First Report of Lumbar Artificial Disc Replacement for Disc Herniation

This is the first report of artificial disc replacement (ADR) for disc herniation. Fourteen (14) Swiss patients with long standing degenerative disc disease (DDD) and recent disc herniation were included. All patients had chronic low back and leg pain due to DDD.

Until now disc replacements have been used for patients with DDD but without disc herniation. The authors report the ADR doesn't work well with a narrow disc space. Patients need at least one-third or more of the normal disc space height to have this operation.

This is because as the disc space gets smaller, the spinal ligament shrinks and tightens. The ADR restores motion in the front (anterior) half of the vertebra. The facet joints in the back (posterior) half of the vertebra are needed for complete motion.

Pain and work status were used to measure the results of this operation. Eleven patients had excellent results. The remaining three had good results. The authors conclude ADR can be used successfully with patients who have long-standing DDD and new onset of disc herniation.

Markus Wenger, MD, and Thomas-Marc Markwalder, MD. A Novel Surgical Treatment of Lumbar Disc Herniation in Patients with Long-Standing Degenerative Disc Disease. In Journal of Neurosurgery: Spine. May 2005. Vol. 2. Pp. 515-520.

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