New Horizons in Spinal Surgery: Spine Arthroplasty

Background: Degenerative primary osteoarthritis is one of the commonest causes of pain in peripheral joints. This is commonly seen in the knee and hip joints. Replacement of these worn out joints is now the established treatment, which gives stable pain free mobile joints. Arthrodesis or fusion of worn out joints is now rarely performed. Degeneration of the intervertebral disc is a common cause of back as well as neck pain. Fusion of the degenerated and unstable spinal segments is an established procedure to relieve pain. But, at the same time this procedure eliminates motion at the fused level and also accelerates degeneration at the adjacent levels. The replacement of the worn out intervertebral disc with “Artificial Disc” is an emerging technology with the aim to maintain motion in the intervertebral unit and, reduce stress on the adjacent levels and thereby decrease the incidence of degeneration at those levels. The "Artificial Disc" does not simply portray another technique in spine surgery, but rather, is the first practical step in the evolution of motionretaining spine surgery. Purpose of the Study: To evaluate early results of total disc replacement in the cervical and lumbar spine. Materials and Methods: A prospective study has been designed with the strict patient selection criteria. A total of 18 artificial discs have been implanted. The SB Charite’ type III disc was used for lumbar spine (6 patients) and the Bryan disc was used for the cervical spine (ten patients and 12 discs). The follow up ranged from three months to two years. All the patients were assessed by standard scoring systems. Results: We report excellent to good early results in all our patients at the end of two years. We did not encounter any complications related to the procedure or the implanted disc. Conclusion: The early results of total disc replacement in cervical and lumbar spine show a promising future to avoid the limitations of spinal fusion. Clearly the long-term results are awaited in comparison to the established spinal fusion procedures.