Artificial disc technology.

Abstract

After approximately 40 years of research and development, artificial disc technology may finally be coming of age. A number of devices are either at the late stage of preclinical study or in the early stage of clinical trial, and the results are promising so far. Due to the multicomponent structure of the disc, surgeons performing disc arthroplasty have the option of replacing either the entire disc or a portion of it. The decision will be largely dependent on the pathological entity addressed, the condition of the patient's spinal disc and surrounding tissues, and the cost and potential risk of the procedure. Driven by demand, almost all the emphasis in artificial disc development has been placed on the lumbar disc, with a smaller effort directed toward the cervical disc. No attempt has been made to develop an artificial thoracic disc. However, by examining the differences and similarities in structure, anatomy, function, mechanism of degeneration, pathology, surgical technique, and complications between the lumbar and thoracic disc, the authors believe it is feasible to apply artificial disc technology in the treatment of thoracic disc disease. Nonetheless, due to the rarity of thoracic disc disease and the more stable structure of this spinal component, the demand for artificial disc or artificial nucleus technology for the thoracic disc probably will be smaller than that for lumbar disc technology.