The miracle disc

Richard Longland lived with back pain for years before undergoing surgery at New England Baptist Hospital last summer to install an artificial disc in his spine. Within a few days, the 42-year-old Woburn resident was at home and walking a couple of miles with "zero back pain." He calls the results of his surgery "just about miraculous."

For nearly four years, Longland's surgeon, Dr. Robert J. Banco, has been participating with his colleagues in a Food and Drug Administration (FDA) study of the safety and benefits of artificial disc replacement surgery. This is a technology they expect will bring relief to tens of thousands of people suffering from back pain when it is approved by the FDA. New England Baptist Hospital, (NEBH) is among a select group of surgical centers throughout the U.S. to study the use of artificial discs.

This seems only fitting, since New England Baptist was among the first in the nation to pioneer artificial hip replacement surgery.

A major step forward Dr. Scott Tromanhauser, an orthopedic spine surgeon at New England Baptist Hospital, calls the artificial disc "the most exciting thing in spine surgery in the last 50 years." The conventional treatment for degenerative discs has been lumbar spinal fusion surgery which fuses and stabilizes bones in the spine. While single disc fusion enjoys a 80-90 percent clinical success rate, there are some concerns with the procedure.

For example, when two or more discs have degenerated, the success rate begins to drop. Additionally, spinal fusion limits a patient's range of motion, which places additional stress on the anatomy adjacent to the fused disc. Tromanhauser says the resulting stress may send some patients back to their surgeons for additional surgery in 5, 10, or 20 years.

Enter the SB Charité III, an artificial disc whose design allows for continued mobility. With a plastic sliding core sandwiched by two metal plates, the artificial disc mimics the function of a healthy disc in much the same way as an artificial hip or knee system replicates the original anatomy. Noting that the technology has been used for more than a decade in Europe, Tromanhauser says artificial disc replacement intuitively makes sense. Outcome data from the NEBH's clinical investigation has helped persuade a panel of experts to unanimously recommend approval of the artificial disc to the FDA. Its approval on the SB Charité III is expected shortly.

Banco describes NEBH results from artificial disc replacement as "overwhelmingly successful." With FDA approval, he predicts that a quarter of patients with degenerative discs will be candidates for artificial disc replacement. Tromanhauser sees this new procedure as an exciting development in the treatment of spine problems, with more patients obtaining better results with the alternative option of artificial disc replacement.

An even brighter future
While Tromanhauser and Banco are excited that New England Baptist Hospital will continue to lead in new, cutting-edge surgical technologies with the anticipated approval of the SB Charité III, they continue to look to the future. Their colleague, Dr. Eric Woodard, is currently in the midst of a similar FDA study on the FlexiCore lumbar artificial disc. Woodard views the Flexi-Core as the next generation of artificial discs whose design represents an advancement in artificial disc technology.

As for Richard Longland, he has slipped effortlessly back into an active lifestyle. He recently began a weight lifting program at his gym and says he is reminded daily of the benefits he receives from his artificial disc "from things as simple as fixing the toilet to mountain biking three or four miles."