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Glossary Words
bone graft
cartilage
cervical spine
degenerative disc disease
disc
discectomy
fusion
herniated disc
lumbar spine
spinal cord
spine
thoracic spine
vertebrae

 

 

 PDN (prosthetic disc nucleus)
PDN from Raymedica

View of implanted PDN

 

 

 

 

The Spine
 
Spine Disc Replacement

Artificial Disc

In the case of degenerative disc disease in the lower lumbar discs (L4/5 or L5/S1), there is another surgical option. In artificial disc replacement, the surgeon removes the damaged disc and replaces it with an artificial one. This surgery is done with the patient on his/her back and the surgeon operates on the spine from the front through an incision near your belly button (see video in the left hand column).

The Charité artificial disc is a three-piece medical device consisting of a sliding core and two metal endplates. The core is made from medical grade plastic Charite' Device and the endplates from a metal alloy like that used in knee replacement components. The artificial disc allows the spine to move as opposed to a spinal fusion where the disc space is immobilized. The link charitedisc.com provides more detailed information on this new option.

View the Charité video

 

Prosthetic Disc Nucleus

The intervertebral discs that reside between each bone of your spine act as shock absorbers. The disc consists of a tough outer layer called the annulus and a soft, jelly-like inner later called the nucleus. The nucleus absorbs most of the shock as you move, keeping the spine supple and the outer annulus contains the nucleus keeping the spine stable. As you age, both the annulus and the nucleus lose some of their
X-ray of implanted ProDisk disc replacement
Side view x-ray of an implanted ProDisk disc replacement

 cushioning ability and more of the stress of movement is borne by the outer annulus.

In an artificial disc, the entire disc is removed (annulus and nucleus) and is replaced. An alternative is nucleus replacement. This approach replaces only the soft cushioning material of the nucleus, leaving the tougher outer annulus intact. The goal in this surgery is to reestablish the original disc height and to redistribute the stress back to the nucleus, like it is in younger discs.

In this surgery, a very small incision is made on your back, just like in a discectomy. A small opening is created in the outer annulus and a Prosthetic Disc Nucleus (see picture in left column) is inserted. In some patients, this insertion can be done using minimally invasive techniques meaning a small, through the skin out-patient procedure. More details on nucleus replacement can be found at raymedica.com

 

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