Sunday, April 7, 2019

Disc Arthroplasty Essay Example for Free

Disc Arthroplasty EssayDegenerative record book disease have been a problem for many people as this disease rents close to embarrassed back pain that seems to paralyze the working force, the middle adulthood population (Smeltzer, 2004). Not only does it bring impaired quality of life to those who suffer from it, scarce Arvind Kulkarni adds large health c ar expenses to the list of problems brought ab egress by this disease as seen in his hold entitled Prosthetic Lumbar platter alternate for chronic discus disease.Spinal fusion, which is the medical management for degenerative disc disease, has been criticized by several doctors in the practice due to its untoward effects in the affected roles over each(prenominal) recovery and spirit improvement. Specialist in the field, Christoph Siepe, identified these unpleasant effects as accelerated adjacent system devolvement, pseudarthrosis, spinal anesthesia canal stenosis, and donor site morbidity. Adjacent segment degener ation, as mentioned by Peter Ullrich in his article entitled Fusion versus substitute Disc Arthroplasty for Lumbar Degenerative Disc Disease, stated that this is the major torsion of spinal fusion and the reason why most surgeons want this modus operandi replaced.Adjacent segment degeneration or ASD happens when mechanical stress is transferred to the adjacent segment, also mentioned by Peter Ullrich. But research showed that this subprogram can be modified to show more positive results. An anterior lumbar interbody fusion showed a low occurrence of revision surgery needed, which meant low frequency of adjacent segment degeneration, all pointed out in Mr. Ullrichs paper. However, to achieve this outcome, Mr. Ullrich declared that there should be an improvement in patient survival and in the procedure. The patients should be those patients having degenerative disc disease in their 5th lumbar to 1st sacral segment, because there is minimal motion at this level.By doing so, he sta tes that fusing these segments do not change the patients mobility as much. But not all are satisfied of this result. Doctors and specialists are continuously make efforts to totally changing the primary medical management for degenerative disc diseases. Studies have been conducted, and several backup man procedures were approved by the FDA. Peter Ullrich stated in his paper that the total disk replacement procedure was approved for medical use by the FDA in the division 2004 using the Charite soppy disc but for only one level of the spinal vertebrae, cosmos the L4 L5 or the L5 S1.This 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 nucleus replacement was done first in 1955 by David Cleveland by injecting methyl-acrylic. Ever since then, there have two other FDA approved products aside from the Charite, the website Spine-Health states that the Prodisc was approved on tremendous 2006 and the Kineflex lumbar on June 2005. A total disc replacement is being described by Jose Reyna in his article, Advances in Artificial Disc Technology, as being composed of two pieces of plates do of metal that has odontiasis to be able to attach itself to the end plates of the vertebral bones above and below it. This means that the ill-tempered intervertebral disc that is causing pain has to be removed and replaced by an artificial disc. Several artificial discs have been developed by various manufacturers in the country and they only differ in frame and composition. The Charite, as mentioned earlier, is made up of a unique sliding core with two metal debase end plates.The Prodisc being based on spherical articulations is made up of cobalt chromium molybdenum alloy as stated in the website Spine-Health. Inventors Qi-Bin Bao and Paul Higham developed a hydrogel prosthetic nucleus made up of PVA powder and a solvent mixed together, as seen on the a rticle, Hydrogel intervertebral disc nucleus with diminished asquint bulging. The total disc replacement procedure has its advantages and disadvantages. Even after some models being approved by the FDA, it is still being assessed thoroughly by specialists in the field. Charles Rosen and Douglas Kiester report distressing results and tortuositys in the total disc replacement procedure.As it was mentioned in their study, this procedure causes fractures, severe pain, dislocations, extrusion of the implant, scene joint degeneration, and unexplained radiculopathy. They attribute these substandard results to the fact that the center of rotation of segmented motion is erroneous. Jose Reyna younger also mentions several disadvantages of the procedure in his study, stating that the anterior approach to the surgery can cause deformity to the aorta and the common iliac vessels, can cause retrograde ejaculation in men by injuring the well-made hypogastric plexus, hemorrhage can result fr om the retroperitoneal approach, and infection can occur.However, he also stated some advantages, as this procedure is said to maintain range 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 three year study conducted by Christoph Siepe et al., entitled clinical Results of Total Lumbar Disc Replacement With ProDisc II Three-Year Results for distinguishable 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.The best outcome was seen in patients exhibiting degenerative disc disease condition plus soft disc herniation or nucleus pulposus prolapse. event was measured against the patients improvement from their preoperative levels. There were inferior results from the patients who had bisegmental damages, and a higher com plication rate. Also it was mentioned that the younger patients, more specifically those aged below forty exhibited better outcome than those quondam(a) 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 will be made a reality.ReferencesCharles Rosen, Douglas Kiester, Thay Q. Lee The Potential Biomechanical etiology for Lumbar Disc Replacement Failures Review of 24 Patients and the Rationale for Revision . The Internet Journal of minimally Invasive Spinal Technology. 2007. Volume 1 Number 2.Medscape. (2002). Advance in Artificial Disc Technology. Retrieved January 22, 2008 from http//www.medscape.com/viewarticle/445057Medscape. (2002). Clinical Results of Total Lumbar Disc Replacement With ProDisc II Three-Year Results for Different Indications. Ret rieved January 22, 2008 from http//www.medscape.com/viewarticle/542479Neurology India. (2005). Prosthetic Lumbar disc replacement for degenerative disc disease. Retrieved January 22, 2008 from http//www.neurologyindia.com/article.asp?issn=0028-3886year=2005volume=53issue=4spage=499epage=505aulast=KulkarniNeurospine. (no indicated year). Fusion versus Artificial Disc Arthroplasty for Lumbar Degenerative Disc Disease. Retrieved January 22, 2008 from http//www.neurospinewi.com/newsletters/fusionvsartificial.htmlPatent Storm. (1996). Hydrogel intervertebral disc nucleus with diminished lateral bulging. Retrieved January 22, 2008 from http//www.patentstorm.us/patents/5534028-fulltext.htmlSmeltzer, S. and Bare, B. (2004). Medical-Surgical Nursing. Philadelphia Lippincott Williams Wilkins.Spine-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

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