'Disc Arthroplasty Essay\r'

' chronic record book disease have been a task for many people as this disease brings both(prenominal) low back disoblige that seems to paralyze the work force, the middle adulthood population (Smeltzer, 2004). Not only(prenominal) does it bring impaired quality of life to those who put forward from it, but Arvind Kulkarni adds large health shell out expenses to the bring up of problems brought about by this disease as seen in his condition entitled Prosthetic lumbar record bookus reclamation for degenerative dish aerial disease.\r\nSpinal amalgamation, which is the medical examination management for degenerative saucer disease, has been criticized by some(prenominal) doctors in the practice due to its untoward make in the long-suffering’s over entirely convalescence and life season return. Specialist in the field, Christoph Siepe, identified these caustic effects as accelerated close formation degeneration, pseudarthrosis, spinal anesthesia canal st enosis, and donor site morbidity. abutting divide degeneration, as mentioned by Peter Ullrich in his article entitled jointure versus Artificial book Arthroplasty for Lumbar Degenerative saucer Disease, utter that this is the major complication of spinal fusion and the reason wherefore most surgeons want this procedure replaced.\r\nAdjacent segment degeneration or ASD happens when mechanical stress is transferred to the adjacent segment, also mentioned by Peter Ullrich. But search betokened that this procedure can be modified to show more positive results. An anterior lumbar interbody fusion showed a low occurrence of revision process needed, which meant low frequency of adjacent segment degeneration, all pointed out in Mr. Ullrich’s paper. However, to achieve this resultant role, Mr. Ullrich declare that in that respect should be an improvement in patient selection and in the procedure. The patients should be those patients having degenerative phonograph reco rding disease in their 5th lumbar to initiatory sacral segment, be get down there is minimal transaction at this level.\r\nBy doing so, he states that fusing these segments do non miscellany the patient’s mobility as much. But not all are satisfied of this result. Doctors and specialists are perpetually making efforts to nubly changing the primary medical management for degenerative disc diseases. Studies have been conducted, and several(prenominal) reclamation procedures were approved by the FDA. Peter Ullrich stated in his paper that the hail disk replacement procedure was approved for medical use by the FDA in the grade 2004 using the Charite drippy disc but for only one level of the spinal vertebrae, be the L4 †L5 or the L5 †S1.\r\nThis is not the first time that a total or partial disc replacement was done. The history of this procedure was mentioned in an article in a website by Spine-Health that disc heart replacement was done first in 1955 by Dav id Cleveland by injecting methyl-acrylic. Ever since then, there have 2 other FDA approved products aside from the Charite, the website Spine-Health states that the Prodisc was approved on August 2006 and the Kineflex lumbar on June 2005.\r\n A total disc replacement is being described by Jose Reyna in his article, Advances in Artificial disk Technology, as being composed of two pieces of plates made of admixture that has teeth to be able to attach itself to the closing plates of the vertebral bones above and below it. This government agency that the particular intervertebral disc that is causing pain has to be removed and replaced by an artificial disc. several(prenominal) artificial discs have been developed by sundry(a) manufacturers in the country and they only differ in design and composition. The Charite, as mentioned earlier, is made up of a unique sliding core with two metal alloy end plates.\r\nThe Prodisc being based on spherical articulations is made up o f cobalt atomic number 24 molybdenum alloy as stated in the website Spine-Health. Inventors Qi-Bin Bao and Paul Higham developed a hydrogel prosthetic cell centre made up of PVA powder and a solvent mixed together, as seen on the article, Hydrogel intervertebral disc nucleus with pocket-sized lateral bulging. The total disc replacement procedure has its advantages and disadvantages. Even aft(prenominal) some models being approved by the FDA, it is soothe being assessed thoroughly by specialists in the field. Charles Rosen and Douglas Kiester fib poor results and complications in the total disc replacement procedure.\r\nAs it was mentioned in their study, this procedure non sums fractures, severe pain, dislocations, expulsion of the implant, facet joint degeneration, and unexplained radiculopathy. They attribute these insufficient results to the fact that the center of rotation of segmented motion is erroneous. Jose Reyna Jr. also mentions several disadvantages of the proced ure in his study, stating that the anterior approach to the surgery can cause injury to the aorta and the common iliac vessels, can cause retrograde ejaculation in men by injuring the superior hypogastric plexus, hemorrhage can result from the retroperitoneal approach, and transmitting can occur.\r\nHowever, he also stated some advantages, as this procedure is said to maintain ramble of motion in majority of the patients as a long-term outcome. There are still a lot of studies to be conducted, and patients to be experimented on. A leash year study conducted by Christoph Siepe et al., entitled clinical Results of Total Lumbar Disc rehabilitation With ProDisc II: Three-Year Results for Different Indications, intended to assess total disc replacement outcome in patients who actually underwent the operation. Their results showed that not all degenerative disc diseases can be treated with this medical management.\r\nThe best outcome was seen in patients exhibiting degenerative disc d isease condition plus soft disc herniation or nucleus pulposus prolapse. Outcome was measured against the patient’s improvement from their preoperative levels. There were inferior results from the patients who had bisegmental damages, and a higher(prenominal) complication rate. Also it was mentioned that the younger patients, more specifically those aged below forty exhibited better outcome than those older than forty. Technology like this is still being developed, studied and modified as we speak. What is important is that there are people out there who care and who try to make a difference, whether it is by inventing, criticizing or being the experimental person wherein these new devices get out be made a reality.\r\nReferences\r\nCharles Rosen, Douglas Kiester, Thay Q. Lee: The potential difference Biomechanical Etiology for Lumbar Disc Replacement Failures: limited review of 24 Patients and the Rationale for Revision . The Internet journal of Minimally Invasive Spinal Technology. 2007. Volume 1 Number 2.\r\nMedscape. (2002). Advance in Artificial Disc Technology. Retrieved January 22, 2008 from http://www.medscape.com/viewarticle/445057\r\nMedscape. (2002). Clinical Results of Total Lumbar Disc Replacement With ProDisc II: Three-Year Results for Different Indications. Retrieved January 22, 2008 from http://www.medscape.com/viewarticle/542479\r\nNeurology India. (2005). Prosthetic Lumbar disc replacement for degenerative disc disease. Retrieved January 22, 2008 from http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2005;volume=53;issue=4;spage=499;epage=505;aulast=Kulkarni\r\nNeurospine. (no indicated year). Fusion versus Artificial Disc Arthroplasty for Lumbar Degenerative Disc Disease. Retrieved January 22, 2008 from http://www.neurospinewi.com/newsletters/fusionvsartificial.html\r\nPatent Storm. (1996). Hydrogel intervertebral disc nucleus with diminished lateral bulging. Retrieved January 22, 2008 from http://www.patentstorm.us/pat ents/5534028-fulltext.html\r\nSmeltzer, S. and Bare, B. (2004). Medical-Surgical Nursing. Philadelphia: Lippincott Williams & Wilkins.\r\nSpine-Health. (1997-2007). Lumbar artificial disc surgery for chronic back pain. Retrieved January 22, 2008 from http://www.spine-health.com/research/discupdate/artificial/artificial01.html\r\n'