Featured Research

from universities, journals, and other organizations

Artificial Disc Replacement As Good Or Better Than Spinal Fusion Surgery, Study Suggests

Date:
March 5, 2009
Source:
Washington University School of Medicine
Summary:
Spine surgeons are reporting that artificial disc replacement works as well and often better than spinal fusion surgery. The two procedures are performed on patients with damaged discs in the neck.

Spine surgeons at Washington University School of Medicine in St. Louis and other U.S. centers are reporting that artificial disc replacement works as well and often better than spinal fusion surgery.

The two procedures are performed on patients with damaged discs in the neck.

Researchers found patients who received an artificial disc lost less motion in the neck and recovered faster than those who had a disc removed and the bones of the spine fused.

"Those who received the artificial disc either did equally as well or a little bit better than those who had fusion surgery," says K. Daniel Riew, M.D., a cervical spine surgeon at Washington University Orthopedics and Barnes-Jewish Hospital. "One of the most important findings was that people who got the artificial disc were able to preserve all of their motion."

A disc in the spine is similar to a jelly donut, with a squishy center surrounded by a tough outer portion. It functions like a shock absorber between the vertebrae. When a disc ruptures, or becomes herniated, the squishy disc tissue can spread into the spinal canal and press against nerves, causing numbness, weakness or pain.

For years, the surgery to treat cervical disc disease relieved pressure by removing the offending disc and then fusing the bones of the spine together. Surgery to implant an artificial disc also removes the damaged disc, but instead of using metal rods, screws and bone grafts to fuse bones together, the surgeon replaces the disc with an implant.

Patients in the study were randomly assigned to receive either the BRYAN Cervical Disc or standard fusion surgery. Ultimately, 242 received the artificial disc, and 221 had spinal fusion. Improvement following surgery was measured with a tool called the neck disability index (NDI). Two years post surgery, patients in both groups had improved NDI scores. Both had less neck and arm pain and were less likely to experience numbness. Overall, the surgery was rated as successful in 83 percent of the patients who received artificial discs and 73 percent of those who had fusion surgery (230 vs. 194). Part of that difference, Riew says, can be explained by better motion in the neck for those who had artificial discs implanted.

He says the neck is always slightly restricted following spinal fusion surgery. Since bones in the neck have been fused together, it is impossible to regain full range of motion. But the defect is subtle.

"Fusion adds a small amount of stress in the spine above and below the fusion site, so bone can break down a little faster than normal," Riew explains. "If the patient is a young person, then they may need another operation in 20 or 30 years. The hope with artificial cervical disc replacement is the preserved motion may protect against additional stress at other levels of the spine."

In the short term, Riew says most patients receiving artificial disc replacement surgery recovered faster and got back to normal life sooner than fusion surgery patients.

"They didn't need to wear a neck brace after surgery," he says. "If they had a job, they returned to work faster. And many had a resolution of their pain faster than fusion patients. With a spinal fusion, there are some pain and activity restrictions until the bone is fully incorporated, but with an artificial disc, as soon as the disc is in, it's 'good to go.'"

Riew, the Mildred B. Simon Distinguished Professor of Orthopaedic Surgery, professor of neurological surgery and chief of the cervical spine service for Washington University Orthopedics, says people from outdoorsmen to couch potatoes have seemed to do well following implantation of artificial discs. Last summer, he implanted an artificial disc into a professional baseball player's cervical spine. That player plans to return to the diamond and continue his career this season.

But at the moment, the discs are not an option for some patients. Those with arthritis or disc disease at multiple levels in the spine are not good candidates. A barrier for those who are good candidates is that many insurance companies don't yet cover them.

The study was supported by Medtronic Sofamor Danek, which manufactures the BRYAN Cervical Disc. Riew has received or will receive financial benefits from Medtronic.


Story Source:

The above story is based on materials provided by Washington University School of Medicine. Note: Materials may be edited for content and length.


Journal Reference:

  1. Heller JG, Sasso RC, Papadopoulos SM, Anderson PA, Fessler RG, Jacker, RJ, Coric D, Cauthen JC, Riew KD. Comparison of BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion: clinical and radiographic results of a randomized, controlled clinical trial. Spine, vol 34 (2)

Cite This Page:

Washington University School of Medicine. "Artificial Disc Replacement As Good Or Better Than Spinal Fusion Surgery, Study Suggests." ScienceDaily. ScienceDaily, 5 March 2009. <www.sciencedaily.com/releases/2009/02/090227130929.htm>.
Washington University School of Medicine. (2009, March 5). Artificial Disc Replacement As Good Or Better Than Spinal Fusion Surgery, Study Suggests. ScienceDaily. Retrieved October 20, 2014 from www.sciencedaily.com/releases/2009/02/090227130929.htm
Washington University School of Medicine. "Artificial Disc Replacement As Good Or Better Than Spinal Fusion Surgery, Study Suggests." ScienceDaily. www.sciencedaily.com/releases/2009/02/090227130929.htm (accessed October 20, 2014).

Share This



More Health & Medicine News

Monday, October 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Microneedle Patch Promises Painless Pricks

Microneedle Patch Promises Painless Pricks

Reuters - Innovations Video Online (Oct. 18, 2014) Researchers at The National University of Singapore have invented a new microneedle patch that could offer a faster and less painful delivery of drugs such as insulin and painkillers. Video provided by Reuters
Powered by NewsLook.com
Raw: Nurse Nina Pham Arrives in Maryland

Raw: Nurse Nina Pham Arrives in Maryland

AP (Oct. 17, 2014) The first nurse to be diagnosed with Ebola at a Dallas hospital walked down the stairs of an executive jet into an ambulance at an airport in Frederick, Maryland, on Thursday. Pham will be treated at the National Institutes of Health. (Oct. 16) Video provided by AP
Powered by NewsLook.com
Raw: Cruise Ship Returns to US Over Ebola Fears

Raw: Cruise Ship Returns to US Over Ebola Fears

AP (Oct. 17, 2014) A Caribbean cruise ship carrying a Dallas health care worker who is being monitored for signs of the Ebola virus is heading back to Texas, US, after being refused permission to dock in Cozumel, Mexico. (Oct. 17) Video provided by AP
Powered by NewsLook.com
Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

AFP (Oct. 17, 2014) All four suspected Ebola cases admitted to hospitals in Spain on Thursday have tested negative for the deadly virus in a first round of tests, the government said Friday. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins