The Artificial Disc

It wasn’t long ago when the artificial disc was considered the cure-all to back problems. The studies that were done in Europe showed success rates that were very impressive. 90% cure rates or so they say. It has been over five years since the artificial disc was approved for usage in the U.S.A. and the “hoopla” has diminished. The American studies showed success rates of around 67% which isn’t much different than any other spinal surgery and the once touted cure has drifted from the spotlight. When the artificial disc or ADR came out, I thought that everyone would be utilizing the device by now. The irony is that it still isn’t mainstream and due to the mediocre results, it probably never will be. In fact during the time that the ADR has been around, one medical device manufacturer paid almost a billion dollars for the rights to a new fusion device call the “X-stop” which fuses the spine at the spinous processes. The X-stop is for another discussion but obviously the big companies saw that the ADR had limited use. Personally, I like the ADR for some things. It is never a first line choice due to the complexity of the surgery, but it could be considered for discogenic low back pain that isn’t resolved by minimal invasive modalities. I don’t see much promise with spinal stenosis since the surgery technique doesn’t allow opeing of the spinal canal. Thus, the ADR is really a disc issue device and if there is bone impinging on the cord, it may be of limited value. As with regular fusions, there is a reasonable failure rate and when these devices fail the solution is to fuse the spine. The other questions invole instability with multiple levels since a significant degree of spinal ligaments anteriorly are affected. I have seen up to 3 levels of the spine done but usually only one or two are performed. The ADR, an interesting device that has been around for twenty years but only available in this country for 5 years. The ADR, as with everything in spine care, has it ups and downs and I believe should be considered a second line treatment option. Always try minimalistic treatments first.

One Comment

  • As an aside, This is my opinion of the ADR device. It is not meant to demean the system but simply to offer a viewpoint.

Leave a Reply