TOTAL DISC REPLACEMENT

Total Disc Replacement in the Treatment of Degenerative Disc Disease and Disc Prolapse

Total Disc Replacement in the Treatment of Degenerative Disc Disease and Disc Prolapse

What Are Degenerative Disk Diseases (DDD)?

The intervertebral provides a resistance to tension and compression in annulus fibrosus and nucleus pulposus respectively, which are mostly composed of proteoglycan. These two structures are involved in providing mechanical support to the disc. Degenerative disk disorder of the lumbar spine particularly is a serious degenerative process. Degenerative disk diseases are also known as spondylosis, refers to the changes that occur at the spinal region in any of the cervical, thoracic or lumbar areas of spines. This disorder progresses due to the age factor and mostly affects the lumbar region. It is a condition in which discs degenerate and lose their flexibility. Moreover, the discs are not even able to cushion or support the spine and have considerably less blood supply (Yong Soo Choi, 2009).

Disc Prolapse

Prolapse disc is more commonly known as slipped disc. Prolapse disc is usually the outcome of herniation i.e. bulging out of the inner softer part of disc I.e. the nucleus pulposus. This bulging structure presses the other structures such as the spinal cord nerve. As a result of this pressing of nerve, inflammation develops. Any of the discs in spine area can be prolapsed. Mostly these defects occur at the lumbar region of the spine or the lower back. Similarly, the size of prolapsed can be differentiated, the larger the prolapse the more severe would be the symptoms (Gibson et al, 2007).

Disc prolapse can be due to trauma or severe stress either by physical activity or aging. Degeneration occurs in disc which ultimately makes it more vulnerable to prolapse. Disc prolapse usually occurs at the lumbar or cervical region. This defect can be successfully imaged by MRI. MRI can distinguish between the type/site/degree of prolapse. This imaging technique has so far aided in the decision of surgical approach that can be applied (Jacob et al, 2011).

Figure 1: Anterior and Posterior view of prolapsed disc

Degenerative Disc Disease: Disc Replacement

A new mode of treatment for patients with dsicogenic back pain has been introduced. Disc replacement has evolved within the recent years and is widely used for spinal treatments. The main advantage of TDR technique is its less destructive approach. Posterior surgery can be replaced by this treatment in order to avoid inflammatory processes. Moreover, TDR also prevents stress and maintains mobility. It also protects the spinal levels at adjacent areas. Spinal fusion, on the other hand, can be regarded as a gold standard by which the newer treatments such as TDR can be measured. Spinal fusion has been used for a period of 50 years and is still being used worldwide. Its long term results are easy to comprehend and are generally reliable (Simmons, Guntupalli, Kowalski, Braun, & Seidel, 1996, pp.1527-1529).

Disc replacement however, offers many advantages over spinal fusion and is widely acclaimed ...