One of the main causes of back pain and spinal disorders is the degeneration of spinal discs. Disc degeneration is painful and often difficult to treat. One of the most promising surgical options currently being developed and in trial is the use of artifical discs.

The spaces between each vertebra in the spine (spinal discs) serve as shock absorbers for the spine. As we age, these discs can deteriorate. When this happens, the discs lose their shock absorbing abilities and cause pain and wear and tear on the vertebra. The first level of treatment are non-surgical options which include rest, pain medications, physical therapy and spinal manipulation. Unfortunately, these treatment methods fail in a significant number of patients with spinal pain.

When non-surgical treatment options fail, surgery is usually the next step. Traditionally, spinal fusion surgery has been the method of choice. However, spinal fusion surgery has a number of drawbacks. First, the bones being fused do not always heal correctly. Second, spinal fusion of more than one level causes stiffness and decreased motion about the spine. third, spine fusion of multiple levels increases stress to the rest of the spine which can create new problems elsewhere in the verebra column. For these reasons, spine surgeons have been looking for an alternative treatment option.

After a number of years of research on the degenerative processes of the spine, artifical discs have been developed to maintain proper spacing between vertebras, to allow for full range of motion, and to provide spinal stability. On October 26, 2004, the FDA approved the CHARITE Artificial Disc manufactured by DePuy Spine, Inc., a Johnson & Johnson company. The disc consists of a plastic core sandwiched by two artificial plates and is intended to replace spinal fusion surgery. It is approved for use in patients who have degenerative disc disease at one level of the lumbar spine (L4-S1) and who have had no relief from low back pain after at least six months of non-surgical treatment. The FDA is requiring DePuy Spine to conduct a post-approval study to assess the product's long-term safety and effectiveness, including the impact on other discs and on the bony structures of the spine. Currently, University of Virginia is one of the spine centers throughout the U.S. that offer disc replacement with the CHARITE.

The best candidates for ADR would be patients who have failed prolonged nonsurgical treatment and who have moderate of severe degenerate disc disease. Also, insurance coverage is a concern since this surgical treatment is not being covered by some of this region's insurance companies at this time.

Please contact your primary care physician and ask for a referral to the Orthopaedic Spine Division if you think you may be a candidate for this procedure (434-243-0266 or 434-243-5432).