Intervertebral Disk Replacement - Keivan Anbarani's Electronic ...

Source: Rick Hansen Spinal Cord Injury Registry, 2001
The following pie chart demonstrates the causes of traumatic spinal cord injuries that have
occurred in the USA.
Figure 2. Causes of SCI
Source: fscip.org, 2010
Spinal Fusion
Over the last decades, anterior cervical discectomy and fusion (ACDF) have been
considered to be the most established and highest standard of treatment for degenerative
disc disease in the spine. ACDF involves a surgical procedure to treat nerve root or spinal
cord compression by removing the ruptured disc and nerve roots of the spine (mainly in
the cervical region) in order to relieve pressure on the nerve roots or on the spinal cord
(Spine Universe, 2010). This procedure is carried out from the front of the neck through a
small incision, hence the name anterior. During the surgery, soft tissues of the neck are
separated and the disc is removed. However, if the disc space is not sufficient to maintain a
normal height, a procedure, using pieces of bone material from a patient or
artificial/synthetic materials to replace the missing space, called bone grafting may be
used. Bone grafting is an extremely complex and significantly risky procedure that can also
result in failures to heal properly. In the long term, spinal fusion of the segment may also
lead to progressive degeneration of the adjacent vertebrae. Hence, introduction of TDR
procedures appear to be a promising clinical procedure for the treatment of SCI.
History
The first total disc replacement (TDR) created and implanted was Fernstram’s steel ball in
1966. Eight patients had 13 corrosion-­‐resistant, stainless steel ball-­‐shaped prostheses
implanted. Reitz et al. also reported implants of the same type on 32 patients, however
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