New artificial discs mean less pain, fewer problems for back patients

The advantages are apparent, Clawson said, including earlier return to work, less rehab time, less pain initially following surgery. There were no significant differences in complications. By three months, studies show the discs are roughly equivalent to a fusion in terms of pain control.

Part of that reduced pain is increased ability to move around earlier. "With most conditions, the more you restrict motion, you tend to have more pain," he said.

Johnsen was released from the hospital the weekend after surgery.

The artificial disc is not for everyone, Clawson said. He estimated that fewer than 10 percent of patients are actually candidates for the procedure. It is ideal for younger patients, 18-55, who have a localized disc injury. It's approved by the FDA for single-disc replacement, although some surgeons are using it for two or three. It is not an option for people who have soft bones.

Long-term complications of the disc aren't known. Will it wear out? Can it spit out the plastic core? Clawson asks. "Once you have a solid fusion, you never need to worry about the hardware. You worry about the next level up or down as an issue. With the artificial disc you may still have to operate on that level. You may have to do a fusion" in the future. It's too early to have that down-the-road data.

If the implant is placed well, Clawson said, "you're not going to have problems."

There are so many advantages and the clinical trial work was so promising that Clawson is among doctors who believe the discs can provide great relief for some people. "I have two in a friend of mine, and he's doing fabulous. But there are fusions that have zero pain and are doing fantastic, too."

The instruments used for the implant are a little bulkier than those used for fusions, he said. And the artificial disc surgery must be much more meticulous. "Where you place the device and how you size it is critical. It's a matter of being kind of a perfectionist and making sure you do it right. It's more challenging," he said.

Typically, two surgeons work together. A vascular surgeon goes through an abdominal incision toward the spine, delicately moving blood vessels and organs aside. Then the spine surgeon uses special tools to remove the damaged disc and make space for implantation of the artificial disc between two vertebrae.

Back pain is a huge problem for 65 million Americans, who spend about $50 billion each year on low-back pain, the most common job-related disability and leading cause of lost workdays. More than 12 million people reportedly suffer degenerative disc disease.

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E-mail: lois@desnews.com