Artificial Disc Replacement Surgery Australia – Professor Timothy Steele explains what cervical disc replacement surgery is like, including common symptoms for candidates, the surgery itself and recovery.
Disc replacement surgery developed as a result of problems associated with cervical fusion surgery. This is the same surgery as discectomy and anterior cervical fusion, but instead of bone, a removable artificial disc is placed in the space. We believe that artificial discs protect adjacent disc levels from developing adjacent segment degeneration. Currently, there are various brands of artificial discs on the market – Prodisc C, Servicor, Prestige and PCN. Because of the change in spinal biomechanics that occurs after fusion surgery, many patients who undergo spinal fusion surgery will develop problems at the next level in the spine called “adjacent segment degeneration”; this may require additional surgery. Up to 20% of patients may require surgery within 10 years of their initial surgery.
Artificial Disc Replacement Surgery Australia
Disc replacement surgery developed as a result of problems associated with cervical fusion surgery. Because of the change in spinal biomechanics that occurs after fusion surgery, many patients who undergo spinal fusion surgery will develop problems at the next level in the spine called “adjacent segment degeneration.” This may require additional surgery; up to 20% of patients may require surgery within 10 years of surgery.
Single Level Total Disc Replacement: Index Level And Adjacent Level Revision Surgery Incidence, Characteristics, And Outcomes
Motion-sparing surgery aims to minimize the risk of developing additional symptoms at adjacent levels after fusion surgery and reduce the need for additional surgery. Young patients have very flexible spines compared to older people. In appropriate cases, patients who require their discs to be removed for spinal cord and nerve decompression may have an artificial disc inserted instead of a spinal fusion. This can help minimize the risk of developing problems at adjacent levels after a fusion procedure.
Dr Steele reported his initial experience with cervical and lumbar disc replacement surgery at St Vincent’s Hospital in 2007. Dr Steele has one of the largest personal series of patients undergoing disc replacement surgery in Australia . He presented his results at the Neurosurgical Society of Australia meeting in September 2008. In August 2009, Dr Steele was the first surgeon in Australia to place the new CerviCore intervertebral disc prosthesis. With disc degeneration, the underlying material can swell and press on the nerves, causing the aforementioned radicular pain. The lower two discs of the spine (L4/5 and L5/S1) carry the most weight and are exposed to significant stress and pressure. They are the discs most often damaged by injury and tend to degenerate more quickly than other discs.
Lumbar arthroplasty is usually performed through the anterior approach. This technique avoids splitting the large back muscles and prevents scarring around the spinal nerves. It allows for complete removal of the damaged intervertebral disc, restoration of its height and placement of an implant with a large footprint to cover the surface of the vertebral endplates.
During the first days at home, patients are advised to avoid lifting weights over 2 kg and any strenuous or repetitive activities that may affect the back or cause discomfort. In the first weeks after surgery, regular short walks, light stretching and a healthy diet are recommended.
Dr. Schuler Performs Region’s First
The human spine is a complex structure with multiple intervertebral discs that play a crucial role in its mobility and stability. They act as shock absorbers and contribute to the flexibility and movement of the spine. Lumbar discs bear the weight of the entire body and are much larger than discs in the neck or chest. Facet joints at each level provide additional stability and protect the discs from excessive translation (spondylolisthesis).
The discs consist of a jelly-like inner part (nucleus pulposus) and an outer fibrous material called the annulus fibrosus, which supports the inner nucleus. The annulus is innervated by numerous pain receptors that signal any injury, tear, or tear. With disc degeneration, the underlying material can swell and press on the nerves, causing the aforementioned radicular pain. The lower two discs of the spine (L4/5 and L5/S1) carry the most weight and are exposed to significant stress and pressure. They are the discs most often damaged by injury and tend to degenerate more quickly than other discs.
It is estimated that 70-80% of all people experience low back pain at some point in their lives. Lower back pain can be caused by degenerated discs, facet joints, herniated discs, spondylolysis, and spondylolisthesis with or without nerve root compression. Accurate identification of the primary pain generator is critical. Natural aging of the disc (degeneration) or trauma can affect its mobility and lead to a decrease in its protective function. Structurally, it can manifest as disc protrusion forming bony spurs (osteophytes) causing pressure on nerve structures and leading to back and hip/leg pain, numbness or weakness.
Lumbar arthroplasty aims to restore the cushioning function of the damaged or degenerated intervertebral disc with simultaneous decompression of the spinal cord and nerve roots. Similar to established hip and knee replacement procedures, the evolution of artificial disc prostheses can also lead to dramatic improvements in patients’ quality of life and high levels of patient satisfaction.
Artificial Disc Replacement Surgery Videos Melbourne
Initial treatment for lumbar disc disease includes rest, gentle physical therapy, pain relievers, or anti-inflammatory medications. Sometimes spinal nerve root injections with local anesthetic or steroids may be given. Surgical treatment is considered only as a last resort to manage severe pain or neurological deficit. Different types of surgery can treat lumbar disc pathology, ranging from a simple decompressive procedure (microdiscectomy or laminotomy) to more complex interventions involving implants (lumbar disc fusion or replacement). Decompression of the spinal canal and nerve roots is primarily indicated for the treatment of neuropathic symptoms, such as leg pain. They are less effective if back pain predominates. Lumbar disc replacement and fusion are considered for patients with intractable and disabling low back pain. Fusion of the vertebrae into a solid bone (arthrodesis) helps to eliminate fastogenic discogenic pain in carefully selected patients, but hinders normal movements in the spine and exerts additional stress on the upper and lower segments. Other potential problems include failure to achieve stable bone fusion (pseudarthrosis) and complications at the bone donor site (usually the iliac crest). Some patients with radiographically confirmed lumbar fusion may still complete without improvement in back pain due to increased biomechanical stress. Therefore, motion-preserving lumbar arthroplasty has been established as an alternative option for chronic low back pain. Although total lumbar disc replacement (TDR) and fusion are similar in approach, technique, and initial results, differences become increasingly apparent over time, particularly after more than five years when adjacent segment disease becomes symptomatic in result of induced fusion. accelerated degeneration.
The possibility of receiving significant benefit from surgery depends on various factors, which will be discussed at your appointment with Dr. Aliashkiewicz.
The meta-analysis study by Deng-Yan Bai et al. (Medicine (Baltimore). 2019 Jul;98(29): Total disc replacement versus fusion for degenerative lumbar disease – a meta-analysis of randomized controlled trials) stated:
Compared with lumbar fusion, total lumbar disc replacement significantly improves ODI, VAS, SF-36, patient satisfaction, overall success, reoperation rate, successful ODI, shortens operative time, shortens hospital stay, reduces postoperative complications.
Artificial Disc Surgery: Cervical Spine
Long-term outcome studies also show that disc replacement reduces the odds of symptomatic adjacent segment degeneration by more than 50% compared with fusion. Many other studies have shown superior patient outcomes, higher patient satisfaction rates, reduced reoperation rates, fewer complications, and reduced costs after lumbar arthroplasty compared to spinal fusion in appropriately selected candidates.
It took decades of biomechanical research, engineering, and meticulous clinical studies to advance medical device technology and produce the current line of artificial intervertebral discs. Modern artificial lumbar disc implants come in a variety of shapes, sizes, heights and types of articulation. This means that an ideal implant that mimics the biomechanical properties of a healthy natural disc and perfectly relieves and transfers the load to the lumbar spine is not yet available. The perfect artificial disc should achieve the following goals:
Extensive biomechanical wear and motion testing is performed to simulate various loads and motions and ensure the durability of the implants and their components. It is estimated that the human spine undergoes more than 100 million flexion/extension cycles in a lifetime. For the minimum lifespan of an artificial disc implant of 40-50 years, it must be able to withstand at least 40 million load cycles.
Implants can be classified as constrained, semi-constrained and unrestricted. A limited disc has a mechanical stop that limits its range of motion and provides physical stability. Semi-constrained devices can move slightly beyond the physiological range of motion, and unrestricted prostheses rely only on the natural restraints of segmental motion such as the vertebral ligaments and facet joints.
Postoperative Care For Cervical Artificial Disc Replacement Surgery
Titanium is the most commonly used disc implant material, followed by cobalt alloys. The special surface treatment increases its integration with the vertebral bones:
Metal components can cause distortions (artifacts) in magnetic resonance imaging (MRI), but
Artificial disc replacement australia, artificial spinal disc surgery, artificial disc surgery, artificial disc replacement surgery cost, artificial neck disc replacement, artificial spinal disc replacement surgery, artificial disc replacement surgery cervical, artificial disc replacement surgery, lumbar artificial disc replacement surgery, artificial disc replacement surgery recovery, disc replacement surgery australia, artificial cervical disc surgery
