Artificial Disc Compared to Spine Fusion

What is soft, elastic, and has superb mechanical strength and endurance? It can also bend, extend, rotate, and twist, holding up for 20 years or more. The answer is the artificial disc. But can artificial discs really live up to the hype? Researchers from around the United States studied 304 patients to answer this question.

Two-thirds of the patients were in a group that received a special disc replacement called the Charité intervertebral disc. One-third (the control group) had a spinal fusion with insertion of a special cage filled with bone chips. The cage was put in place of the vertebral body. Results were compared up to two years later.

The authors give a detailed review of artificial discs. They present pros and cons of their use. They also offer a description of each kind on the market. Sizes, angles, and function are discussed. The Charité disc used in this study restores disc height and motion as closely to normal as possible.

In this study, the Charité artificial disc was as safe and effective as fusion. This study limited use of the disc to one level in the low back area. All patients had degenerative disc disease. The number of neurological problems after each type of surgery was the same.

The authors suggest three factors needed for the best results:

  • Getting the disc in just the right spot is important. Proper placement will make sure the disc works well.
  • Patients should be selected carefully. Based on past studies, it seems the best patients have a damaged disc at only one level. The joints around the disc shouldn't be damaged.
  • The surgeon must have good training and experience.

    Fred H. Geisler, MD, PhD, et al. Neurological Complications of Lumbar Artificial Disc Replacement and Comparison of Clinical Results with Those Related to Lumbar Arthrodesis in the Literature: Results of a Multicenter, Prospective, Randomized Investigational Device Exemption Study of Charité Intervertebral Disc. In Journal of Neurosurgery: Spine. September 2004. Vol. 1. No. 2. Pp. 143-154.

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