The bottom line is that no one really knows. Lumbar disc replacements are much less commonly performed than fusion procedures. Also, people have only had disc replacements for a few year, so no one really knows how well these implants will hold up over time. Finally, there is not enough data to really know if disc replacements will prevent arthritis of neighboring joints over the years.
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Spinal fusion, however, has well known potential disadvantages, including : –
Artificial disc replacement offers a reversible, viable alternative to fusion that possibly avoids the accepted shortcomings of fusion. By inserting an artificial disc instead of performing spinal fusion, there is the possibility of reducing damage to nearby discs and joints. This is because artificial disc replacement allows for motion preservation, near normal distribution of stress along the spine and restoration of pre-degenerative disc height.
The surgical procedure to implant a Bryan cervical artificial disc is similar in approach and technique to traditional cervical spine surgery that has been used for more than five decades. A small incision, usually less than an inch long, is made in the skin of the neck just off the midline of the spine. Vital structures like nerves, arteries and the esophagus (the tube that connects the mouth and the stomach) are gently pulled out of the way so the surgeon can have access to the spine.
The disc is removed using a microscope and surgical instruments made for this purpose. Once the disc has been safely removed in its entirety, the empty disc space is prepared by milling or shaping the endplates (bottom of each vertebrae) to incorporate the Bryan cervical artificial disc replacement. The artificial disc is placed while the disc space between the two vertebrae (the bones of the spine) is held open.
Once firmly in place, tension is taken off the vertebral bodies above and below compressing the artificial disc and holding it in place. Both surfaces of the Bryan cervical artificial disc are made of porous beaded titanium metal that will incorporate and encourage bony ingrowth for long-term stability. The metal endplates surround a polyurethane core and saline cushion. Care and restrictions following surgery, as well as potential complications, are similar to those that occur with spinal fusion.
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