’s, knows all about neck and back pain. As medical director of the Spine Institute, Dr. Delamarter leads the number one center in the U.S. today for artificial disc replacement surgery in the neck and spine. Most recently, he performed the first three-level cervical (neck) disc replacement surgery in the country on a 50-year-old patient, inserting three ProDisc artificial implants in between her cervical vertebrae (bones).

“Artificial disc replacement could be revolutionizing the way we treat degenerative disc disease today,” says Dr. Delamarter. “In the past, people suffering from the disease underwent spinal fusion, which leaves patients stiff and is slow to heal. With disc replacement, patients experience normal range of motion without stiffness and the recovery period is only one to two weeks.

“I believe that once the procedure is approved by the FDA, up to 80 percent of fusion surgeries will ultimately be replaced with disc replacement surgery in the future,” Dr. Delamarter says.

Currently, the artificial disc procedure is being performed in clinical trials at several centers in the U.S., including The Spine Institute. As the largest center in the U.S. for artificial disc replacement in the lower back (lumbar spine) and neck (cervical spine), The Spine Institute is the leading investigative center, with more than 200 patients currently involved in clinical trials there.

FDA approval of the procedure for the lumbar spine, which has undergone nearly 15 years of clinical trials, is expected by early 2005, according to Dr. Delamarter. Artificial cervical disk replacement is a new procedure and is available only through participation in a clinical trial such as those being performed at The Spine Institute.

With artificial disc replacement, a ProDisc implant is inserted into either the neck or spine to replace cartilage between vertebrae. Unlike spinal fusion, which fuses vertebrae together and stops motion at the location of the diseased disc, the ProDisc allows the connecting vertebrae to return to their original range of motion. In addition, artificial disc replacement avoids future degeneration of the disc above or below the implant.

How Do I Know If I Have Degenerative Disc Disease?

As we age, the discs in our spinal column begin to lose their flexibility and shock-absorbing abilities. These discs, known as intervertebral discs, are made of mostly water. They cushion each separate vertebrae of the neck and spine and absorb the stress of movement as we go about our daily routines.

In addition to age, repetitive strain and possibly genetics also play a role in causing the discs to wear and tear, leading to degenerative disc disease. And because there is little blood supply to the discs, they cannot repair themselves if injured.

As a worn disc becomes thinner, it narrows the space between the vertebrae, compressing the nerves and causing them to swell and signal pain. Pieces of the damaged disc can also break off, causing pain. Not everyone with degenerative disc disease develops symptoms, however, so it is important to consult your physician to determine a proper diagnosis of the disease.

How to tell if you simply strained your back or if you are suffering from a degenerative disc? Following are symptoms of the disease to help guide you in seeking treatment:

• You suffer from chronic low back pain with intermittent episodes of severe pain;
• The pain and stiffness increases towards the end of the day;
• Sitting down may worsen the pain more than standing;
• Bending, twisting and lifting generally worsen the pain;
• You feel pain, numbness and tingling in the legs;
• You feel pain in the neck, shoulder blades, arms and hands, as well as numbness and tingling in the shoulder and arms

For more information about artificial disc replacement surgery, you can contact Dr. Delamarter at (310) 828-7757 or visit the center’s website at www.espineinstitute.com.

To learn more about Saint John’s Health Center, please call Saint John’s at (310) 829-5511 or visit the health center’s website at http://www.stjohns.org