Spinal Fusion Alternative
Spinal fusion is the last step in treating degenerative disc disease.
Alternatives to spinal fusion are desirable because of spinal fusion’s low success rates and complications fusion adds to the movement of the skeleton, particular to the rest of the spine. Creation of a long solid bone, where there was once a joint, makes a long lever, which interacts with other spinal discs adjacent to the fusion, which may already be compromised. Because of these many long-term problems some insurance companies are not paying for fusions and in particular multi-level fusions. Fusion of the knee and hip joints were once the treatment of the choice until the alternative of artificial knees and hips were developed.
Nearly all disc herniations and disc bulges are caused by degenerative disc disease. The vast majority of spinal canal stenosis, neuroforaminal stenosis and the consequential radiculopathy are associated with degenerative disc disease and/or osteophyte growth.
Artificial Disc Replacement (ADR) follows in the tradition of knee and hip replacements with mechanical joints. Like spinal fusion, artificial disc replacement surgery removes the remains of the sometimes painfully diseased disc and reestablishes the height of the intervertebral disc space. Unlike spinal fusion artificial disc replacement preserves the motion of the spine, heals quickly with more certainty, and does not contribute to the accelerated degeneration of discs in the adjacent segments. Also, the good news for ADR patients is that good artificial discs last thirty to forty years without maintenance or repair, whereas knee and hip replacements last ten to fifteen years. We should note that it is not device failure but the failure of the bone-to-implant connection that fails in the knees and hips due to the sheer forces. This is not present in artificial disc replacement, because ninety-nine percent of the forces in the spine are compression forces.