Disc Arthroplasty Essay

Degenerative record disease grow been a problem for many people as this disease brings about down in the mouth back pain that seems to paralyze the working force, the middle adulthood parkwealth (Smeltzer, 2004). Not only does it bring impaired quality of life to those who offer from it, but Arvind Kulkarni adds large health care expenses to the list of problems brought about by this disease as seen in his article entitle Prosthetic lumbar dish aerial replace handst for chronic dish antenna disease.Spinal fusion, which is the medical exam centering for degenerative track record disease, has been criticized by several doctors in the practice pay adapted to its untoward effects in the patients over all(prenominal) convalescence and lifetime improvement. Specialist in the field, Christoph Siepe, identified these unpleasant effects as accelerated adjacent system degeneration, pseudarthrosis, spinal backal stenosis, and donor billet morbidity. Adjacent segment degeneratio n, as mentioned by Peter Ullrich in his article entitled jointure versus stylised record book Arthroplasty for Lumbar Degenerative Disc Disease, stated that this is the major complication of spinal fusion and the reason why most surgeons want this procedure replaced.Adjacent segment degeneration or ASD happens when mechanical stress is transferred to the adjacent segment, also mentioned by Peter Ullrich. nevertheless research showed that this procedure can be special to show to a greater extent positive results. An anterior lumbar interbody fusion showed a low detail of revision surgery needed, which meant low frequency of adjacent segment degeneration, all pointed out in Mr. Ullrichs paper. However, to achieve this import, Mr. Ullrich declared that in that location should be an improvement in patient selection and in the procedure. The patients should be those patients having degenerative disc disease in their 5th lumbar to 1st sacral segment, because there is minimal motio n at this level.By doing so, he states that fusing these segments do non change the patients mobility as much. But not all are satisfied of this result. Doctors and specialists are continuously making efforts to wholly changing the primary medical management for degenerative disc diseases. Studies have been conducted, and several replacement procedures were approved by the FDA. Peter Ullrich stated in his paper that the total disk replacement procedure was approved for medical use by the FDA in the year 2004 using the Charite artificial disc but for only one level of the spinal vertebrae, existence the L4 L5 or the L5 S1.This is not the showtime time that a total or incomplete disc replacement was done. The history of this procedure was mentioned in an article in a website by Spine-Health that disc nucleus replacement was done first in 1955 by David Cleveland by injecting methyl-acrylic. Ever since then, there have deuce other FDA approved products aside from the Charite, the website Spine-Health states that the Prodisc was approved on August 2006 and the Kineflex lumbar on June 2005. A total disc replacement is be exposit by Jose Reyna in his article, Advances in Artificial Disc Technology, as being composed of two pieces of plates made of metal that has teeth to be able to attach itself to the end plates of the vertebral bones above and below it. This pith that the particular intervertebral disc that is causing pain has to be aloof and replaced by an artificial disc. Several artificial discs have been developed by various manufacturers in the country and they only differ in material body and composition. The Charite, as mentioned earlier, is made up of a unique sliding middle with two metal devalue end plates.The Prodisc being based on spherical articulations is made up of cobalt chromium molybdenum alloy as stated in the website Spine-Health. Inventors Qi-Bin Bao and Paul Higham developed a hydrogel prosthetic nucleus made up of PVA powder and a resolving mixed together, as seen on the article, Hydrogel intervertebral disc nucleus with small-scale lateral bulging. The total disc replacement procedure has its advantages and disadvantages. Even by and by some models being approved by the FDA, it is still being assessed well by specialists in the field. Charles Rosen and Douglas Kiester report poor results and complications in the total disc replacement procedure.As it was mentioned in their study, this procedure causes fractures, severe pain, dislocations, extrusion of the implant, view joint degeneration, and unexplained radiculopathy. They attribute these substandard results to the fact that the center of rotary motion of segmented motion is erroneous. Jose Reyna Jr. also mentions several disadvantages of the procedure in his study, stating that the anterior approach to the surgery can cause injury to the aorta and the common iliac vessels, can cause retrograde ejaculation in men by injuring the superior hypogastri c plexus, hemorrhage can result from the retroperitoneal approach, and infection can occur.However, he also stated some advantages, as this procedure is verbalize to maintain range of motion in majority of the patients as a long-term outcome. There are still a lot of studies to be conducted, and patients to be experimented on. A three year study conducted by Christoph Siepe et al., entitled Clinical Results of Total Lumbar Disc Replacement With ProDisc II Three-Year Results for distinct Indications, intended to assess total disc replacement outcome in patients who actually underwent the operation. Their results showed that not all degenerative disc diseases can be treated with this medical management.The best outcome was seen in patients exhibiting degenerative disc disease condition plus soft disc herniation or nucleus pulposus prolapse. Outcome was measured against the patients improvement from their surgical levels. There were inferior results from the patients who had bisegme ntal damages, and a higher complication rate. Also it was mentioned that the younger patients, more specifically those aged below forty exhibited better outcome than those older than forty. Technology like this is still being developed, studied and modified as we speak. What is important is that there are people out there who care and who try to make a difference, whether it is by inventing, criticizing or being the experimental person wherein these new devices will be made a reality.ReferencesCharles Rosen, Douglas Kiester, Thay Q. Lee The Potential Biomechanical Etiology for Lumbar Disc Replacement Failures criticism of 24 Patients and the Rationale for Revision . The Internet Journal of Minimally encroaching(a) Spinal Technology. 2007. Volume 1 Number 2.Medscape. (2002). Advance in Artificial Disc Technology. Retrieved January 22, 2008 from http//www.medscape.com/viewarticle/445057Medscape. (2002). Clinical Results of Total Lumbar Disc Replacement With ProDisc II Three-Year Re sults for Different Indications. Retrieved January 22, 2008 from http//www.medscape.com/viewarticle/542479Neurology India. (2005). Prosthetic Lumbar disc replacement for degenerative disc disease. Retrieved January 22, 2008 from http//www.neurologyindia.com/article.asp?issn=0028-3886year=2005volume=53issue=4spage=499epage=505aulast=KulkarniNeurospine. (no indicated year). Fusion versus Artificial Disc Arthroplasty for Lumbar Degenerative Disc Disease. Retrieved January 22, 2008 from http//www.neurospinewi.com/newsletters/fusionvsartificial.htmlPatent Storm. (1996). Hydrogel intervertebral disc nucleus with diminished lateral bulging. Retrieved January 22, 2008 from http//www.patentstorm.us/patents/5534028-fulltext.htmlSmeltzer, S. and Bare, B. (2004). Medical-Surgical Nursing. Philadelphia Lippincott Williams & Wilkins.Spine-Health. (1997-2007). Lumbar artificial disc surgery for chronic back pain. Retrieved January 22, 2008 from http//www.spine-health.com/research/discupdate/artifi cial/artificial01.html