Featured Research

from universities, journals, and other organizations

Artificial disc a viable alternative to fusion for two-level disc disease, study finds

Date:
May 20, 2011
Source:
Cedars-Sinai Medical Center
Summary:
When two adjacent discs in the low back wear out, become compressed and cause unmanageable pain, numbness or other symptoms, replacement with artificial discs can be a viable alternative to standard fusion surgery, based on two-year post-surgery data from a randomized, multicenter trial.

When two adjacent discs in the low back wear out, become compressed and cause unmanageable pain, numbness or other symptoms, replacement with artificial discs can be a viable alternative to standard fusion surgery, based on two-year post-surgery data from a randomized, multicenter trial recently published in the Journal of Bone and Joint Surgery.

Previous studies have compared single-disc replacement with fusion but this is believed the first to evaluate the two forms of treatment for two contiguous discs, said Rick B. Delamarter, MD, vice chair for Spine Services in the Department of Surgery and co-medical director of the Spine Center at Cedars-Sinai Medical Center. He is the article's first author.

As part of the approval process for a specific artificial disc (the ProDisc-L), the study was designed to meet Food and Drug Administration criteria comparing overall results from a disc replacement patient group with those of a fusion group. Those comparisons found the two therapies comparable in terms of outcomes deemed favorable, but Delamarter said individual patient outcomes suggest the disc replacement operation may have advantages.

"Overall, 24 months after surgery, patients in both groups had less pain and were able to reduce their use of medication, but the percentages were higher in the disc replacement group. Seventy-three percent of disc replacement patients met the study's pain improvement criteria, compared with less than 60 percent of the fusion patients. Of these, only 19 percent in the disc replacement group continued to need narcotics for pain, compared with 40 percent in the fusion group. Also, more disc replacement patients said they were satisfied with their outcomes and would choose to have the surgery again," Delamarter said.

The article reported that disc replacement operations were quicker and resulted in less blood loss, hospital stays were shorter and patients experienced more rapid improvement.

Discs act as cushions between the bones (vertebrae) of the spine. When healthy, they have enough "give" to allow the back to be flexible but they are firm enough to provide stability. With age or injury, they can lose their pliability and density. Nerves may become pinched between the bones, causing pain not just in the spine but in other parts of the body.

Fusion surgery is intended to relieve symptoms of degenerative disc disease by removing the damaged disc and replacing it with bone. Rods and screws are attached to the spine to hold the bones in place while the vertebrae grow together (fuse). Studies show these procedures often can be effective in certain situations but there can be drawbacks: fused sections of the spine can lose their flexibility, potentially impeding normal movement and putting greater stress on the surrounding discs. The adjacent discs then can be prone to injury, often requiring more fusion surgery.

Artificial discs are designed to maintain natural spine movement. They may reduce the need for follow-up surgery.

"Although our data extend two years out from surgery, fully evaluating the benefits or disadvantages of either procedure will require longer follow-up to detect adjacent-level disc degeneration and possible device wear," said Delamarter, who joined Cedars-Sinai in 2009.

In a commentary on the article in the same journal, Andrew J. Schoenfeld, MD, of the William Beaumont Army Medical Center in El Paso, Texas, said the authors "are to be commended for an important work that contributes substantially to the growing literature regarding total disc replacement. While it has limitations, the work of Delamarter et al. should be recognized as the first prospective, randomized study on two-level total disc replacement and one that highlights short-term clinical advantages for the procedure, such as accelerated rehabilitation and enhanced pain relief."

The study included 237 patients treated from January 2002 to June 2004 by 38 spine surgeons at 16 sites across the United States. It was funded by Synthes USA, the device manufacturer. Delamarter is a consultant for Synthes and receives royalties on the ProDisc devices, but he does not receive royalties on any patient he sees or treats.


Story Source:

The above story is based on materials provided by Cedars-Sinai Medical Center. Note: Materials may be edited for content and length.


Journal References:

  1. R. Delamarter, J. E. Zigler, R. A. Balderston, F. P. Cammisa, J. A. Goldstein, J. M. Spivak. Prospective, Randomized, Multicenter Food and Drug Administration Investigational Device Exemption Study of the ProDisc-L Total Disc Replacement Compared with Circumferential Arthrodesis for the Treatment of Two-Level Lumbar Degenerative Disc Disease: Res. The Journal of Bone and Joint Surgery, 2011; 93 (8): 705 DOI: 10.2106/JBJS.I.00680
  2. A. J. Schoenfeld. Commentary on an article by Rick Delamarter, MD, et al.: 'Prospective, Randomized, Multicenter Food and Drug Administration Investigational Device Exemption Study of the ProDisc-L Total Disc Replacement Compared with Circumferential Arthrodesis for the Tr. The Journal of Bone and Joint Surgery, 2011; 93 (8): e41 DOI: 10.2106/JBJS.J.01847

Cite This Page:

Cedars-Sinai Medical Center. "Artificial disc a viable alternative to fusion for two-level disc disease, study finds." ScienceDaily. ScienceDaily, 20 May 2011. <www.sciencedaily.com/releases/2011/05/110520174637.htm>.
Cedars-Sinai Medical Center. (2011, May 20). Artificial disc a viable alternative to fusion for two-level disc disease, study finds. ScienceDaily. Retrieved October 21, 2014 from www.sciencedaily.com/releases/2011/05/110520174637.htm
Cedars-Sinai Medical Center. "Artificial disc a viable alternative to fusion for two-level disc disease, study finds." ScienceDaily. www.sciencedaily.com/releases/2011/05/110520174637.htm (accessed October 21, 2014).

Share This



More Health & Medicine News

Tuesday, October 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

How Nigeria Beat Its Ebola Outbreak

How Nigeria Beat Its Ebola Outbreak

Newsy (Oct. 20, 2014) The World Health Organization has declared Nigeria free of Ebola. Health experts credit a bit of luck and the government's initial response. Video provided by Newsy
Powered by NewsLook.com
Another Study Suggests Viagra Is Good For The Heart

Another Study Suggests Viagra Is Good For The Heart

Newsy (Oct. 20, 2014) An ingredient in erectile-dysfunction medications such as Viagra could improve heart function. Perhaps not surprising, given Viagra's history. Video provided by Newsy
Powered by NewsLook.com
Ebola Worries End for Dozens on U.S. Watch Lists

Ebola Worries End for Dozens on U.S. Watch Lists

Reuters - US Online Video (Oct. 20, 2014) Forty-three people who had contact with Thomas Eric Duncan, the first person diagnosed with Ebola in the U.S., were cleared overnight of twice-daily monitoring after 21 days of showing no symptoms. Rough Cut (no reporter narration). Video provided by Reuters
Powered by NewsLook.com
CDC Calls for New Ebola Safety Guidelines

CDC Calls for New Ebola Safety Guidelines

AP (Oct. 20, 2014) Centers for Disease Control and Prevention Director Dr. Tom Frieden laid out new guidelines for health care workers when dealing with the deadly Ebola virus including new precautions when taking off personal protective equipment. (Oct. 20) Video provided by AP
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