Discus implantation is still a relatively new treatment in many countries. It not only relieves severe pain, but also results in normalization of the movement of the spine when successful. The treatment became routine in most advanced countries around year 2002-2004 and this method will gradually replace conventional methods of operation.

The current need for prosthetic surgery is estimated to be around 100 annually for every 1 million inhabitants. The future needs are estimated at one third of the spinal fusion surgery performed today. The spinal fusion surgery performed in most countries amount to around 15 operations per 50.000 inhabitants - but it is expected that this figure will rise.

 

In severe osteoarthritis of the spinal column the cartilage discs between the vertebrae gradually degenerate. In advanced cases the cartilage disc is largely destroyed, resulting in great pain. Treatment with a discus implant replaces the cartilage disc with an artificial disc/joint. It may consist of two moveable metal parts or two metal parts with polyethylene between. The treatment means that in addition to pain relief the normal movement of the spine is restored.

Discus implant surgery replaces the conventional operation method, which consists of the removal of the destroyed cartilage disc between the vertebrae and in the same process a stabilizing fusion of the spinal column is performed where two or more vertebrae are joined together. This reduces the pain to a certain extent, but there is not the same movement as when treated with discus implant/prothesis.

All present experience indicate that the discus implant solution is a good as, or better, than the conventional fusion method used for degenerative disorders in the neck or the lower back. The complication ratio is not higher and theoretically there are many advantages as the mobility is retained and some of the complications connected with the fusion method are avoided.

 

Artificial disc replacementin lower back and neckhas existed in some way for 20 years.Discus prosthodontics/implants has been used in Europe at several centers in recent years, and there are a number of reports on the methodology and results from consecutive patient studies. Given that the methodonly began to spread around 2002-2004, the present evidence is perfectly acceptable, and it can only be described as extremely positive thatmany randomized studies are in progress.

Several prosthesis designs have been used. The most commonly used design today is the prosthesis with metal parts with or without a polyethylene part in between, quite similar to the prosthetic designs used in knee surgery. In the market there are now four different types of prosthesis with widespread use. The Charité prosthesis was the first commercially available, Prodisc came into use around 1990 and the Maverick prosthesis from Medtronic was launched about year 2000. Other types of prosthesis are under development and will increase the use of discus implantation.

There exists a large number of articles documenting biomechanical comparison, prosthesis design, rationale and a larger number of works that deal with consecutive patient studies covering each treatment method.

Besides, a number of randomized clinical studies both in USA, Europe and Scandinavia have been carried out since the treatment method took hold around 2002.

Overall, there is already much solid evidence in favor of discus implatation. The first experience in most countries is very positive and indicate that the method will have great usefulness in the future.