Little artificial disc is...(Houston)

[Harrison]

Dec. 8, 2004, 10:46PM

Little artificial disc is a big pain reliever
Technique used widely for the last decade in Europe
By PATRICK KURP
Chronicle Correspondent

All Ruthann Jacklin really wanted was to lift her 2-year-old daughter, Joanna, and give her a big hug.

It was a simple enough wish, but one denied Jacklin because of the nagging, sometimes crippling pain in her lower back. The agony had plagued her intermittently for several years, but starting last April it became a constant companion.

"One pain management doctor I went to see told me it was all in my head. There was no doubt in my mind the pain was in my back," said Jacklin, 29, a service representative for the U.S. Department of Veterans Affairs.

Finally, Dr. Vivek Kushwaha, an orthopedic surgeon at Memorial Hermann Hospital, diagnosed degenerative disc disease, a condition Jacklin shares with her mother and sister.

On Dec. 1, Jacklin received an innovative treatment using a new artificial spinal disc. For some patients, the artificial disc replaces the traditional fusion method.

"This patient presented with a challenging situation � almost bone on bone," Kushwaha said. "She was in a great deal of pain."

The artificial disc, which measures about a 1 1/2 inches in diameter and consists of a movable plastic core sandwiched between two metal endplates, was approved for use in October by the U.S. Food and Drug Administration. The device has been used in Europe for more than a decade.

The artificial disc is placed in the spine through a small incision just below the navel. The patient is placed under general anesthesia and the procedure lasts between one and two hours.

Previously, patients like Jacklin usually underwent spinal fusion surgery, in which the damaged disc is removed and the adjacent vertebrae are joined using bone grafts and metal screws or cages. The procedure, performed some 200,000 times each year in the United States, results in additional stress being placed on the adjacent discs and in a loss of motion in that portion of the spine.

Also, patients often must wear a brace for at least three months after surgery, and full recovery can take up to six months.

The artificial disc, which is not appropriate for all back pain patients (especially the elderly), preserves the natural motions of the spine. Jacklin will not need to wear a brace, and she expects to return to work in about six weeks.

"Now the pain is down to a low roar and I feel no shooting pains at all in my legs," Jacklin said two days after surgery. "There's some pain from the surgery itself, but that's about it."

INNOVATIVE TREATMENT
� To learn more: For information about the artificial disc procedure, call Memorial Hermann Hospital at 713-222-2273 (CARE).