Lumbar Disc Replacement

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Evolution of Lumbar Disc Replacement

Surgical treatment of lumbar disc degeneration has been rooted in removing the pain generator, which in this instance is the disc. Historically, and still commonly performed, the treatment has been in lumbar interbody fusion. In this procedure, the disc is removed surgically, and a metal or bone device is placed to fill the gap. This device helps fuse the two vertebral levels thereby preventing motion. However, the spine is a very mobile part of the body, and relies on small motion at each level of the lumbar spine to produce the large amount of lumbar spine motion overall.

What has been found is that if you fuse two or more levels of the spine, there are increased forces across the remaining levels with motion. This causes a more rapid degeneration of the other levels and can necessitate further surgical intervention. Around 25% of people require re-operation within 10 years of the original surgery. These problems prompted the development of lumbar disc arthroplasty in order to remove the pain generating disc, while maintaining motion of the lumbar spine and to try and prevent adjacent level secondary degeneration.

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