As people age, the spine tends to wear down. A condition that often develops in aging adults, degenerative disc disease, can lead to extreme back pain and other symptoms. Degenerative disc disease may have to be addressed with surgical intervention if conservative treatment yields poor results. Degenerative disc disease patients usually have two surgical options, either artificial disc replacement surgery or spinal fusion surgery. Many studies compare the two, but a recent research review suggests that artificial disc replacement is just as effective and has less life-threatening complications than spinal fusion surgery for patients suffering from degenerative disc disease in the lumbar spine.
According to Arthritis Today, artificial disc replacement consists of removing the damaged spinal disc and replacing it with an artificial disc. The goal of artificial disc replacement is to preserve the spine’s natural motion, according to the American Academy of Orthopaedic Surgeons. Spinal disc fusion involves the removal of the damaged bones and tissues, and the subsequent fusion of the adjacent vertebrae. According to the researchers, only 60 to 80 percent of patients who receive spinal fusion surgery have satisfactory pain relief.
To determine which method is safer and more effective, the researchers analyzed clinical studies conducted between 2005 and 2012. The research they used, which consisted of six randomized controlled trials and one nonrandomized comparative study, was gleaned from electronic databases. In the trials they analyzed, four different types of artificial discs and three different fusion procedures were used.
The researchers evaluated the safety of each procedure by looking at “the number of adverse events such as infection and nerve or blood vessel injury that occurred after both ADR and fusion.” There wasn’t much difference between artificial disc replacement and spinal fusion, but two studies showed that spinal fusion led to more life-threatening complications than artificial disc replacement. In addition to gauging procedure safety, the researchers also looked at effectiveness by analyzing pain scores, use of medication, patient satisfaction and a measure of how back pain affects function.
Most studies revealed that the artificial disc replacement patients experienced significant improvements in both pain and function, used less opioid medication, did not have as many problems in adjacent areas of the spine and were more satisfied with their procedure two years after surgery as compared with the spinal fusion patients. Five years after the procedures, however, there were no noticeable differences in outcomes between the artificial disc replacement and spinal fusion patients.
The researchers stress that surgery should always be considered as a last resort.