Patient Information Resources


Long Island Spine Specialists, P.C.
763 Larkfield Road
2nd Floor
Commack, NY 11725
Ph: (631) 462-2225
Fax: (631) 462-2240






Child Orthopedics
General
Pain Management
Spine - Cervical
Spine - General
Spine - Lumbar
Spine - Thoracic

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Six months after I got a lumbar disc replacement at L45, I started having serious back and buttock pain. I couldn't sleep. I couldn't walk. I couldn't stand for more than a few minutes. They had to take the new disc out. It was polished smooth where it wasn't supposed to be and pitted and dented where it was supposed to be smooth. What causes something like this to happen?

Lumbar artificial disc replacements (ADRs) have been used in Europe for 20 years now, but they are relatively new in the United States. Long-term studies aren't available yet, but a few reports of early failure such as you describe have been published.

From studies of the implants removed and from analyzing the nearby tissue, here's what we know so far. Tiny particles of material from the plastic part of the implant flake off. This is called wear debris.

The wear debris sets up an inflammatory response in the nearby tissue. Scar tissue forms and the implant starts to loosen. The plastic can deform or become smooth and polished. It depends on the forces applied to it.

For example, if the bone around the implant softens and dissolves, the implant sinks down. This sinking process is called subsidence. Now the ADR rubs against the ends of the vertebral bodies forming a flat area that looks polished.

If the ADR is not placed correctly, uneven wear can occur. Scratches in all directions have been seen in some implants that were removed. In a few cases, the plastic core of the implant has even fractured.

The exact causes for implant failure are unknown. As mentioned, poor positioning and wear debris can contribute to the problem. But some ADRs fail without these factors. More research is needed to get to the bottom of this problem and to find ways to keep it from happening.


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