Treatment with discussion prosthesis
Discussion Prosthodontics is a new treatment in Denmark. It not only relieves severe pain, but also guarantees a normalization of the movement of the spine. The treatment method was put into routine use around 2004, and the viewer so successful that it is estimated that discussion prosthesis will replace conventional methods of operation.
The current need for prosthetic surgery is estimated to be between 200 to 300 patients annually. The future needs are estimated at one third of the fusion surgery performed today. The fusion surgery performed ca.1.500 operations in Denmark a year - but it is expected that this figure will rise.
Short of reading
In severe osteoarthritis of the spinal column damaged cartilage disc between anterograde, moving forward gradually. In advanced cases, the cartilage disc is largely destroyed, resulting in great pain. Treatment with discussion prosthesis is to replace the cartilage disc with an artificial joints. It may consist of two metal parts moving or two metal parts with polyethylene between. The treatment means that in addition to pain relief, then assured the patient also a normalization of the movement of the spine.
Discussion Prosthodontics Treatment replaces the conventional operation method, which consists of the removal of the leather cartilage disc between the vertebrae and in the same action makes a stabilizing, stivgørende operation of the spinal column. This reduced pain intensity to a certain extent, but there is not the same movement as when treated with discus-prosthesis.
Background and development of reading
Artificial replacement disc in lower back and neck which has existed in some way. 20 years. Evidensen the use of prosthetics, discussion is under construction. Discussion Prosthodontics has been used in Europe at several centers in recent years, and there exist a number of reports on the methodology and results from consecutive patient series. Given that the method spread only began around 2004, is evidensen perfectly acceptable, and it can only be described as extremely positive that so many randomized studies are in
Several prosthesis designs have been used. The most commonly used design today is the prosthesis with metal-conductor with or without polyethylendel, quite equal prosthetic design used in knekirurgien.
In the market there are now four different types of prosthesis, which has widespread use. Charité prosthesis was the first that were commercially available, Prodisc is used by around 1990 and Maverick prosthesis from Medtronic is from about. 2000. Other types of prosthesis under development and will increasingly use.
There exists a large number of articles documenting biomechanical comparison, prosthesis design, rationale and a larger number of works that deal with consecutive patient series from each treatment. There are ongoing now, in addition, at least four randomized clinical trials in the U.S. and Europe:
Study 1: USA - examines Charité prosthesis to the anterior cage spondylodese. There are over 300 patients in the study and Interim results show very good "outcomes" of prosthesis patients. Complications not increased in proportion to the anterior fusion. Study results published in peer-reviewed magazine.
Study 2: United States - will examine Prodisc to circumferential fusion ie. front - rear operation. Interim results show better results for prostheses
Study 3: European study - the same status as studio 2
Study 4: Scandinavian studies - Multicentre study in Denmark and Sweden with the investigation of Medtronic prosthesis to bagre uinstrumenteret merger. Interim results are not available.
Overall, there are so soon solid evidence for the method of application. The first experience in Denmark, are very positive and indicate that the method will have great usefulness in the future. It is also very promising that we have compiled their early experiences with the method in Denmark and have ascertained that there are not significant or serious complications recorded by the interference in the first phase of deployment.