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Lower Spine News

Perfect Candidate for Artificial Disc Replacement

Artificial disc replacements (ADRs) are new enough that surgeons aren't sure which patients are the best candidates for this procedure. Until enough studies are done to identify the ideal patient, ADRs will be used for a variety of patients with different spine conditions.

The authors of this study present the three-year results of 92 patients using the ProDisc II ADR. Results reported are for a follow up period of at least two years. Patients were divided into four groups based on their diagnosis. All patients included did not respond to intensive conservative care before surgery.

The four groups included: 1) degenerative disc disease (DDD), 2) DDD and disc herniation, 3) discectomy (disc removal), and 4) DDD with Modic changes. Modic changes refer to bone marrow and endplate changes seen on MRI. The endplate is the fibrocartilage layer between the outer covering of the disc and the vertebral bone.

Results were measured on the basis of patient satisfaction and function. Return to work was also assessed. Previous surgery (discectomy) did not have a negative effect on the results. Patients who had more than one disc replaced had more problems with poorer results compared to patients with a single level replacement.

The results of this study show the best candidates for ADR include:
  • Patients with DDD
  • Patients who have DDD with or without Modic changes
  • Patients with DDD and disc herniation
  • Patients who only need one level replaced

    Specific uses for ADRs have not been clearly defined yet. This study helps narrow the field toward the goal of finding the best candidates for ADR.


    Christoph J. Siepe, MD, et al. Clinical Results of Total Lumbar Disc Replacement with ProDisc II. In Spine. August 1, 2006. Vol. 31. No. 17. Pp. 1923-1932.

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