Artificial Disc for Degenerative Disc Disease

Author: V. Dimov, M.D.
Reviewer: S. Randhawa, M.D.

A 45-year-old male with a severe degenerative disc disease (DDD) of the lumbar spine continues to complain of back pain. Physical therapy, NSAIDs and opioids relieve the pain only temporary. He has had lower back pain (LBP) for 9 months.

Past medical history (PMH)

Negative apart from LBP due to DDD.

Medications

Aleve (naproxen), Percocet (oxycodone and acetaminophen).

What would you recommend?

The patient was referred to a spine surgeon who recommended an artificial disc.

What is an artificial disc?

The Charite™ artificial disc is an alternative to spinal fusion for patients who have one diseased disc between L4 and L5 or between L5 and S1.

The artificial disc was originally developed at the CHARITÉ University Hospital in Berlin, Germany in 1980's.

Spinal fusion joins the vertebrae above and below the disc into a single immobile segment. The advantage of Charite disc placement is that patients can recover quicker and retain far more flexibility as compared to spinal fusion.

How is the surgery performed?

The placement of the artificial disk is done through an abdominal incision as opposed to the spinal fusion which requires an approach from the back.

A vascular surgeon is often present during the Charite disk placement to make sure that major vessels (aorta and vena cava) and not affected by mistake.

Who qualifies for artificial disc surgery?

- patients with diseased disc between L4 and L5 or between L5 and S1
- patients who have failed at least six months of conservative treatment

Who does not qualify for for artificial disc surgery?

- disc deterioration or instability at more than one spinal level
- osteoporosis or osteopenia

What happened?

The patient had a Charite disc placement and an uneventful recovery.

Final diagnosis:

Artificial Disc Placement for Degenerative Disc Disease.

References

Charitedisc.com
Prospective randomized study of the Charite artificial disc: data from two investigational centers. Spine J. 2004 Nov-Dec;4(6 Suppl):252S-259S
Artificial Disc Offers New Hope for Treating Back Pain. Listen to NPR story.
For Back Pain, Few Easy Answers on Surgery. Listen to NPR story.
Image source: Medgadget

Published: 07/01/2004
Updated: 02/22/2010

10 comments:

  1. This is just free advertising for the artificial disc--not a case study. The lawsuits are pouring in from the clinical trials for all companies. I have a close friend who got fired from one of these companies because he refused to falsify data and threatened to go to the FDA. The company was hiding adverse events from the FDA.

    ReplyDelete
  2. I had L4-5 & L5-S1 disk's replaced
    in Feb 06, 11 months later and having as much if not more pain now then prior to surgery.
    Scared to death now about what the future holds.

    ReplyDelete
  3. Do't do it. I had L5-S1 replaced when the L4-5 was also bad. should have had duel fusion on both levels. Now no doctor wants to touch me and in more pain than before.Just don't do it if your thinking of it.

    ReplyDelete
  4. I was injured at work having been impacted by a large log on the head and rolled over my body..progressive back problems for years and still fighting comp board. I did quite a bit of physio, chiropractic and acu and some of the dangerous drugs like vioxx and neuronton was sheduled for cortizon injection for a bout a third of my lower back from s1 levels up to T levels..nothing was investigated on higher levels...anyway I was at risk of permanent spinal cord injury just for the suggested injections ..so i guess you put up with it best you can rathere than at the hands of a butcher

    ReplyDelete
  5. Many patients have had success. You have only had a personal view and probably have not studied this surgery at all. So I say this as a neutral voice, do your research before you come on here and give your limited view of this surgery. There have been documented problems but majority of the problems are because of the surgeons, only 4% are because of the disc itself.

    ReplyDelete
  6. Charite ruined my life and there are hundreds if not thousands like me. There are doctors out there who got rich getting this device FDA approval at the suffering of people like me. The 4% number is a lie. The doctors who did the followup study are the same doctors who gained finacially from getting this approved. They did not call me for the follow up study nor did they contact any of the fail Charite people I stay in contact with. Why is that?? Becuase the truth might cost them and they cannot let that happen. I have lost all faith in the FDA and I have worked in the pharmaceutical / Medical Device industry for 15 years.

    ReplyDelete
  7. I had surgery at L4/5 with ADR and consider it a success. Everyone reacts differently to surgery and not everyone is a candidate for ADR.

    ReplyDelete
  8. Hi,
    My name is Libby and I had a spinal fusion in 1997 when I was 26 years old, it was done at the L4 L5 level. I had a great 10 years and then in 2007 while on a treadmill I experienced a severe pain and horrible back spasms. I am told that L3 L4 and L5 S1 are severely degenerated and both levels need to be fused. I was wondering if disc replacement surgery could help me and if there is anybody out there that is in the same situation ? I do not know anybody with a triple spinal fusion and worry that it would not be successful. Disc replacement sounds much better because it would preserve mobility between the levels. Any thoughts?

    ReplyDelete
    Replies
    1. Hi, how are you doing now Libby? I had L4L5 fusion in 2011 and i just found out last year that my L5S1 is bulging and degenerated but to be fair it already had a mild bulge in 2011 but wasn't bad enough that it needed to be fused.

      I m not getting any more surgeries and I am going to heal this disc naturally

      Delete
  9. I had ADR surgery L5 S1 in 2002 things were ok for the first months until the Charite ADR failed. One Doctor wanted to remove it so I called Depuy spoke to the director of something she said attempting to remove the disc was a really bad idea. I advised her no other doctors in the area would even see me. About 60 days later Depuy referred me to a doctor who did a posterior fusion with hardware it did not take. I have had a spinal cord stimulator, and 3 additional surgeries to try an stabilize my spine now I have a ton of scare tissue and am is constant pain take tons of drugs. The ADR has ruined my life. I was in the study group and the person at the hospital doing the study was not supposed to have contact with the doctor who implanted the ADR, She was in the room during my followup visits and the Doctor was telling her what to write down! As soon as it was know that I was having problems the doctor did not want to see me so he referred me to some one else. As I look back it was probably because he could no longer hide my issues from the study. You see a lot of people who say the ADR has been great for them when they do posts a few months after they get it, but like me it never lasts and causes far more problems for them in the future. For those who go ahead and get ADR good luck and for those of you who have gotten one and feel great just wait.

    ReplyDelete