Spinal Disc Replacement - Methods

There are a various number of forms that back pains take. One type of back pain is caused by a spinal disc affliction (discus intervertebralis) which is referred to in common terms as a spinal disc injury. The spinal discs are each located between two vertebral bodies and consist of an outer ring made of fibrous cartilage (anulus fibrosis) and an inner core made of soft cartilage tissue (nucleus pulposus). Directly behind this is the vertebral canal which houses the spinal cord. Degenerative changes or sudden accidents can cause the outer cartilage ring of the spinal disc to rub. This can cause the soft cartilage tissue of the core to partially protrude and press on the spinal cord in the vertebral canal or against laterally emergent nerve roots. Depending on which nerves are affected by this compression, this may result in neck pains, back pains, paraesthesia, motor problems, delayed or reduced reflexes, or loss of bladder control.2 If the symptoms are not improved by conservative methods, if no positive changes are achieved via a spinal disc operation, and if there are especially severe problems, an operative procedure on the spinal disc can be taken into consideration. This is possible in the neck and lumbar vertebrae. The presence of a recent spinal disc prolapse in only one mobile segment of an otherwise healthy spine is a further favorable precondition for the installation of a spinal disc replacement. The spinal joints should not display any other signs of degeneration.^3,4

The procedure is carried out using general anesthesia from the front through the opening of the peritoneum (retroperitoneal, transperitoneal). After the removal of the spinal disc, the prosthesis, which is mostly consists of metal and plastic, is installed and anchored to the bordering vertebral bodies.

The advantage of a spinal disc replacement lies in the greater range of movement that the prosthesis offers in comparison to the earlier popular method of joint fusion (spondylodesis). The mobility of the prosthesis also offers the advantage of not subjecting the neighboring spinal discs to additional loads. In some cases a replacement of just the spinal disc core can be performed. Determining which method applies to you can only be done after your doctor has conducted an exhaustive individual examination.^5,6